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This survey study examined 164 in-service special education teachers' perceptions of training strategies in their cross categorical teacher preparation program in the United Sates for developing knowledge and skills in systematic instruction, an evidence-based practice for students with extensive support needs. Both classroom-based and field-based training strategies were evaluated along with teachers' perceptions of the contribution and importance of the various training strategies. Results from Chi-square tests, Pearson correlations, multivariate analysis of covariance, and repeated measures of analysis of covariance indicated that teachers felt prepared to implement systematic instruction after exiting their program and after teaching students with disabilities, and the perceived effectiveness of training strategies was related to teacher experience. Teachers perceived modeling and receiving performance feedback in both university classrooms and field-based settings to contribute to their knowledge and skill development in systematic instruction. We present the results in terms of implications for practice and future research. [ABSTRACT FROM AUTHOR]

Flash flooding is a damaging weather event, yet it remains challenging to quantify its severity. We propose a development—the Flashiness‐Intensity‐Duration‐Frequency (F‐IDF) curve—to quantify flash flood intensity based on the frequency and duration of the event. As a proof‐of‐concept, we mapped Contiguous US (CONUS)‐wide F‐IDF values at 3,722 stream gage locations and explored their relations with basin attributes. It is found that (a) The return periods of flash flood events are highly associated with the return peroids of rainfall events; (b) Climatological precipitation amounts exhibit the most positive correlation with flashiness while a basin's drainage area is the most negatively correlated; (c) Correlation of flashiness with basin attributes decreases with increasing F‐IDF return periods and shorter event durations. Both aspects are attributable to the rainfall signal overwhelming the underlying basin attributes as the intensities become more extreme. This new metric has implications for hydrology and emergency responders. Plain Language Summary: Flash floods are among the most devasting natural hazard types that can cause severe property damage and loss of life. However, it's challenging to measure and quantify the severity. This study proposes a new way of quantifying flash flood intensity using a newly developed Flashiness‐Intensity‐Duration‐Frequency (F‐IDF) curve. It links flash flood severity with how often they happen and how long they last. We mapped F‐IDF values across the United States and found that certain areas are more prone to flash floods than others. The amount of rain and the size of the basin area are the most important factors in determining how severe a flash flood is. This new quantification tool can help experts better identify and respond to flash flood risks. Key Points: We introduce the Flashiness‐Intensity‐Duration‐Frequency curve to quantify flash flood intensityThe CONUS‐wide Flashiness‐Intensity‐Duration‐Frequency values are provided at 3,722 stream gage locationsThe relations between 59 basin attributes and flashiness values are explored [ABSTRACT FROM AUTHOR]

The remote sensing satellite cluster system, as an important component of the next generation of space architecture in the United States, has important application prospects in the military field. In order to improve the effects of time, with regard to the effectiveness evaluation of the remote sensing satellite cluster system, neural network methods are generally used to satisfy the requirements of real-time decision-making assistance in the military field. However, there are two problems that emerge when applying the existing neural network methods to an effectiveness evaluation of the remote sensing satellite cluster. On the one hand, the neural network model architecture needs to be designed specifically for the remote sensing satellite cluster system. On the other hand, there is still a lack of hyperparameter optimization methods that consume less time and have good optimization effects for the established neural network model. In this regard, two main modifications were made to the back-propagation neural network, to which an effectiveness evaluation was applied. The first comprised a new architecture named BPS, which was designed for the back-propagation neural network so as to improve its prediction accuracy. In BP architecture, one back-propagation neural network is established for each indicator involved in the effectiveness evaluation indicator system of the remote sensing satellite cluster; the output of each back-propagation neural network model is modified to the residual value between the corresponding indicator value and the value that is predicted through a multiple linear regression analysis of the corresponding indicator. The second modification involved the multi-round traversal method, which is based on the three-way decision theory, and it was proposed in order to significantly improve the model's training time, which is a new type of hyperparameter optimization method. The results show that compared with the traditional simulation model, the modified back-propagation neural network model based on three-way decision theory can quickly and effectively provide stable and accurate evaluation results; this can assist with and meet the requirements for real-time decision-making in the military field. [ABSTRACT FROM AUTHOR]

Background: Various therapeutic strategies are available for the first-line treatment of patients with advanced hepatocellular carcinoma (aHCC). But which approach is the most cost-effective remains uncertain. Objectives: This study aims to evaluate the cost-effectiveness of first-line strategies in aHCC patients from the perspective of Chinese and US payers. Design: A network meta-analysis (NMA) and cost-effectiveness study. Data sources and methods: A NMA was conducted to collect all first-line strategies with aHCC from 1 October 1 2018 until 1 January 2022. The relevant randomized controlled trial literature in PubMed, Embase, and Cochrane Library for the last 3 years were searched. The abstracts of meetings of the American Society of Clinical Oncology, European Society of Medical Oncology, and American Association for Cancer Research were also reviewed. A Markov model that included three states was developed. One-way sensitivity and probabilistic sensitivity analysis were performed to investigate the uncertainty of the economic evaluation. Scenario analysis was conducted to explore the economic benefits of treatment strategies in low-income populations. Results: Base-case analysis in China included 1712 patients showed that atezolizumab combined with bevacizumab, sintilimab combined with bevacizumab, lenvatinib (LEVA), and sorafenib (SORA) added 0.46, 1.25, 0.77, and −1.08 quality-adjusted life-years (QALYs), respectively, compared with donafenib, resulting in an incremental cost-effective ratio of $85607.88, $12109.27, and $1651.47 per QALY at a willingness-to-pay (WTP) of $11101.70/QALY. In the United States, only the incremental cost-effectiveness ratios (ICERs) of SORA was higher that were lower than the WTP threshold ($69375/QALY), and LEVA was the most cost-effective strategy with the ICERs were 25022.13/QALY. Conclusion: The NMA and cost-effectiveness analysis revealed that LEVA is the favorite choice in the first-line treatment of Chinese aHCC patients and US payers' perspective when the WTP was $11101.70/QALY in China and $69375.0/QALY in the United States. Registration: This study has been registered on the PROSPERO database with the registration number CRD42021286575. [ABSTRACT FROM AUTHOR]

Despite several flood databases available in the United States, there is a benefit to combine and reconcile these diverse data sources into a comprehensive flood database with a unified common format and easy public access in order to facilitate flood-related research and applications. Typically, floods are reported by specialists or media according to their socioeconomic impacts. Recently, data-driven analysis can reconstruct flood events based on in situ and/or remote-sensing data. Lately, with the increasing engagement of citizen scientists, there is the potential to enhance flood reporting in near-real time. The central objective of this study is to integrate information from seven popular multi-sourced flood databases into a comprehensive flood database in the United States, made readily available to the public in a common data format. Natural language processing, geocoding, and harmonizing processing steps are undertaken to facilitate such development. In total, there are 698 507 flood records in the United States from 1900 to the present, which highlights the longest and most comprehensive recording of flooding across the country. The database features event locations, durations, date/times, socioeconomic impacts (e.g., fatalities and economic damages), and geographic information (e.g., elevation, slope, contributing area, and land cover types retrieved from ancillary data for given flood locations). Finally, this study utilizes the flood database to analyze flood seasonality within major basins and socioeconomic impacts over time. It is anticipated that thus far the most comprehensive yet unified database can support a variety of flood-related research, such as a validation resource for hydrologic or hydraulic simulations, hydroclimatic studies concerning spatiotemporal patterns of floods, and flood susceptibility analysis for vulnerable geophysical locations. The dataset is publicly available with the following DOI: 10.5281/zenodo.4547036 (Li, 2020). [ABSTRACT FROM AUTHOR]

The treatment strategy for management of Burkitt lymphoma (BL) has evolved during the past decades and the clinical outcome for this disease as a whole has also improved. Due to limited information reported on survival trends of patients with stage I/II (limited‐stage) BL, here we used the Surveillance, Epidemiology, and End Results (SEER) database to conduct our study. The time period was divided into two eras (1983‐2001 and 2002‐2014) as the recent era reflected more intensive chemotherapy regimens, the availability of rituximab, the widespread use of antiretroviral therapy (ART) and improvements in supportive care. Patients with limited‐stage BL had a significantly better 5‐year overall survival (OS) in the 2002‐2014 era in both univariate analysis and multivariate analysis, compared with those in the 1983‐2001 era (64.1% vs 57.4%). However, clinical outcomes of elderly patients (≥60 years) and children patients (0‐19 years) did not significantly improve. Older age and race of black were correlated with poorer OS in multivariate analysis, whereas sex, primary sites, and application of radiotherapy did not significantly influence OS. In conclusion, the prognosis of patients with limited‐stage BL has improved in the 2002‐2014 era, but the outcome was still much poorer in elderly patients, which needs to be improved by identifying newly molecular‐targeted drugs and developing novel personalized therapeutic approaches. Patients with limited‐stage BL had a significantly better 5‐year overall survival (OS) in the 2002‐2014 era in both univariate analysis and multivariate analysis, compared with those in the 1983‐2001 era (64.1% vs 57.4%). However, clinical outcomes of elderly patients (≥60 years) and children patients (0‐19 years) did not significantly improve. [ABSTRACT FROM AUTHOR]

• Most of the natural geographical distribution of Nulembo lutea was sampled. • Low level of genetic diversity was revealed in American lotus populations. • High genetic differentiation and strong population structure was observed. • Low level of gene flow among the genetic pools was revealed. American lotus (Nelumbo lutea Willd.) is a popular plant with ornamental, medicinal, and culinary value. Studies related to the genetic diversity and population structure of N. lutea are limited. We sampled 326 individuals from 19 populations of wild N. lutea across its distribution range in the USA and genotyped them using 12 microsatellite markers. A total of 274 alleles were amplified by 12 microsatellites with a mean of 22.83. We observed a low level of genetic diversity for American lotus (A e = 2.40 and H E = 0.459) in the USA. The analysis of molecular variance (AMOVA) exhibited closer variation among populations (42.00%) than within populations (58.00%) of N. lutea, with strong genetic differentiation observed (F ST = 0.419). There was no significant correlation between genetic and geographic distances. The Bayesian analysis and neighbor-joining dendrogram displayed strong population structure. A very low level of historical gene flow (N M = 0.073) was observed among the populations. Fourteen of the 19 populations showed a demographic bottleneck, indicating the vulnerability of the American lotus populations. We thus proposed priority population sites for the conservation of N. lutea via both ex-situ and in-situ techniques. [ABSTRACT FROM AUTHOR]

Abstract: The incidence of adenocarcinoma of the lung is increasing in the United States, however, the difficulties in obtaining lung cancer families and representative samples of early to late stages of the disease have lead to the study of mouse models for lung cancer. We used Spectral Karyotyping (SKY), mapping with fluorescently labeled genomic clones (FISH), comparative genomic hybridization (CGH) arrays, gene expression arrays, Western immunoblot and real time polymerase chain reaction (PCR) to analyze nine pairs of high-invasive and low-invasive tumor cell strains derived from early passage mouse lung adenocarcinoma cells to detect molecular changes associated with tumor invasion. The duplication of chromosomes 1 and 15 and deletion of chromosome 8 were significantly associated with a high-invasive phenotype. The duplication of chromosome 1 at band C4 and E1/2–H1 were the most significant chromosomal changes in the high-invasive cell strains. Mapping with FISH and CGH array further narrowed the minimum region of duplication of chromosome 1 to 71–82 centimorgans (cM). Expression array analysis and confirmation by real time PCR demonstrated increased expression of COX-2, Translin (TB-RBP), DYRK3, NUCKS and Tubulin-α4 genes in the high-invasive cell strains. Elevated expression and copy number of these genes, which are involved in inflammation, cell movement, proliferation, inhibition of apoptosis and telomere elongation, were associated with an invasive phenotype. Similar linkage groups are altered in invasive human lung adenocarcinoma, implying that the mouse is a valid genetic model for the study of the progression of human lung adenocarcinoma. [Copyright &y& Elsevier]

Background: Atherogenic index of plasma (AIP), a marker of atherosclerosis and cardiovascular disease (CVD). However, few studies have investigated association between AIP and all-cause mortality and specific-mortality in the general population., Methods: This study included data from 14,063 American adults. The exposure variable was the AIP, which was defined as log10 (triglycerides/high-density lipoprotein cholesterol). The outcome variables included all-cause mortality and specific-mortality. Survey-weighted cox regressions were performed to evaluate the relation between AIP and all-cause mortality and specific-mortality. Weighted restricted cubic spline was conducted to examin the non-linear relationship., Results: During 10 years of follow-up, we documented 2,077, 262, 854, and 476 cases of all-cause mortality, diabetes mortality, CVD mortality and cancer mortality, respectively. After adjustment for potential confounders, we found that atherogenic index of plasma (AIP) was significantly associated with an increased risk of diabetes mortality when comparing the highest to the lowest quantile of AIP in female (p for trend = 0.001) or participants older than 65 years (p for trend = 0.002). AIP was not significantly associated with all-cause mortality, CVD mortality and cancer mortality (p > 0.05). Moreover, a non-linear association was observed between AIP and all-cause mortality in a U-shape (p for non-linear = 0.0011), while a linear relationship was observed with diabetes mortality and non-diabetes mortality (p for linear < 0.0001)., Conclusions: In this study, there is a no significant association between high AIP levels and a high risk of all-cause and cardiovascular mortality. Besides, a higher AIP was significantly associated with an increased risk of diabetes mortality, which only found in women older than 65 years. AIP was associated with all-cause mortality in a U-shape. This association could be explained by the finding that higher AIP predicted a higher risk of death from diabetes, and that lower AIP predicted a higher risk of death from non-diabetes causes., (© 2024. The Author(s).)

Background: This study aimed to estimate population-level and state-level lead-attributable mortality burdens stratified by socioeconomic status (SES) class in the USA., Methods: Based on the National Health and Nutrition Examination Survey (NHANES), we constructed individual-level SES scores from income, employment, education and insurance data. We assessed the association between the blood lead levels (BLL) and all-cause mortality by Cox regression in the NHANES cohort (n = 31 311, 4467 deaths). With estimated hazard ratios (HR) and prevalences of medium (2-5 μg/dL) and high (≥ 5 μg/dL) BLL, we computed SES-stratified population-attributable fractions (PAFs) of all-cause mortality from lead exposure across 1999-2019. We additionally conducted a systematic review to estimate the lead-attributable mortality burden at state-level., Results: The HR for every 2-fold increase in the BLL decreased from 1.23 (1.10-1.38) for the lowest SES class to 1.05 (0.90-1.23) for the highest SES class. Across all SES quintiles, medium BLL exhibited a greater mortality burden. Individuals with lower SES had higher lead-attributable burdens, and such disparities haver persisted over the past two decades. In 2017-19, annually 67 000 (32 000-112 000) deaths in the USA were attributable to lead exposure, with 18 000 (2000-41 000) of these deaths occurring in the lowest SES class. Substantial disparities in the state-level mortality burden attributable to lead exposure were also highlighted., Conclusions: These findings suggested that disparities in lead-attributable mortality burden persisted within US adults, due to heterogeneities in the effect sizes of lead exposure as well as in the BLL among different SES classes., (© The Author(s) 2024; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.)

Partisan sorting in residential environments is an enduring feature of contemporary American politics, but little research has examined partisan segregation individuals experience in activity spaces through their daily activities. Relying on advances in spatial computation and global positioning system data on everyday mobility flows collected from smartphones, we measure experienced partisan segregation in two ways: place-level partisan segregation based on the partisan composition of its daily visitors and community-level experienced partisan segregation based on the segregation level of places visited by its residents. We find that partisan segregation experienced in places varies across different geographic areas, location types, and time periods. Moreover, partisan segregation is distinct from experienced segregation by race and income. We also find that partisan segregation individuals experience is relatively lower when they visit places beyond their residential areas, but partisan segregation in residential space and activity space is strongly correlated. Residents living in predominantly black, liberal, low-income, non-immigrant, more public transit-dependent, and central city communities tend to experience a higher level of partisan segregation., (© 2023. The Author(s).)

Background: Manganese (Mn) is an essential trace element with a narrow toxic margin for human health. The association between Mn exposure and adverse visceral adipose tissue (VAT) accumulation is unclear. Objective: This study aimed to estimate the associations of blood Mn levels with VAT mass or visceral obesity in the general population in the United States. Method: This cross-sectional study included data of 7297 individuals released by National Health and Nutrition Examination Survey (NHANES). VAT was quantified with dual-energy X-ray absorptiometry, and blood Mn was measured using inductively coupled plasma mass spectrometry. The generalized linear model and generalized additive model (GAM) were applied to estimate the linear and non-linear associations between Mn levels and VAT mass, respectively. Logistic regression was used to estimate the associations between blood Mn levels and the risk of visceral obesity. Results: Fully adjusted generalized linear regression revealed that individuals in the higher quantile of Mn had increased VAT mass compared with those in the lower quantile (β per quantile change = 0.025; 95% CI of 0.017, 0.033; p < 0.001). Positive associations were also observed in males and females (males: β per quantile change = 0.012, 95% CI of 0.002, 0.022 (p = 0.020); female: β per quantile change = 0.036; 95% CI of 0.023, 0.048 (p < 0.001)). The GAM illustrated that the non-linear associations between blood Mn levels and VAT mass were in U-shape patterns (effective degree of freedom >1 in total participants, males, and females). A stratified analysis found significant interactions between Mn and the family income-to-poverty ratio (PIR) in males, with stronger associations in males with a PIR < 1.3 (β = 0.109; 95% CI of 0.048, 0.170). Additional analyses revealed that individuals in the highest quantile of Mn had a 39% higher risk of visceral obesity (OR = 1.39; 95% CI of 1.15−1.69; p < 0.001). Conclusions: Higher blood Mn levels were positively associated with increased VAT mass and visceral obesity risk. The adverse VAT phenotype associated with excessive blood Mn levels should be further investigated.

Background: Bibliometric analysis can analyze development trends and predict research hotspots. We used these analyses to better understand the pregnancy-related implications of thyroid diseases., Methods: Publications on thyroid diseases during pregnancy from 1926 to hitherto were retrieved based on the Web of Science database. The publications and references, the institutions and countries, the journals, the keywords and citations were analyzed by utilizing VOSviewer, CiteSpace and Cit- NetExplorer., Results: A total of 3310 publications were retrieved and were cited 87913 times. The United States took the dominant position in outputs and collaborations. Harvard University had the most articles 86, which also had the highest h-index 30. Thyroid ranked first with 201 publications and Journal of Clinical Endocrinology Metabolism had the highest h-index 67. Among the 49 burst keywords, "antibody" had the longest burst period from 1991 to 2012, "thyroxine" had the strongest burst strength 16.7026, "hypothyroxinemia" appeared most recently in 2018. The most frequent keyword was "pregnancy" which occurred 1324 times. All the top 98 frequent keywords were clustered into 4 clusters. The citation network visualization was grouped into 8 groups., Conclusion: The research focus of thyroid diseases in pregnancy ranged from clinical thyroid dysfunction to milder thyroid dysfunction. Guidelines published by the American Thyroid Association enacted a crucial purpose in the treatment and development of thyroid diseases during pregnancy. Some randomized controlled studies of unresolved problems and long-term follow-up of offspring may be the direction of future research. In the meantime, bibliometric methods can help scholars choose journals, track research hotspots, and identify the direction or focus of future research., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Phytoestrogens are naturally plant-derived compounds that could bind to estrogen receptors and mimic estrogenic effects. Previous studies showed a positive association between phytoestrogens and hypothyroidism; however, little is known on phytoestrogens and thyroid hormones. This study was designed to investigate the associations between urinary phytoestrogens and thyroid hormone levels. Based on the US National Health and Nutrition Examination Survey (NHANES) 2007-2010, 4103 participants were recruited in this cross-sectional study. Linear regression models and multiple linear regressions models were applied to examine the relationships between urinary phytoestrogens and thyroid hormone levels. Urinary O-desmethylangolensin (O-DMA) was found to be correlated with serum FT 4 levels in the female 20-60-year-of-age group (β=0.018, 95% CI: 0.006, 0.031). Higher enterolactone (ENT) levels were significantly positively associated with TSH levels in the 12-19-year-of-age female group (β=0.196, 95% CI: 0.081, 0.311). In the male group, enterodiol (END) was significantly positively correlated with TSH and TT 3 in the 12-19-year-of-age group, respectively (TT 3 : β=3.444, 95% CI: 0.150, 6.737; TSH: β=0.104, 95% CI: 0.005, 0.203). However, equol (EQU) levels were negatively associated with TT 4 (12-19-year-of-age: β=- 0.166, 95% CI: - 0.279, - 0.034; 20-60-year-of-age: β=- 0.132, 95% CI: - 0.230, - 0.034). Our study provided epidemiological evidence that urinary phytoestrogens were powerfully associated with thyroid hormone levels. The results also supported that phytoestrogens acted as endocrine disruptors. It is imperative and important to pay attention to the intake of phytoestrogens., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background & Aims: Type 2 diabetes prevention diet confers a lower risk of type 2 diabetes, which exhibits overlapping mechanisms with pancreatic cancer. We performed a prospective study to examine whether adherence to this dietary pattern is associated with a reduced risk of pancreatic cancer., Methods: A population-based cohort of 101,729 American adults was identified. A dietary diabetes risk reduction score was computed to reflect adherence to this dietary pattern, with higher scores representing greater adherence. Cox regression was used to compute hazard ratios (HRs) for pancreatic cancer incidence. Prespecified subgroup analyses were used to identify the potential effect modifiers., Results: After an average follow-up of 8.86 years (900,871.67 person-years), a total of 402 pancreatic cancer cases were observed. In the fully adjusted model, participants in the highest quartile of dietary diabetes risk reduction score were found to have a reduced risk of pancreatic cancer compared with those in the lowest quartile [HR quartiles 4 versus 1 : 0.62; 95% confidence interval (CI): 0.44, 0.86; P trend  = 0.004], which remained in a series of sensitivity analyses. Subgroup analyses further found that this favorable association was more pronounced in current or former smokers (HR quartiles 4 versus 1 : 0.48; 95% CI: 0.30, 0.77) than in never smokers (HR quartiles 4 versus 1 : 0.71; 95% CI: 0.44, 1.15), although the interaction test did not reach statistical significance (P interaction  = 0.095)., Conclusions: Greater adherence to type 2 diabetes prevention diet is associated with a lower risk of pancreatic cancer in this US population. More studies are needed to confirm our findings., Competing Interests: Conflict of interest None declared., (Copyright © 2021 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Allergen immunotherapy (AIT) for allergic rhinitis (AR), asthma, and other allergic diseases has developed quickly. House dust mite (HDM), Artemisia (wormwood), Humulus japonicus (Japanese hop), Alternaria alternata, and Cladosporium herbarum are the five most common inhalant allergens in China. AIT has been performed in China for over 60 years. With the support of the Chinese Medical Association (CMA) and the Chinese Medical Doctors Association (CMDA), the Chinese College of Allergy and Asthma (CCAA) was established in 2016 as a specialized branch of CDMA and is the main certification authority for AIT. Chinese allergists and scientists have made tremendous progress in the development of AIT. There have been many publications by Chinese allergists and scientists worldwide encompassing original research studies, systematic reviews, case studies, and clinical trials. Currently, conventional subcutaneous immunotherapy (SCIT) is the preferred AIT in China, but sublingual immunotherapy (SLIT) is beginning to gain recognition. An increasing number of clinical trials have been conducted to investigate the clinical efficacy and side effects of SLIT and SCIT. In China, HDM is the only commercial standardized allergen extracts in clinical use, whereas the others are crude allergen extracts. Besides standardized allergen extracts, other forms of hypoallergenic extracts are still being investigated and developed in China. Immunotherapy in China is similar to that in the USA in which allergen extracts can be mixed for SCIT. However, allergen extracts cannot be mixed for SCIT in Europe.

Atrial Fibrillation (AFib) is by itself a strong risk factor for many life-threatening heart diseases. An estimated 2.7 to 6.1 million people in the United States have AFib. With the aging of the U.S. population, this number is expected to increase. In this preliminary study, a heart rate-duration criteria region is proposed to automatically label symptomatic AFib events using recordings from portable ECG monitors. A Markov Chain algorithm is implemented to classify prediction intervals that are 2 minutes before the symptomatic AFib events. The method yields an overall accuracy value of 82% with 0.91 AUC.

Peer problems are linked to attention deficit hyperactivity disorder (ADHD) symptoms and the serotonin system is thought to be involved in ADHD-related behavior. Hence, from a Gene × Environment perspective, the serotonin transporter 5-HTTLPR may play a moderating role. In two large community samples, the moderating role of 5-HTTLPR was examined related to more hyperactivity-impulsivity symptoms (HI symptoms) predicted by more peer problems. In Study 1, involving 642 Norwegian children, results indicated that for s-allele carriers only, caregiver-reported peer problems at age 4 predicted more parent-reported HI symptoms at age 6. In Study 2, similar results emerged involving 482 American children. Discussion focuses on differential sensitivity to the adverse effects of poor peer relations., (© 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.)

Background: To develop and validate a nomogram based on log of odds between the number of positive lymph node and the number of negative lymph node (LODDS) in predicting the overall survival (OS) and cancer specific survival (CSS) for epithelial ovarian cancer (EOC) patients., Materials and Methods: A total of 10,692 post-operative EOC patients diagnosed between 2004 and 2013 were obtained from the Surveillance, Epidemiology, and End Results (SEER) database and randomly divided into training (n = 7,021) and validation (n = 3,671) cohorts. Multiple clinical pathological parameters were assessed and compared with outcomes. Parameters significantly correlating with outcomes were used to build a nomogram. Bootstrap validation was subsequently used to assess the predictive value of the model., Results: In the training set, age at diagnosis, race, marital status, tumor location, stage, grade and LODDS were correlated significantly with outcome in both the univariate and multivariate analyses and were used to develop a nomogram. The nomogram demonstrated good accuracy in predicting OS and CSS, with a bootstrap-corrected concordance index of 0.757 (95% CI, 0.746-0.768) for OS and 0.770 (95% CI, 0.759-0.782) for CSS. Notably, in this population our model performed favorably compared to the currently utilized Federation of Gynecology and Obstetrics (FIGO) model, with concordance indices of 0.699 (95% CI, 0.688-0.710, P < 0.05) and 0.719 (95% CI, 0.709- 0.730, P < 0.05) for OS and CSS, respectively. Using our nomogram in the validation cohort, the C-indices were 0.757 (95% CI, 0.741-0.773, P < 0.05, compared to FIGO) for OS and 0.762 (95% CI, 0.746-0.779, P < 0.05, compared to FIGO) for CSS., Conclusions: LODDS works as an independent prognostic factor for predicting survival in patients with EOC regardless of the tumor stage. By incorporating LODDS, our nomogram may be superior to the currently utilized FIGO staging system in predicting OS and CSS among post-operative EOC patients.

Gender disparities in short- and long-term outcomes have been documented in cardiac and valvular heart surgery. However, there is a paucity of data regarding these differences in the bicuspid aortic valve (BAV) population. The aim of this study was to examine gender-specific differences in short- and long-term outcomes after surgical aortic valve (AV) replacement in patients with BAV. A retrospective analysis was performed in 628 consecutive patients with BAV who underwent AV surgery from April 2004 to December 2013. To reduce bias when comparing outcomes by gender, propensity score matching obtained on the basis of potential confounders was used. Women with BAV who underwent AV surgery presented with more advanced age (mean 60.7 ± 13.8 vs 56.3 ± 13.6 years, p <0.001) and less aortic regurgitation (29% vs 44%, p <0.001) and had a higher risk for in-hospital mortality (mean Ambler score 3.4 ± 4.4 vs 2.5 ± 4.0, p = 0.015). After propensity score matching, women received more blood products postoperatively (48% vs 34%, p = 0.028) and had more prolonged postoperative lengths of stay (median 5 days [interquartile range 5 to 7] vs 5 days [interquartile range 4 to 6], p = 0.027). Operative, discharge, and 30-day mortality and overall survival were not significantly different. In conclusion, women with BAV who underwent AV surgery were older, presented with less aortic regurgitation, and had increased co-morbidities, lending higher operative risk. Although women received more blood products and had significantly longer lengths of stay, short- and long-term outcomes were similar., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Background: Postsurgical late reinterventions for atrial fibrillation (AF) include cardioversions (CV) or catheter ablations (CA). Commonly used methods for reporting and modeling the frequency and timing of CA or CV have well-known shortcomings., Objective: The purpose of this study was to present intuitive and robust methods to visualize, summarize, and model late reinterventions type/timing and vital status simultaneously., Methods: We present (1) the SMART plot (Summary of Mortality And Outcomes Reported Over Time); (2) the reintervention mean cumulative function (MCF); and (3) the proportional means model and the proportional rates model. We illustrate these methods in 3 groups: patients age ≤60 years, 60-75 years (reference), and >75 years who underwent surgical AF ablation., Results: Patients age >75 years had a significantly lower MCF of CVs (hazard ratio [HR] 0.50, P <.001). MCF for CAs was not significantly lower for patients age >75 years (HR 0.57, P = .13). For combined reinterventions (CV or CA), the age group >75 years had a significantly lower MCF (HR 0.51, P <.001). There were no significant differences in late CV or CA reintervention patterns for patients age ≤60 years., Conclusion: The methods presented provide a comprehensive framework for displaying, summarizing, and modeling repeated late reinterventions after surgical AF ablation. Other areas of application are described, further emphasizing the potential for immediate use., (Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)

Background: Severe symptomatic aortic stenosis (AS) is associated with high mortality without intervention. The impact of waiting time for aortic valve replacement (AVR), either surgically or transcatheter, has not been reported., Methods: From January 2008 to December 2012, we identified 1,005 patients with severe symptomatic AS. AVR was recommended for 823 patients (82%). Of these 823 patients, 721 (87.6%) underwent AVR. We modeled overall survival (OS) since AVR recommendation or intervention date using Cox and multistate models., Results: Overall, the median (first, third quartiles) waiting time until operation was 2.9 (1.3, 5.1) weeks. Mortality at these times was lower (p<0.001) in the AVR group (1.2%, 0.3%, 1.7%, respectively) than in the group that did not receive AVR (6.9%, 2.9%, 9.8%, respectively). Thirty-day mortality after AVR was 3.9% (3.2% surgical AVR [SAVR] and 7.0% transcatheter AVR [TAVR]). In patients receiving AVR, waiting time was not associated with increased mortality. Mortality while waiting for AVR was 3.7% and 11.6% at 1 and 6 months, respectively. Mortality while waiting for TAVR was higher than that for SAVR (1-, 6-, and 12-month mortality of 3.7%, 8.0%, and 9.6%, respectively, in SAVR group and 3.8%, 23.3%, and 27.5%, respectively, in TAVR group; p<0.001)., Conclusions: Some patients do not receive AVR in a timely fashion, and prolonged waiting time for AVR is associated with mortality greater than the AVR operative mortality. Although waiting time was not associated with poor operative outcomes after AVR, many patients may die while waiting for AVR. Patients should receive AVR on a semiurgent, not elective, basis., (Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

We extended our previous genome-wide association study for psoriasis with a multistage replication study including 8,312 individuals with psoriasis (cases) and 12,919 controls from China as well as 3,293 cases and 4,188 controls from Germany and the United States and 254 nuclear families from the United States. We identified six new susceptibility loci associated with psoriasis in the Chinese study containing the candidate genes ERAP1, PTTG1, CSMD1, GJB2, SERPINB8 and ZNF816A (combined P < 5 × 10⁻⁸) and replicated one locus, 5q33.1 (TNIP1-ANXA6), previously reported (combined P = 3.8 × 10⁻²¹) in the European studies. Two of these loci showed evidence for association in the German study at ZNF816A and GJB2 with P = 3.6 × 10⁻³ and P = 7.9 × 10⁻³, respectively. ERAP1 and ZNF816A were associated with type 1 (early onset) psoriasis in the Chinese Han population (test for heterogeneity P = 6.5 × 10⁻³ and P = 1.5 × 10⁻³, respectively). Comparisons with the results of previous GWAS of psoriasis highlight the heterogeneity of disease susceptibility between the Chinese and European populations. Our study identifies new genetic susceptibility factors and suggests new biological pathways in psoriasis.

Joseph James Kinyoun (1860-1919), an American bacteriologist, was the first director of NIH (National Institute of Health). His interest in bacteriology and the work of isolation of the cholera organism laid the groundwork for the present health research program of NIH. In 1900, Kinyoun identified and confirmed the diagnosis in an outbreak of plague in San Francisco. In addition, Kinyoun contributed a lot in the prevention and antisepsis of diphtheria, the spread of knowledge of bacteriology, and research of public health.

The medical education of America gradually became one of the models of the advanced medical education throughout the world in the beginning of 20th century. The medical educational revolution in America led by the report of Flexner was an important foundation for the successful development of medical education in America. The occurrence of the Flexner Revolution was closely connected with the transformation of medical concepts and educational ideas which were led by the revolution in various social factors. So we can say that the Flexner Revolution was led by ideas.

Karl F. Meyer who was born in Switzerland was American famous bacteriologist of 20th century. During the World War II, Dr. Meyer urged the U. S. military to take positive reply measures against the bacteria war started by Japanese army and achieved significant accomplishments in the preventive and therapeutic theory of plague as well as the manufacture of plague vaccine. After the World War II, Meyer devoted to the scientific field of plague prevention and made great achievements in the area of animal diseases and public health. In 1951, he received the Lasker Award of America.