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Processes driving nutrient retention in stormwater green infrastructure (SGI) are not well quantified in water-limited biomes. We examined the role of plant diversity and physiochemistry as drivers of microbial community physiology and soil N dynamics post precipitation pulses in a semi-arid region experiencing drought. We conducted our study in bioswales receiving experimental water additions and a montane meadow intercepting natural rainfall. Pulses of water generally elevated soil moisture and pH, stimulated ecoenzyme activity (EEA), and increased the concentration of organic matter, proteins, and N pools in both bioswale and meadow soils. Microbial community growth was static, and N assimilation into biomass was limited across pulse events. Unvegetated plots had greater soil moisture than vegetated plots at the bioswale site, yet we detected no clear effect of plant diversity on microbial C:N ratios, EEAs, organic matter content, and N pools. Differences in soil N concentrations in bioswales and the meadow were most directly correlated to changes in organic matter content mediated by ecoenzyme expression and the balance of C, N, and P resources available to microbial communities. Our results add to growing evidence that SGI ecological function is largely comparable to neighboring natural vegetated systems, particularly when soil media and water availability are similar. [ABSTRACT FROM AUTHOR]

Women in cardiology experience considerable gender disparities in publications, which hinders their career advancements to higher faculty and senior leadership positions. However, the extent of these disparities across different types of cardiovascular literature is not well understood. We investigated gender differences in authorship across various cardiovascular publications over a decade and examined geographic variations in the representation of women authors. All papers published from January 1, 2010, to December 31, 2019, in 4 major cardiovascular journals (Journal of the American College of Cardiology , European Heart Journal , Journal of the American Medical Association Cardiology , and Nature Reviews Cardiology) were reviewed. Of the 18,535 papers with 111,562 authors, 20.6% of the authors were women, and 47.7% of the papers had no women authors. Over 10 years, the proportion of women authors remained low (20.7% in 2010 to 21.4% in 2019), with the lowest proportion in editorial papers (14.8%) and the highest in research papers (21.8%). More women as first (34.6%) and last (47.6%) authors were affiliated with institutions in the United States compared with other countries. The proportion of women middle-order authors was higher on papers with women as first authors (29.4% vs 20.5%) or last authors (30.6% vs 21.3%), compared with papers with men as first or last authors, respectively. Over the past decade, the proportion of women authors across all article types in major cardiovascular journals remained low. A call to action is needed to promote women in cardiology and provide them with equitable opportunities. [Display omitted] [ABSTRACT FROM AUTHOR]

Summary: SMARCA4 is a gene traditionally considered a tumor suppressor. Recent research has however found that SMARCA4 likely promotes cancer growth and is a good target for cancer treatment. The drug carbamazepine, an autophagy inducer, was used on colorectal cancer cell lines, HCT1116 and Hke3 (KRAS mutant and wildtype). Our study finds that Carbamazepine affects SMARCA4 levels and that this effect is different depending on the KRAS mutation status. This study analyzes the effect of carbamazepine on early-stage autophagy via ULK1 as well as simulates the docking of carbamazepine on KRAS, depending on the mutation status. Our study highlights the therapeutic uses of carbamazepine on cancer, and we propose that carbamazepine in conjunction with other chemotherapies may prove useful in targeting KRAS-mutated colorectal cancer. [ABSTRACT FROM AUTHOR]

There is debate over whether Asian American students face additional barriers, relative to white students, when applying to selective colleges. Here we present the results from analyzing 685,709 applications submitted over five application cycles to 11 highly selective colleges (the "Ivy-11"). We estimate that Asian American applicants had 28% lower odds of ultimately attending an Ivy-11 school than white applicants with similar academic and extracurricular qualifications. The gap was particularly pronounced for students of South Asian descent (49% lower odds). Given the high yield rates and competitive financial aid policies of the schools we consider, the disparity in attendance rates is likely driven, at least in part, by admissions decisions. In particular, we offer evidence that this pattern stems from two factors. First, many selective colleges give preference to the children of alumni in admissions. We find that white applicants were substantially more likely to have such legacy status than Asian applicants. Second, we identify geographic disparities potentially reflective of admissions policies that disadvantage students from certain regions of the United States. We hope these results inform discussions on equity in higher education. [ABSTRACT FROM AUTHOR]

Objective: This article considers the influence of female legislators on gun legislation across U.S. states. Females have behavioral differences with males and likely different exposure to gun‐related violence. Method: Using data from 1991 to 2020, we estimate the drivers of gun legislation across U.S. states. The dependent variables are alternately the total number of gun laws enacted and 5‐year differences in gun laws. Results: We find that female legislators in state houses significantly increase the supply of gun laws. Female senators, on the other hand, were no different from their male counterparts. In other results, states with greater population density had more gun laws, while economic prosperity, race, and the elderly population did not generally have significant effects. Finally, when special interest aspects, involving gun ownership, mass shooting episodes, and states with single‐party control of the legislative and executive branches are considered, mass shootings and single‐party control increase laws, while gun owners have the opposite effect. These findings show significance when 5‐year differences in gun laws are used. Conclusions: Our findings suggest that when it comes to gun legislation and female legislator representation, it matters which chamber of the legislature females are elected to. Furthermore, different interest groups can significantly bear upon gun legislation. [ABSTRACT FROM AUTHOR]

Background and aim: Emerging literature suggests the role of social media in substance use disorders (SUD). This study aimed to explore the content of YouTube videos for persons on SUD treatment/recovery, describing the users' exposure and engagement metrics and understanding viewers' perspectives. Methods: We generated a set of 10 key phrases to search on YouTube. Eighty eligible videos were analyzed using a mixed-methods approach. Content analysis of all videos and thematic analysis of 30 videos were done using the three most viewed videos from each key phrase. The reliability of videos was assessed using a modified DISCERN. The total number of views, likes, dislikes, and comments were noted and created engagement metrics. The linguistic analysis of viewers' comments was done to assess their perspectives. Results: Sixty-three (78.8%) videos were from the US, and 59 (73.8%) were intended for persons or families with substance misuse. Persons in recovery uploaded 23 (28.7%) videos. We identified five themes – reasons for using drugs, symptoms of addiction, consequences of drug use, how to stop drug use, and expressed tone in the language. The positivity and relative positivity ratios were highest for videos developed by persons in recovery. There was a negative correlation between the relative positivity ratio and content fostering internalized stigma. Words with negative emotional experiences dominated the viewers' comments. Conclusion: YouTube content on SUD treatment and recovery is popular and revolves around the biopsychosocial understanding of addiction. There is an urgent need for a language policy and regulation of non-scientific content. [ABSTRACT FROM AUTHOR]

Background: Intrauterine transfusion (IUT) is an invasive but critical and potentially life‐saving intervention for severe fetal anemia with demonstrated improvement in outcomes. The fetus is vulnerable to hemodynamic alterations and transfusion‐related adverse events; therefore, special consideration must be given to blood component selection and modification. There is widespread IUT practice variability, and existing guidance primarily relies on expert opinion and single center experiences. Study Design and Methods: Experts in Maternal Fetal Medicine, Pediatric Hematology, and Transfusion Medicine from centers across the United States, collectively performing about 120 IUT annually, offer a multidisciplinary perspective on the performance of IUT and preparation of blood components. This perspective includes strategies for identifying an at‐risk fetus, communicating between disciplines, determining the necessary blood volume, selecting and processing blood components, documenting the procedure in medical record, and managing the neonate. Results: Identifying an at‐risk fetus relies on review of the clinical history, non‐invasive monitoring, and laboratory evaluation. We recommend the use of relatively fresh, group O, cytomegalovirus‐safe, freshly irradiated, red blood cells (RBC) that are Hemoglobin S negative and antigen‐negative for any maternal antibody, if indicated. These RBC units should be concentrated to remove additives and increase the hematocrit thus minimizing fluctuations in fetal volume status. The units intended for IUT should be labeled clearly and the documentation of transfusion differentiated in the maternal medical record. Discussion: An awareness of the technical, logistical, and regulatory considerations for IUT performance will facilitate improved communication and patient care, especially when rare units of RBC are required. [ABSTRACT FROM AUTHOR]

Introduction: A scientometric analysis was conducted to characterize the global research publications in extrahepatic portal venous obstruction (EHPVO), and state-of-the-art visualization graphics were generated to provide insight into specific bibliometric variables. Materials and Methods: The Web of Science database was accessed for research productivity and bibliometric variables of countries, institutions, authors, journals, and content analysis of top-20 cited documents were performed. Collaborative networks and co-occurrence of keywords map were generated using VOSviewer software. Results: Two hundred and sixteen records were retrieved with an annual growth rate of 2.53%. India is the leading country in productivity (n = 4339), followed by the USA and China. Post Graduate Institute of Medical Education and Research, Chandigarh, was the top productive institute. Sarin SK was the most prolific author, having the highest citations received and h-index. The hotspot topics were "portal hypertension," "cirrhosis," "children," "biliopathy/cholangiopathy," "liver fibrosis," and "liver transplantation" as per keyword co-occurrence networking. J Gastroenterol Hepatol had the most publications of EHPVO research as well the h-index. Regarding collaborative network mapping, the USA and Primignani M were the significant nodes among country and author, respectively. Conclusion: EHPVO research publication volume is low but is gradually progressing with dominant contributions from Indian institutes and authors. Most highly cited articles are of low level of evidence, and multi-institutional collaborative research can be the way forward. [ABSTRACT FROM AUTHOR]

This paper investigates the effect of patenting uncertainty on innovations. Although the patent system was established to provide incentives and certainty of returns to innovators, the patenting process itself contains elements of uncertainty, including pendency and variation in grant ratios. We use time series data on patent applications and patent grants from the United States and measure patent uncertainty in terms of variation in the grant ratio, i.e., the difference in the number of patent applications and the number of patent grants. Findings show that greater patent uncertainty has a depressing effect on innovation rates. Moreover, our findings reveal important differences between the short-run and long-run effects and between overall patents and utility patents. We also consider the effects of the America Invents Act and find that the Act led to more patent applications. Besides adding to the literature, these findings underscore the point that transaction costs of patenting might be undermining the intent of innovation policy by reducing innovation. [ABSTRACT FROM AUTHOR]

Background Only 74% of infectious diseases (ID) training positions were filled in the 2022 fellowship match, indicating a need to find increasingly novel and creative solutions for ID recruitment and outreach. Methods The websites of 2321 universities and 181 medical schools across the United States were manually searched for the presence of undergraduate clubs and interest groups, respectively, for multiple medical specialties and subspecialties, including ID. Geographic data were used to compare the proximity of ID fellowships to undergraduate institutions. Results ID student groups were extremely rare among the categories studied throughout undergraduate institutions (6 out of 2048, or 0.29%). Only 58 of 163 (35.6%) medical schools nationwide included an ID student group. Geographic comparison found that every adult ID fellowship is in the same county and/or city as at least 1 undergraduate institution and 28.5% of adult ID fellowships are in the same zip code as at least 1 undergraduate institution. Conclusions The relative paucity of ID student interest groups presents an opportunity for the ID community to begin outreach and recruitment at the undergraduate and medical student levels, specifically through student groups. [ABSTRACT FROM AUTHOR]

In her book, "Neoliberalism as Exception," Aihwa Ong usefully observes that the North American university has been dirempted from it historical role of preparing young people for democratic citizenship. It has instead, according to Ong, become the great global marketplace and grand bazaar for international students' ambitions. In what follows, we draw on Ong's insights. Specifically, we report on a global ethnographic study that looks at the way in which six form students (whom we are calling the "Argonauts") in two Barbadian elite schools--Old Cloisters and Ardent Arbors--are orienting themselves to the future in a moment of aggressive recruiting by North American universities. These developments bring students' global imaginations into profound tension with historical narratives and traditions linking these schools to England. This new context is epitomised by the transactions between the students and international college representatives at an annual international college fair that brings North American recruiters to the island in search of academic talent. We document this encounter at some length, pointing to the collision between the students' roiling ambitions and the schools' deep sense of heritage and tradition linked to the metropolitan paradigm of British public school traditions.

Coronavirus disease 2019 (COVID-19) convalescent plasma (CCP) use between October and December 2020 was characterized using the National Inpatient Sample database. CCP was administered in 18.0% of COVID-19-associated hospitalizations and was strongly associated with older age and increased disease severity. There were disparities in the receipt of CCP by race and ethnicity, geography, and insurance. [ABSTRACT FROM AUTHOR]

Objective: The Student Bodies-Eating Disorders intervention (SB-ED), a digital cognitive behavior therapy-guided self-help intervention for college women with an eating disorder, is effective for reducing eating disorder psychopathology. The purpose of this study was to evaluate moderators and mediators of the SB-ED intervention. To our knowledge, this is the first evaluation of clinical mediators of a digital intervention for women with eating disorders. Method: This is an exploratory secondary analysis of a cluster randomized trial comparing the SB-ED intervention to referral to usual care among 690 women at 27 United States colleges. Moderators included body mass index (BMI), race, ethnicity, weight/shape concerns, eating disorder impairment, thin ideal internalization, depression, anxiety, and motivation for treatment, assessed at baseline. Thin ideal internalization and depressive symptoms were tested as predictors at postintervention and mediators at 2-year follow-up. Outcome was change in global eating disorder psychopathology. Results: BMI moderated the effect of the intervention at follow-up (but not posttreatment), with individuals with a lower BMI experiencing more continued improvements in eating disorder psychopathology following the intervention than individuals with a higher BMI. Thin ideal internalization mediated the effect of the intervention at follow-up, and depression partially mediated the effect of the intervention at follow-up. Conclusions: Results of the mediator analyses suggest that helping college women reduce inflated internalization of the thin ideal and improve depressive symptoms leads to improvements in eating disorder psychopathology. Results also suggest opportunities to optimize the intervention so individuals across the BMI spectrum experience ongoing improvements over time. What is the public health significance of this article?: The digital guided self-help Student Bodies-Eating Disorders intervention reduces women's thin ideal internalization and depressive symptoms, which in turn leads to improvements in eating disorder psychopathology. Women with higher body mass index (BMIs) experienced less continued improvement following the intervention, indicating future directions for intervention optimization. [ABSTRACT FROM AUTHOR]

Detecting anomalous behavior on smartphones is challenging since malware evolution. Other methodologies detect malicious behavior by analyzing static features of the application code or dynamic data samples obtained from hardware or software. Static analysis is prone to code's obfuscation while dynamic needs that malicious activities to cease to be dormant in the shortest possible time while data samples are collected. Triggering and capturing malicious behavior in data samples in dynamic analysis is challenging since we need to generate an efficient combination of user's inputs to trigger these malicious activities. We propose a general model which uses a data collector and analyzer to unveil malicious behavior by analyzing the device's power consumption since this summarizes the changes in software. The data collector uses an automated tool to generate user inputs. The data analyzer uses changepoint analysis to extract features from power consumption and machine learning techniques to train these features. The data analyzer stage contains two methodologies that extract features using parametric and non-parametric changepoint. Our methodologies are efficient in data collection time than a manual method and the data analyzer provides higher accuracy compared to other techniques, reaching over 94% F1-measure for emulated and real malware. [ABSTRACT FROM AUTHOR]

Using recent data on the unvaccinated population across US states, this paper focuses on the determinants of vaccine hesitancy related to the COVID‐19 pandemic. Findings show that more prosperous states and states with more elderly residents and more physicians have lower vaccine hesitancy. There was some evidence of the significance of race, but internet access and history of other contagious diseases failed to make a difference. States with centralized health systems and those with mask mandates generally had a lower percentage of unvaccinated populations. Finally, the presence of Democrats in state legislatures tended to lower vaccination hesitancies, ceteris paribus. [ABSTRACT FROM AUTHOR]

PURPOSE Integrating social care into clinical care requires substantial resources. Use of existing data through a geographic information system (GIS) has the potential to support efficient and effective integration of social care into clinical settings. We conducted a scoping literature review characterizing its use in primary care settings to identify and address social risk factors. METHODS In December 2018, we searched 2 databases and extracted structured data for eligible articles that (1) described the use of GIS in clinical settings to identify and/or intervene on social risks, (2) were published between December 2013 and December 2018, and (3) were based in the United States. Additional studies were identified by examining references. RESULTS Of the 5,574 articles included for review, 18 met study eligibility criteria: 14 (78%) were descriptive studies, 3 (17%) tested an intervention, and 1 (6%) was a theoretical report. All studies used GIS to identify social risks (increase awareness); 3 studies (17%) described interventions to address social risks, primarily by identifying relevant community resources and aligning clinical services to patients' needs. CONCLUSIONS Most studies describe associations between GIS and population health outcomes; however, there is a paucity of literature regarding GIS use to identify and address social risk factors in clinical settings. GIS technology may assist health systems seeking to address population health outcomes through alignment and advocacy; its current application in clinical care delivery is infrequent and largely limited to referring patients to local community resources. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic severely tested the resilience of the US blood supply with wild fluctuations in blood donation and utilisation rates as community donation opportunities ebbed and hospitals post‐poned elective surgery. Key stakeholders in transfusion services, blood centres, supply chains and manufacturers reviewed their experiences during the SARS‐CoV‐2 pandemic as well as available literature to describe successes, opportunities for improvement and lessons learned. The blood community found itself in uncharted territory responding to restriction of its access to donors (approximately 20% decrease) and some supplies; environmental adjustments to address staff and donor concerns about coronavirus transmission; and the development of a new product (COVID‐19 convalescent plasma [CCP]). In assuring that the needs of the patients were paramount, the donation process was safe, that clinicians had access to CCP, and vendor relationships aligned, the blood banking community relearned its primary focus: improving patient outcomes. [ABSTRACT FROM AUTHOR]

This paper integrates a unique dimension of gender in the analysis of economic vulnerability in urban contexts by focusing on women aged 50 and older. We use a probit model to predict the likelihood of vulnerability with a zero-one dummy dependent variable, and four categories of socioeconomic characteristics as predictors: educational attainment, labour market participation, individual demographics, and household characteristics. Using a pooled cross-section of data from the American Community Survey (2013–2017 5-Year estimates), we explore the transmission channel of vulnerability across the four largest cities in the US. The results show, through average marginal effects, a strong association between economic vulnerability and key socioeconomic indicators. The findings support the view that gender differences in labour market participation remain key in explaining disparities. Our two policy prescriptions focus on a more targeted approach in implementing retirement policy changes and loosening the link between labour supply and income. [ABSTRACT FROM AUTHOR]

Background: A paucity of data exists about the current practice of fetal red blood cell (RBC) transfusion in the United States (US). This investigation describes intrauterine transfusion (IUT) RBC product selection and processing practices at different US institutions. Methods: A transfusion medicine and maternal‐fetal medicine (MFM) team designed a survey to interrogate and characterize RBCs utilized for IUT. This survey was distributed to seventy US institutions with fetal treatment centers (October 2020–April 2021) identified through the NAFTNet (North American Fetal Therapy Network). Results: Thirty‐seven institutions responded (response rate 53%, 37/70), but five were excluded for not performing IUTs. Most (84%; 27/32) performed 1–24 IUTs annually; two performed >50 IUTs/year. Group O, Rh(D) negative RBC units were always used by 66% (21/32), and 75% (24/32) provided hemoconcentrated RBCs by washing (17/24) or dry packing (6/24). Overall, 66% (21/32) targeted a hematocrit ≥75%. Fifty percent provided both leukocyte‐reduced and CMV‐negative RBC units. Irradiation of RBC units was performed within 6 h of issue at 63% (20/32) of sites. Most (81%, 26/32) used RBC units at <7 days of age after collection, 56% (18/32) always provided washed RBC units, while 19% (6/32) issued washed RBC only if fresh units are unavailable. Implicated maternal RBC alloantibodies were matched for 78% (25/32) of the time. The transfused volume was universally determined by the MFMs. Discussion: Heterogeneity and lack of standardization exist in RBC product selection and special processing steps for IUTs in the US. Hence, the establishment of a consensus to standardize IUT protocols is needed. [ABSTRACT FROM AUTHOR]

Background: The number of times a research work gets cited by another article is one of the article-level metrics for assessing the quality of a research publication. Citation analysis by bibliometric review has been performed in several disciplines. The current study was aimed to systematically review the literature available on pediatric inguinal hernia since 1960 in terms of the 25 most cited articles in this field and analyze the bibliometric variables author and organizational collaborative patterns. Methods: Thomson Reuters Web of Science citation indexing database and research platform were used to retrieve the most cited articles in pediatric inguinal hernia (PIH) using appropriate search strings. The characteristics (name of authors, the total number of authors, the title of publication, journal of publication, year of publication, etc.) of the 25 top-cited articles were recorded. Specific bibliographical parameters were derived and analyzed. Visualization maps were generated using VOSviewer software. Results: The analysis revealed that the Journal of Pediatric Surgery was leading the choice of journal for publication. While most of the publications originated from the United States of America, Schier was the most influential author. Five of the eight top-productive authors are also the most connected. Conclusion: Articles on laparoscopic repair in PIH have been heavily cited. Following the United States of America, Turkey stands out as the topmost productive country in PIH. The publications on PIH show that "collaboration" is the bridging force between productivity and influence on the academic community. [ABSTRACT FROM AUTHOR]

Per the American Society for Apheresis, therapeutic plasma exchange (TPE) is a Category III indication in the management of immune thrombocytopenia (ITP). This nationally representative study evaluates TPE utilization in hospitalized adults with a primary admission diagnosis of ITP. Hospitalizations with ITP as the primary admitting diagnosis were analyzed from the 2010 to 2014 National Inpatient Sample, the largest all‐payer inpatient database in the United States. Univariate and multivariable logistic regressions were used to determine clinical outcomes in ITP patients undergoing TPE. Sampling weights were applied to generate nationally representative estimates. From 2010 to 2014, there were a total of 56,149 admissions with a primary admitting diagnosis of ITP, of which 0.66% admissions (n = 372) also coded TPE. Most subjects undergoing TPE were the highest disease severity class: major (34.6%) and extreme severity (31.0%), by all‐patients refined diagnoses‐related groups severity of illness subclass. After multivariable analysis, underlying severity of illness remained the most significant predictor of TPE (P <.001). ITP admissions with TPE had a high rate of comorbidities (50%) and significantly longer mean length of hospital stay than those without (P <.001). TPE was reported in ~0.6% of hospitalizations with ITP as the primary diagnosis in this nationally representative sample from 2010 to 2014. TPE was performed in patients with the highest severity of underlying illness, and higher rates of comorbidities. [ABSTRACT FROM AUTHOR]

Aim: A study was conducted to explore the characteristics of the videos on pediatric inguinal hernia repair on YouTube and compare the most popular videos (MPV) with the least popular ones in terms of educative value vis-a-vis their popularity. Materials and Methods: The term "Pediatric inguinal hernia repair" was searched for on YouTube on August 15, 2021, with the filter set to "view rate." Pertinent data were collected from the 50 MPV and the 50 least popular videos (LPV) and then compared. The h-index and affiliation of the surgeon were obtained from the Scopus database, and their affiliation was further categorized as academic or nonacademic. Results: One hundred and seventy-five videos were found with median views of MPV: LPV being 9270 (interquartile range [IQR] – 12099):127 (IQR – 194), respectively (P < 0.0001). Most of the videos in the MPV and LPV groups were uploaded from the United States of America (USA) (MPV – 17 and LPV – 13) and India (MPV – 15 and LPV – 15). The MPV were on YouTube for a median duration of 3.1 (IQR – 5.5) years as compared to 1.2 (IQR – 2.3) years for the LPV (P < 0.0001). Ninety-two surgeons were identified. The median h-index of the surgeons of MPV was 3 (IQR – 12) in comparison to 1 (IQR – 10) of LPV (P = 0.13). The ratio of academic versus nonacademic affiliation among MPV and LPV was almost equal in both the groups. Conclusions: On either end of the spectrum of popularity, the majority of the pediatric inguinal hernia videos on YouTube were surgical videos uploaded from the USA and India. The educative value of these videos was found to be low and widely dispersed. Surgeons from both academic and nonacademic affiliations had contributed similarly. [ABSTRACT FROM AUTHOR]

Introduction: Current in‐hospital burden and healthcare utilization patterns for persons with haemophilia (PWH) A and B, including both children (ages < 18 years) and adults (ages ≥ 18 years), in the United States (US) are lacking. Aim: To evaluate healthcare utilization, the prevalence of comorbidities, and mortality in hospitalized paediatric and adult PWH using a contemporary nationally representative cohort. Methods: Hospitalizations of PWH either as the primary reason for admission (principal diagnosis) or one of all listed diagnoses were identified using ICD‐10 codes from the 2017 Nationwide Inpatient Sample (NIS), the largest publicly available all‐payer inpatient discharge database in the US. Sampling weights were applied to generate nationally representative estimates. Results: The contemporary cohort included 10,555 hospitalizations (paediatrics, 18.3%; adults, 81.7%) among PWH as one‐of‐all listed diagnoses (n = 1465 as principal diagnosis). Median age (interquartile range) was 46 (24–66) years overall; adults, 54 (35–70) years and paediatric, 4 (1–11). The most common comorbidities in adults were hypertension (33.4%), hyperlipidaemia (23.6%), and diabetes (21.1%). In children, hemarthrosis (11.4%), contusions (9.6%), and central line infections (9.3%) were the most common. The overall mortality rate was 2.3%. Median hospital charges per haemophilia admission were $52,616 ($24,303–$135,814) compared to $26,841 ($12,969–$54,568) for all‐cause admissions in NIS. Conclusion: Bleeding and catheter‐related infections are the significant reasons for paediatric haemophilia admissions. Adult haemophilia admissions tend to be associated with age‐related comorbidities. Costs for haemophilia‐related hospitalizations are higher than the national average for all‐cause hospitalizations. [ABSTRACT FROM AUTHOR]

In studies of discrimination, researchers often seek to estimate a causal effect of race or gender on outcomes. For example, in the criminal justice context, one might ask whether arrested individuals would have been subsequently charged or convicted had they been a different race. It has long been known that such counterfactual questions face measurement challenges related to omitted-variable bias, and conceptual challenges related to the definition of causal estimands for largely immutable characteristics. Another concern, which has been the subject of recent debates, is post-treatment bias: many studies of discrimination condition on apparently intermediate outcomes, like being arrested, that themselves may be the product of discrimination, potentially corrupting statistical estimates. There is, however, reason to be optimistic. By carefully defining the estimand—and by considering the precise timing of events—we show that a primary causal quantity of interest in discrimination studies can be estimated under an ignorability condition that may hold approximately in some observational settings. We illustrate these ideas by analyzing both simulated data and the charging decisions of a prosecutor's office in a large county in the United States. [ABSTRACT FROM AUTHOR]

Background: The United States (US) Expanded Access Program (EAP) to coronavirus disease 2019 (COVID-19) convalescent plasma was initiated in response to the rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19. While randomized clinical trials were in various stages of development and enrollment, there was an urgent need for widespread access to potential therapeutic agents. The objective of this study is to report on the demographic, geographical, and chronological characteristics of patients in the EAP, and key safety metrics following transfusion of COVID-19 convalescent plasma.Methods and Findings: Mayo Clinic served as the central institutional review board for all participating facilities, and any US physician could participate as a local physician-principal investigator. Eligible patients were hospitalized, were aged 18 years or older, and had-or were at risk of progression to-severe or life-threatening COVID-19; eligible patients were enrolled through the EAP central website. Blood collection facilities rapidly implemented programs to collect convalescent plasma for hospitalized patients with COVID-19. Demographic and clinical characteristics of all enrolled patients in the EAP were summarized. Temporal patterns in access to COVID-19 convalescent plasma were investigated by comparing daily and weekly changes in EAP enrollment in response to changes in infection rate at the state level. Geographical analyses on access to convalescent plasma included assessing EAP enrollment in all national hospital referral regions, as well as assessing enrollment in metropolitan areas and less populated areas that did not have access to COVID-19 clinical trials. From April 3 to August 23, 2020, 105,717 hospitalized patients with severe or life-threatening COVID-19 were enrolled in the EAP. The majority of patients were 60 years of age or older (57.8%), were male (58.4%), and had overweight or obesity (83.8%). There was substantial inclusion of minorities and underserved populations: 46.4% of patients were of a race other than white, and 37.2% of patients were of Hispanic ethnicity. Chronologically and geographically, increases in the number of both enrollments and transfusions in the EAP closely followed confirmed infections across all 50 states. Nearly all national hospital referral regions enrolled and transfused patients in the EAP, including both in metropolitan and in less populated areas. The incidence of serious adverse events was objectively low (<1%), and the overall crude 30-day mortality rate was 25.2% (95% CI, 25.0% to 25.5%). This registry study was limited by the observational and pragmatic study design that did not include a control or comparator group; thus, the data should not be used to infer definitive treatment effects.Conclusions: These results suggest that the EAP provided widespread access to COVID-19 convalescent plasma in all 50 states, including for underserved racial and ethnic minority populations. The study design of the EAP may serve as a model for future efforts when broad access to a treatment is needed in response to an emerging infectious disease.Trial Registration: ClinicalTrials.gov NCT#: NCT04338360. [ABSTRACT FROM AUTHOR]

This study used focus group methodology to examine South Asian (SA) American women's conceptualizations of eating disorders (EDs) and body dissatisfaction, and their perspectives regarding cultural influences on these conditions. Using a qualitative descriptive approach, seven focus groups were conducted (N = 54, mean age = 20.11 years, SD = 2.52). Themes (n = 15) were organized according to the amended objectification theory framework. Women described experiences of cultural stressors specifically related to living in the United States, and weight stigma from multiple sources, especially older women (e.g., mothers, relatives, and aunties). Participants also experienced pressures to achieve competing body and appearance ideals ("thin" and "healthy"). In addition, they reported pressures to possess light skin, dark black hair, minimal body hair, and marry young, and noted these pressures negatively impacted their body esteem. Findings indicate that a combination of "traditional" and culturally-influenced factors are important to consider when conceptualizing eating pathology and body image in young SA American women. [ABSTRACT FROM AUTHOR]

This paper examines the impact of internet information on COVID-19 vaccination rates across U.S. states. Does greater information on the internet about COVID-19 vaccine access increase the number of vaccines administered? Does greater information about COVID-19 vaccine reliability facilitate vaccine administration? To gauge the COVID-19 related information on the world-wide-web we created two cross-state datasets using Google search. One search dealt with searching for information on vaccination availability and scheduling in each state, while the other search involved information on vaccine reliability and its side effects. The estimation results showed that greater availability of the relevant information on the internet increased vaccine administration rates, and this was true for both types of internet searches, resulting in an affirmative answer to the questions above. In contrast, the diffusion of internet access and the digital divide across states did not have a significant impact on vaccination rates. Whereas supply chain issues have garnered most of the attention in terms of the limitations of quickly vaccinating the public, our results show that internet information might be acting as a (largely unheralded) enabler. [ABSTRACT FROM AUTHOR]

Background: The United States (US) leads all high-income countries in gunshot wound (GSW) deaths. However, previous US studies have not evaluated the national blood transfusion utilization patterns in hospitalized GSW patients.Methods: Data from 2016 to 2017 were analyzed from the Nationwide Emergency Department Sample (NEDS) and Nationwide Inpatient Sample (NIS), the largest all-payer emergency department (ED) and inpatient databases, respectively. Using stratified probability sampling, weights were applied to generate nationally representative estimates. Multivariable Poisson-regression models were used to estimate prevalence ratios (PR) of blood transfusion.Results: There were 168,315 ED visits and 58,815 hospitalizations (age = 18-90 years) following a GSW. The majority of hospitalizations were men (88.5%), age 18-24 years (31.8%), and assault-related GSW (51.3%). Blacks had the largest proportion (48.7%) overall of all GSW hospitalizations; Whites accounted for the highest proportion of intentional self-harm injuries (72.4%). Blood transfusions occurred in 12.7% of hospitalizations (12.0% red blood cell [RBC], 4.9% plasma, and 2.5% platelet transfusions). Only 1.9% of cases were associated with transfusion of all three blood components. Hospitalizations with major/extreme severity of illness had significantly higher prevalence of transfusion versus those with mild/moderate severity [crude PR = 4.79 (95%CI:4.15-5.33, p < .001)]. Overall, 8.2% of hospitalizations with GSW died, of whom 26.8% required blood transfusions, which was significantly higher than survivors [crude PR = 2.34 (95%CI:2.10-2.61, p < .001)]. The vast majority (95%) of the transfusions among those who died were within 48 h since admission.Conclusions: Gun-related violence is a public health emergency in the US, and GSWs are a source of significant mortality, blood utilization, and health care costs. [ABSTRACT FROM AUTHOR]

This article uniquely examines the drivers of government impersonation across US states. Government impersonation is a relatively new white-collar crime that is slowly being recognized by policy makers and largely ignored by researchers. Results show that it is the decentralized government structure, rather than government size, that significantly affects government impersonation. Greater diffusion of the Internet and economic freedom also contribute to impersonation fraud, while urbanization has a mitigating effect. The share of elderly residents, democratic governorships, or the distance of a state from the nation's capital did not appreciably impact government impersonation but impacted overall fraud. Interestingly, greater enforcement employment results in more fraud coming to light. Some of the factors impacting government impersonation fraud differ from those affecting overall fraud. Therefore, blanket policies to combat overall fraud would not necessarily be effective in checking government impersonation. [ABSTRACT FROM AUTHOR]

Objective To analyze industry payments to pain medicine physicians in the United States. Design Retrospective cohort study using publicly available databases. Subjects The study includes U.S. pain medicine physicians (PMPs) with reports in the Open Payments program from 2013 to 2018. Methods The Centers for Medicare and Medicaid Services Open Payments program was analyzed for general, investment, and ownership payments to PMPs reported from 2013 to 2018. The nature, type, and geographic variation of payments were analyzed. Results The main findings of the study are as follows: 1) Payments made to PMPs constituted a small proportion of the payments made to all physicians in the United States, and the number of transactions and the total dollar amount seem to have decreased from 2016 to 2018. 2) The median number of payments among physicians with reported payments was around 4 (interquartile range: 18), and the majority of them were under $20. 3) The majority of payments were for in-kind items and services (85%) and were made for food and beverages (91%), travel and lodging (5.5%). 4) Some of the ownership and investment interest payments exceeded $500,000. 5) The top five drugs associated with physician payments included medications with opioids. 6) A very small minority of payments were made for entertainment or gifts. 7) A third of PMPs with reports had payments reported under more than one taxonomy. Conclusions Overall payments made to PMPs seem to be decreasing since 2016. The majority of the payments are made for the food, beverage, and travel categories. Public and physician awareness of the Open Payments system reports is essential to promote transparency and to minimize adverse effects of financial relationships on patient care. [ABSTRACT FROM AUTHOR]

This paper adds some formal research to the success of ongoing efforts to combat the COVID-19 pandemic by examining the drivers of the administration and delivery efficiency of coronavirus vaccines. For this purpose, we use data from the 50 US states and place the formal analysis in the context of socio-economic drivers of vaccinations. Results show that state-economic prosperity and rural population aid vaccine administration and delivery efficiency. Delivery efficiency improves in states with more nursing homes per capita, in states with more COVID-19 deaths, and with more health workers. A subset of health workers, including physicians and nurses, did not significantly impact administration or efficiency. On the other hand, vaccination efficiency was lower in states with a centralized public health agency. States with a larger share of the elderly population and those with Democrats as governors were no different from others with regard to vaccinations. Robustness checks are performed using vaccination data from a more recent period. Finally, a state's legacy of corrupt activity, across two different time dimensions, is broadly consistent with the greasing effects of corruption. Some policy implications based on the evolving data are discussed. [ABSTRACT FROM AUTHOR]

Prostate Cancer is a significant health concern in the United States, with an estimated 288,300 new cases diagnosed annually. The design and effectiveness of clinical trials for prostate cancer treatments are influenced by the disease's substantial geographic and demographic variabilities. While clinical trials aim to address and improve prostate cancer symptoms, the degree to which these trials accurately represent the diverse population of prostate cancer patients remains ambiguous. Consequently, our study aims to investigate the influence of geographic and racial disparities within prostate cancer clinical trials and how these disparities might affect patient care in the United States. A search of clinicaltrials.gov yielded 3222 clinical trials on prostate cancer. From these, only 811 completed or terminated trials were selected for demographic analysis, with demographic information manually extracted from each study. Using publicly accessible data from the;National Cancer Institute (NCI), we mapped the density of prostate cancer cases per racial/ethnic group using county, catchment, and census county GEOID/FIPS. A multi-step approach to anchoring trial outcomes was adopted. This involved geographic analysis using county/catchment data integrated with demographic trial data to circumvent rigid location anchoring. A Local Indicators of Spatial Association (LISA) analysis was conducted to;classify each county into one of five categories with respect to prostate cancer incidence rates. These were defined as "hotspots" and "coldspots", indicative of significantly high and low incidence rates, respectively, that exceed spatial randomness, and others denoting mixed incidences. Our assessment of prostate cancer clinical trial distribution across the counties revealed noteworthy patterns. Counties marked as high-incidence hotspots for Asian, Hispanic, and African American populations tended to host the majority of clinical trials. Interestingly, In counties notable for having high rates of prostate cancer among African Americans, there was a non-significant spatial association in clinical trials conducted. This pattern can be attributed to the fact that minority populations are often concentrated in large urban areas, where most trials and academic/research institutions are located. Contrastingly, trials were less frequently conducted in counties marked as high-incidence hotspots for Caucasian and Native American populations. One plausible explanation for this disparity is that these high-incidence hotspots are in rural areas with limited healthcare access. Consequently, the urban Caucasian population, with better access to healthcare and screening services, displays lower incidence rates than their rural counterparts. The disparities in trial distribution emphasize the need for inclusive recruitment strategies targeting rural, African American, and Native American;communities. The overrepresentation of urban minorities in these trials and the underrepresentation of Caucasians and Native Americans in high-incidence areas are pressing concerns. Future research should focus on developing targeted strategies to address these disparities, thereby enhancing the inclusivity and effectiveness of prostate cancer clinical trials.;These disparities can skew trial outcomes and limit the generalizability of the results. Given that clinical trials serve as the bedrock for advancements in treatment strategies for prostatic cancers, concerted efforts must be made to include underrepresented populations through increasing awareness, removing barriers to participation, and developing trial protocols with inclusivity in mind. [ABSTRACT FROM AUTHOR]

Background: We hypothesized that variability in practice exists for newborn immunohematology testing due to lack of consensus guidelines. We report the results of a survey assessing that variability at hospitals in the United States and Canada.Study Design and Methods: An AABB Pediatric Subsection working party developed and validated a survey of newborn immunohematology testing practice. The survey was sent electronically to transfusion service leadership at teaching institutions.Results: The response rate was 67% (61/91); 56 surveys meeting inclusion criteria were analyzed. Approximately 90% (50/56) were from birth hospitals and 16.1% (9/56) were from pediatric hospitals. Newborn immunohematology testing is ordered as a panel by 66.0% (33/50) of birth hospitals. ABO group and DAT is mandated before discharge in 14/56 (25.0%) and 13/56 (23.2%), respectively. About 76.8% (43/56) selectively perform a DAT according to blood blank or clinical parameters. The most common DAT practices include anti-IgG only testing by 73.2% (41/56) and use of umbilical cord specimen type by 67.9% (38/56). A positive DAT is a critical value for 26.8% (15/56) and followed with eluate testing when a maternal antibody screen is positive for 48.2% (27/56). In the setting of a non-ABO maternal red cell antibody, 55.4% (31/56), phenotype neonatal red cells when the DAT is positive. Group O RBC are transfused irrespective of the DAT result for 82.1%, (46/56).Conclusion: There is variability in newborn immunohematology testing and transfusion practice and potential overutilization of the DAT. Evidence-based consensus guidelines should be developed to standardize practice and to improve safety. [ABSTRACT FROM AUTHOR]

Using data on U.S. states, this paper studies the factors driving lottery-related crimes, focusing on spillovers from other gambling and corruption. Although state-sponsored lotteries have become quite popular in the United States in recent years, formal research on their causes is rather limited. Results show corruption to increase lottery-related crimes, while higher lottery prize money and greater economic prosperity have the opposite effect. We find crowding out from electronic gaming machines. However, competition from Native American casinos or casino gambling crimes does not significantly impact lottery crimes. [ABSTRACT FROM AUTHOR]

Where do partisans get their election news in the contemporary media environment? We track the online news consumption of a national sample during the 2016 presidential campaign. We find levels of partisan isolation in news exposure are two to three times greater than in prior studies, although the absolute level of isolation remains modest. The partisan divide for election-related news exceeds the divide for non-political news. This tendency of partisans to follow like-minded news providers occurs despite the relatively small differences in the partisan slant of the content offered by the majority of sources they visited. Finally, we find that partisans who gravitated to congenial news providers did not shift their evaluations of the presidential candidates during the campaign. [ABSTRACT FROM AUTHOR]

Objective: Incidence of youth‐onset diabetes in India has not been well described. Comparison of incidence, across diabetes registries, has the potential to inform hypotheses for risk factors. We sought to compare the incidence of diabetes in the U.S.‐based registry of youth onset diabetes (SEARCH) to the Registry of Diabetes with Young Age at Onset (YDR—Chennai and New Delhi regions) in India. Methods: We harmonized data from both SEARCH and YDR to the Observational Medical Outcomes Partnership (OMOP) Common Data Model. Data were from youth registered with incident diabetes (2006‐2012). Denominators were from census and membership data. We calculated diabetes incidence by averaging the total cases across the entire follow‐up period and dividing this by the estimated census population corresponding to the source population for case ascertainment. Incidence was calculated for each of the registries and compared by type and within age and sex categories using a 2‐sided, skew‐corrected inverted score test. Results: Incidence of type 1 was higher in SEARCH (21.2 cases/100 000 [95% CI: 19.9, 22.5]) than YDR (4.9 cases/100 000 [95% CI: 4.3, 5.6]). Incidence of type 2 diabetes was also higher in SEARCH (5.9 cases/100 000 [95% CI: 5.3, 6.6] in SEARCH vs 0.5/cases/100 000 [95% CI: 0.3, 0.7] in YDR). The age distribution of incident type 1 diabetes cases was similar across registries, whereas type 2 diabetes incidence was higher at an earlier age in SEARCH. Sex differences existed in SEARCH only, with a higher rate of type 2 diabetes among females. Conclusion: The incidence of youth‐onset type 1 and 2 diabetes was significantly different between registries. Additional data are needed to elucidate whether the differences observed represent diagnostic delay, differences in genetic susceptibility, or differences in distribution of risk factors. [ABSTRACT FROM AUTHOR]

Objective Fibromyalgia is a functional pain disorder in which patients suffer from widespread pain and poor quality of life. Fibromyalgia pain and its impact on quality of life are not effectively managed with current therapeutics. Previously, in a preclinical rat study, we demonstrated that exposure to green light-emitting diodes (GLED) for 8 hours/day for 5 days resulted in antinociception and reversal of thermal and mechanical hypersensitivity associated with models of injury-related pain. Given the safety of GLED and the ease of its use, our objective is to administer GLED as a potential therapy to patients with fibromyalgia. Design One-way crossover clinical trial. Setting United States. Method We enrolled 21 adult patients with fibromyalgia recruited from the University of Arizona chronic pain clinic who were initially exposed to white light-emitting diodes and then were crossed over to GLED for 1 to 2 hours daily for 10 weeks. Data were collected by using paper surveys. Results When patients were exposed to GLED, but not white light-emitting diodes, they reported a significant reduction in average pain intensity on the 10-point numeric pain scale. Secondary outcomes were assessed by using the EQ-5D-5L survey, Short-Form McGill Pain Questionnaire, and Fibromyalgia Impact Questionnaire and were also significantly improved in patients exposed to GLED. GLED therapy was not associated with any measured side effects in these patients. Conclusion Although the mechanism by which GLED elicits pain reduction is currently being studied, these results supporting its efficacy and safety merit a larger clinical trial. [ABSTRACT FROM AUTHOR]

This paper examines the presence of contagion in health care fraud across jurisdictional boundaries. Using state‐level data for the United States, we find evidence of contagion in medical fraud. There are also spillovers from border corruption on medical fraud, but no evidence of spillovers from international borders. In other findings, greater urbanization, greater elderly population, and higher hospital occupancy positively contribute to medical fraud, while nursing employment has a mitigating effect. Further, it is economic inequality rather than economic prosperity that seems relevant. The main findings are robust to consideration of simultaneity, but dependent upon the prevalence of fraud across states. [ABSTRACT FROM AUTHOR]

Objective: To examine eating disorder (ED) symptomatology, related clinical impairment, and comorbid psychopathology in college women with EDs across five racial and two ethnic groups. Method: Participants were 690 women from 28 US universities who screened positive for an ED. Thirteen variables assessing ED symptoms, related clinical impairment, and comorbid psychopathology were compared across racial and ethnic groups using analyses of variance (ANOVAs) and independent samples t‐tests. Results: Across racial groups, significant differences emerged in binge eating and laxative use. Asian women reported significantly more binge eating than White women (p <.01). Individuals self‐identified as the "Other" racial group reported greater laxative use than Asian and White women (ps ≤.01). No other significant differences emerged across all other variables (ps ≥.13). Across ethnic groups, Hispanic women reported significantly more laxative use (p <.01), and more comorbid insomnia symptoms (p =.03) than non‐Hispanic women. No other significant differences were observed (ps ≥.24). Discussion: Findings suggest that binge eating, laxative use, and insomnia symptoms differ across racial and ethnic groups in US college women who screened positive for EDs. Findings can inform tailoring of ED screening to reduce current disparities in these underrepresented populations. [ABSTRACT FROM AUTHOR]

Background: With improved safety of allogeneic blood supply, the use of preoperative autologous donations (PADs) and perioperative autologous cell salvage (PACS) has evolved. This study evaluated temporal trends in PAD and PACS use in the United States. Methods: The National Inpatient Sample database, a stratified probability sample of 20% of hospitalizations in the United States, was used to compare temporal trends in hospitalizations reporting use of PADs and PACS from 1995 to 2015. Factors associated with their use were examined between 2012 and 2015 with use of multivariable Poisson regression. Sampling weights were applied to generate nationally representative estimates. Results: There was a steady decrease in hospitalizations reporting PAD transfusions from 27.90 per 100 000 in 1995 to 1.48 per 100 000 hospitalizations in 2015 (P‐trend <.001). In contrast, PACS increased from a rate of 1.16 per 100 000 in 1995 to peak of 20.51 per 100 000 hospitalizations in 2008 and then steadily declined (P‐trend<.001). Higher odds of PACS and PADs were observed in older patients, elective procedures (vs urgent), and urban teaching/nonteaching hospitals (vs rural hospitals) (P <.001). PACS was more common in hospitalizations in patients with higher levels of severity of illness as compared to those with minor severity (adjusted prevalence ratio [adjPR], 2.39; 95% confidence interval [CI], 2.08‐2.73; P<.001), while PADs were performed less often in patients with higher underlying severity of illness (All Patient Refined Diagnosis Related Groups, 4 vs 1, adjPR, 0.61; 95% CI, [0.39‐0.95]; P =.028). Conclusions: There was a significant decrease in PAD red blood cell transfusions, while PACS has increased and subsequently decreased; PACS plays an important role in surgical blood conservation. The subsequent decline in PACS likely reflects further optimization of transfusion practice through patient blood management programs and improvement of surgical interventions. [ABSTRACT FROM AUTHOR]

Background: In 2019, the United States Food and Drug Administration published its final recommendations to mitigate bacterial contamination of platelets. We sought to evaluate our secondary bacterial culture (SBC) strategy in light of those recommendations.Study Design and Methods: A retrospective analysis was conducted of SBC data (October 2016-2019) at our institution. SBC was performed upon receipt (Day 3 after collection); 5 mL of platelet product was inoculated aseptically into an aerobic bottle and incubated at 35°C for 3 days. For 8 months, a 10-mL inoculum was trialed. No quarantine was applied. All positive cultures underwent Gram staining and repeat culture of the platelet product (if available). A probable true positive was defined as concordant positive culture between the initial and repeat culture. The incidence of probable true- and false-positive cultures were reported descriptively and differences evaluated by sampling volume.Results: Over 3 years, 55 896 platelet products underwent SBC, yielding 30 initial positive results (approx. 1/1863 platelets); 25 (83.3%) signaled within 24 hours of SBC. The rates of probable true positive, false positive, and indeterminate for 5 mL were 0.027% (1/3771), 0.002% (1/45 251) and 0.018% (1/5656), respectively. The respective rates for 10 mL were 0.018% (1/5323), 0.07% (1/1521), and 0%. Seven of eight (87.5%) false-positive SBCs occurred with a 10-mL inoculum. No septic transfusion reactions were reported.Conclusion: SBC continues to interdict bacterially contaminated units of platelets. Our findings suggest higher rates of false positivity using large-volume inocula. [ABSTRACT FROM AUTHOR]

Background: Factors associated with red blood cell (RBC), plasma, and platelet transfusions in hospitalized neonates and children across the United States have not been well characterized.Methods: Data from the Kids' Inpatient Database (KID) 2016 were analyzed. KID is a random sample of 10% of all uncomplicated in-hospital births and 80% of remaining pediatric discharges from approximately 4200 US hospitals. Sampling weights were applied to generate nationally representative estimates. Primary outcome was one or more RBC transfusion procedures; plasma and platelet transfusions were assessed as secondary outcomes. Analysis was stratified by age: neonates (NEO; ≤28 d), and nonneonates (PED; >28 d and <18 y). Multivariable logistic regression was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs).Results: Among 5,604,984 total hospitalizations, overall prevalence of transfusions was 1.07% (95% CI, 0.94%-1.22%) for RBCs, 0.17% (95% CIs, 0.15%-0.21%) for plasma and 0.35% (95% CI, 0.30%-0.40%) for platelet transfusions. RBC transfusions occurred among 0.43% NEO admissions and 2.63% PED admissions. For NEO admissions, RBC transfusion was positively associated with nonwhite race, longer length of hospitalization, highest risk of mortality (aOR, 86.58; 95% CI, 64.77-115.73) and urban teaching hospital location. In addition to the above factors, among PED admissions, RBC transfusion was positively associated with older age, female sex (aOR, 1.10; 95% CI, 1.07-1.13), and elective admission status (aOR, 1.62; 95% CI, 1.46-1.80). Factors associated with plasma and platelet transfusions were largely similar to those associated with RBC transfusion, except older age groups had lower odds of plasma transfusion among PED admissions.Conclusions: While there is substantial variability in the proportion of neonates and nonneonatal children transfused nationally, there are several similar, yet unique, nonlaboratory predictors of transfusion identified in these age groups. [ABSTRACT FROM AUTHOR]

Givosiran is a small interfering ribonucleic acid agent that was recently approved in the United States for the treatment of acute hepatic porphyria (AHP). This phase I study evaluated the safety, pharmacokinetic, and pharmacodynamic profile of subcutaneously (SC) administered givosiran in patients with acute intermittent porphyria, the most common AHP type. Givosiran was rapidly absorbed from the SC injection site with peak plasma concentrations achieved within 0.5-5 hours followed by elimination with a short half-life of 4-10 hours. Plasma exposures of AS(N-1)3' givosiran, an active metabolite with equal potency as givosiran, was 35%-75%. Givosiran treatment resulted in a rapid and dosedependent reduction in urinary aminolevulinic acid (ALA) and porphobilinogen (PBG) towards the upper limit of normal (ULN) in AHP patients. Greater and more sustained reductions in ALA and PBG were achieved with once monthly dosing compared with once quarterly dosing. After monthly dosing, trough ALA levels were reduced to below the ULN, approximately 95% reduction from baseline, at both the 2.5 and 5.0 mg/kg doses. [ABSTRACT FROM AUTHOR]

This paper examines the impact of intellectual property rights (IPR) infringement on the input (R&D spending) and output (patents) of the research process. The extant literature proxies IPR enforcement via composite indices or indicators of institutional quality, whereas this paper employs a direct (hard) measure of IPR crimes. Using data across U.S. states, results show that IPR crimes reduce research spending but do not impact patenting. Upon comparison with a broader measure of weak institutional quality (corruption), we find that greater corruption has a robust negative effect on patenting, but not on R&D spending. Quantitatively, the elasticities of R&D spending with respect to IPR crimes are greater than those of patents with respect to corruption, suggesting that studies that proxy IPR crimes via other measures are likely underestimating their impacts on technological change. [ABSTRACT FROM AUTHOR]

Recording of crimes as terror incidents often falls in an unclear/fuzzy area due to overlaps with other crimes such as hate crimes, drug or mental health-related crimes, etc. This paper addresses the recording of crimes as terror crimes across US states, alternately considering both the prevalence and intensity of such crimes. Placing the explanatory variables under institutional, economic, social, political and enforcement categories, results show that weak institutions, ceteris paribus, undermine the recording of terror crimes. In other significant influences, states with greater ethnic homogeneity were less likely to have recorded terror crimes and more populous states had greater incidence (but not greater intensity) of recorded terror activity. Some implications for policy are discussed. [ABSTRACT FROM AUTHOR]

We develop a model that shows that an overconfident manager, who sometimes makes value-destroying investments, has a higher likelihood than a rational manager of being deliberately promoted to CEO under value-maximizing corporate governance. Moreover, a risk-averse CEO's overconfidence enhances firm value up to a point, but the effect is nonmonotonic and differs from that of lower risk aversion. Overconfident CEOs also underinvest in information production. The board fires both excessively diffident and excessively overconfident CEOs. Finally, Sarbanes-Oxley is predicted to improve the precision of information provided to investors, but to reduce project investment. [ABSTRACT FROM AUTHOR]