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Personal and family history of suicidal thoughts and behaviors (PSH and FSH, respectively) are significant risk factors associated with suicides. Research is limited in automatic identification of such data from clinical notes in Electronic Health Records. This study developed deep learning (DL) tools utilizing transformer models (Bio_ClinicalBERT and GatorTron) to detect PSH and FSH in clinical notes derived from three academic medical centers, and compared their performance with a rule-based natural language processing tool. For detecting PSH, the rule-based approach obtained an F1-score of 0.75 ± 0.07, while the Bio_ClinicalBERT and GatorTron DL tools scored 0.83 ± 0.09 and 0.84 ± 0.07, respectively. For detecting FSH, the rule-based approach achieved an F1-score of 0.69 ± 0.11, compared to 0.89 ± 0.10 for Bio_ClinicalBERT and 0.92 ± 0.07 for GatorTron. Across sites, the DL tools identified more than 80% of patients at elevated risk for suicide who remain undiagnosed and untreated. [ABSTRACT FROM AUTHOR]

The organ shortage continues to present problems around the world including the United States. In response, some countries have switched from an opt-in organ donor registry to an opt-out registry. The United States currently utilizes an opt-in registry where an individual is not considered an organ donor until they register their intentions. In the current study, U.S. adults were randomly assigned to a 2 (message valence: promotional, refutational) x 2 (autonomy restoration postscript: present, not present) x 2 (social proof: high likes, low likes) posttest only control group design evaluating social media message regarding an opt-out organ donor registry for implementation in the U.S. Results revealed an interaction between message valence and autonomy on freedom threat perceptions toward the message. Consistent with psychological reactance theory, freedom threat perceptions were positively associated with reactance, which in turn was positively associated with an intention to sign a petition and call a representative to voice disapproval of the opt-out organ donor registry. The discussion is focused on pragmatic recommendations for organ donor practitioners and advocates as well as the theoretical contributions to reactance theory. [ABSTRACT FROM AUTHOR]

In July 2020, rapper Megan Thee Stallion was shot by her then boyfriend Tory Lanez, a fellow rapper. The incident brought to the surface (again) a long, ongoing conversation about the experiences of Black women survivors of intimate partner violence, much like other high-profile cases (e.g., Tina Turner) have done before. Specifically, these cases show how Black men particularly can uphold patriarchal violence in intimate or romantic contexts. Moreover, these cases show the tensions that can arise when survivors seek help from law enforcement. For example, the idea of racial loyalty and not calling the police on a Black man and how this affects the options available to Black women. In other words, Black women often have nowhere to turn for help when they experience violence. In this article, I employ Black Feminist Autoethnography as a methodological framework to analyze a personal instance of road rage where I was attacked, to explore how Black women survivors make meaning of their experiences, the thought process behind their decision to involve the police, how Black men uphold patriarchal violence in non-intimate contexts, and how Black women resist or refuse to accept the violence. This analysis reveals the raced and gendered components underlying the private/public nature of interpersonal violence experienced by Black women and the relationship between intimate and non-intimate interpersonal violence. Implications for qualitative social work research and practice include the use of Black Feminist Autoethnography as a methodological framework to identify areas of empowerment, strength, and support for survivors of violence. [ABSTRACT FROM AUTHOR]

The United States has an increasing number of people from around the world, which has led to a rise in mixed-citizenship romantic relationships. Yet, these relationships and family structures remain significantly understudied. Mixed-citizenship romantic relationships, referring to individuals in a romantic relationship who hold or previously held different citizenships, are faced with various unique experiences in comparison to same-citizenship romantic relationships (e.g. immigration rhetoric, filing of paperwork, and financial obligations). Grounded in relational dialectics theory, this study examined how discourses operate and inform the meaning of mixed-citizenship romantic relationships, as well as the ways discourses compete. Through 15 semi-structured interviews, results reveal two discourses: A Discourse of Love is the Driving Force and A Discourse of Material Uncertainty. Moreover, discourses competed for dominance and, at times, intersected to create new meanings. Findings illuminate implications of talk for members of mixed-citizenship relationships, and offer suggestions for practitioners in communicating about these consequences. [ABSTRACT FROM AUTHOR]

Background The endemic coronaviruses OC43, HKU1, NL63, and 229E cause cold-like symptoms and are related to SARS-CoV-2, but their natural histories are poorly understood. In a cohort of children followed from birth to 4 years, we documented all coronavirus infections, including SARS-CoV-2, to understand protection against subsequent infections with the same virus (homotypic immunity) or a different coronavirus (heterotypic immunity). Methods Mother–child pairs were enrolled in metropolitan Cincinnati during the third trimester of pregnancy in 2017-2018. Mothers reported their child's sociodemographics, risk factors, and weekly symptoms. Mid-turbinate nasal swabs were collected weekly. Blood was collected at 6 weeks, 6, 12, 18, 24 months, and annually thereafter. Infections were detected by testing nasal swabs by an RT-PCR multi-pathogen panel and by serum IgG responses. Health care visits were documented from pediatric records. Analysis was limited to 116 children with high sample adherence. Reconsent for monitoring SARS-CoV-2 infections from June 2020 through November 2021 was obtained for 74 (64%) children. Results We detected 345 endemic coronavirus infections (1.1 infections/child-year) and 21 SARS-CoV-2 infections (0.3 infections/child-year). Endemic coronavirus and SARS-CoV-2 infections were asymptomatic or mild. Significant protective homotypic immunity occurred after a single infection with OC43 (77%) and HKU1 (84%) and after two infections with NL63 (73%). No heterotypic protection against endemic coronaviruses or SARS-CoV-2 was identified. Conclusions Natural coronavirus infections were common and resulted in strong homotypic immunity but not heterotypic immunity against other coronaviruses, including SARS-CoV-2. Endemic coronavirus and SARS-CoV-2 infections in this US cohort were typically asymptomatic or mild. [ABSTRACT FROM AUTHOR]

Demographic shifts and the growth of diversity, equity, and inclusion (DEI) initiatives are occurring simultaneously on college campuses. This study seeks to understand their intersection by focusing on age in DEI initiatives on college campuses. Findings from six focus groups suggest that age is not given much attention in DEI initiatives. Participants acknowledge the issue of age; but in general, they strive to keep other identities, like race and gender, in the forefront, especially in the face of low resources. While it may be difficult to elevate age in DEI initiatives on campuses, interventions were identified. [ABSTRACT FROM AUTHOR]

Science has a history of excluding marginalized groups, including people who are lesbian, gay, bisexual, trans, queer, and other marginalized gender and sexual identities (LGBTQ+), and recent calls urge the wildlife sciences to address disparities. Literature on inclusion in the life sciences generally has focused on personal affirmation and has neglected comprehensive discussion of barriers rooted in historical, structural, and sociocultural context. In our literature review, we construct a narrative highlighting the intersections between historic LGBTQ+ exclusion in society and wildlife science due to current policy trends, pressures of cis‐heteronormativity, and survival barriers on LGBTQ+ people in wildlife sciences in the United States. Wildlife scientists must have competency on LGBTQ+ marginalization topics to advance inclusion in our discipline, and this should include comprehension of historic and current legislation and social perceptions. To bolster inclusion efforts, we recommend thoughtful data collection on experiences of LGBTQ+ people within the wildlife sciences. To address root causes of exclusion, institutions and organizations should address disparities in financial support, housing, and physical and mental health resources as part of LGBTQ+ advocacy, in addition to interpersonal efforts. [ABSTRACT FROM AUTHOR]

Background Respiratory viral shedding is incompletely characterized by existing studies due to the lack of longitudinal nasal sampling and limited inclusion of healthy/asymptomatic children. We describe characteristics associated with prolonged virus detection by polymerase chain reaction (PCR) in a community-based birth cohort. Methods Children were followed from birth to 2 years of age in the PREVAIL cohort. Weekly nasal swabs were collected and tested using the Luminex Respiratory Pathogen Panel. Weekly text surveys were administered to ascertain the presence of acute respiratory illnesses defined as fever and/or cough. Maternal reports and medical chart abstractions identified healthcare utilization. Prolonged virus detection was defined as a persistently positive test lasting ≥4 weeks. Factors associated with prolonged virus detection were assessed using mixed effects multivariable logistic regression. Results From a sub-cohort of 101 children with ≥70% weekly swabs collected, a total of 1489 viral infections were detected. Prolonged virus detection was found in 23.4% of viral infections overall, 39% of bocavirus infections, 33% of rhinovirus/enterovirus infections, 14% of respiratory syncytial virus (RSV) A infections, and 7% of RSV B infections. No prolonged detection was found for influenza virus A or B, coronavirus 229E or HKU1, and parainfluenza virus 2 or 4 infections. First-lifetime infection with each virus, and co-detection of another respiratory virus were significantly associated with prolonged detection, while symptom status, child sex, and child age were not. Conclusions Prolonged virus detection was observed in 1 in 4 viral infections in this cohort of healthy children and varied by pathogen, occurring most often for bocavirus and rhinovirus/enterovirus. Evaluating the immunological basis of how viral co-detections and recurrent viral infections impact duration of virus detection by PCR is needed to better understand the dynamics of prolonged viral shedding. [ABSTRACT FROM AUTHOR]

Correlational research finds that transgender youth who have been homeless are more likely to have attempted suicide; however, there is not yet research explaining why this correlation might exist. To understand connections between housing insecurity and suicidality for transgender people the present study analyzed in-depth interviews with 30 transgender young people (ages 15–25) in the United States who had experienced homelessness. Interviews took place in LGBTQ community centers, and were analyzed for inductive themes using Qualitative Content Analysis. In contrast with theories suggesting that homelessness predicts increased suicidality because of the stressors of homelessness, this study found that gender-based parental rejection and other dysfunctional family dynamics interacted to create a hostile environment that contributed to both suicidality and homelessness for trans participants. In fact, suicide attempts occurred most often while participants still lived in disaffirming homes and usually ceased after participants left the unsafe home, suggesting that leaving a disaffirming family home, even if it results in homelessness, may decrease suicidality for some youth. Findings suggest that service providers working with transgender youth experiencing homelessness must consider familial gender disaffirmation, other familial stressors, and lack of access to shelter as equal threats to trans youth's wellbeing and design interventions accordingly. [ABSTRACT FROM AUTHOR]

Summary: Background: An approved therapy for nonalcoholic steatohepatitis (NASH) and fibrosis remains a major unmet medical need. Aim: To investigate the histological and metabolic benefits of pegozafermin, a glycoPEGylated FGF21 analogue, in subjects with biopsy‐confirmed NASH. Methods: This proof‐of‐concept, open‐label, single‐cohort study, part 2 of a phase 1b/2a clinical trial, was conducted at 16 centres in the United States. Adults (age 21–75 years) with NASH (stage 2 or 3 fibrosis, NAS≥4) and magnetic resonance imaging proton density fat fraction (MRI‐PDFF) ≥8% received subcutaneous pegozafermin 27 mg once weekly for 20 weeks. Primary outcomes were improvements in liver histology, and safety and tolerability. Results: Of 20 enrolled subjects, 19 completed the study. Twelve subjects (63%) met the primary endpoint of ≥2‐point improvement in NAFLD activity score with ≥1‐point improvement in ballooning or lobular inflammation and no worsening of fibrosis. Improvement of fibrosis without worsening of NASH was observed in 26% of subjects, and NASH resolution without worsening of fibrosis in 32%. Least‐squares mean relative change from baseline in MRI‐PDFF was −64.7% (95% CI: −71.7, −57.7; p < 0.0001). Significant improvements from baseline were also seen in serum aminotransferases, noninvasive fibrosis tests, serum lipids, glycaemic control and body weight. Adverse events (AEs) were reported in 18 subjects (90%). The most frequently reported AEs were mild/moderate nausea and diarrhoea. There were no serious AEs, discontinuations due to AEs, or deaths. Conclusions: Pegozafermin treatment for 20 weeks had beneficial effects on hepatic and metabolic parameters and was well tolerated in subjects with NASH. ClinicalTrials.gov: NCT04048135. [ABSTRACT FROM AUTHOR]

Purpose: The authors assessed common content knowledge of health-related fitness in a national representative sample of preservice physical education teachers in the United States. Methods: Six hundred and twenty-one preservice physical education teachers from 68 physical education teacher education (PETE) programs located in different regions in the United States completed the 40 multiple choice items health-related fitness knowledge test during the semester prior to their student teaching. In addition, each PETE program coordinator/department head completed the PETE Program Information Questionnaire. Results: The mean percentage correct on the test was 61.3% (M = 24.5, SD = 4.9). Analyses of variance and t-test analyses indicated that common content knowledge of health-related fitness was not a function of sex, program size, or region of the United States. Discussion/Conclusions: These data suggest that preservice physical education teachers in the United States lack common content knowledge of health-related fitness and warrant the attention of PETE programs. [ABSTRACT FROM AUTHOR]

De novo events appear more common in female and simplex autism spectrum disorder (ASD) cases and may underlie greater ASD risk in older fathers' offspring. This study examined whether advancing paternal age predicts an increase in simplex (n = 90) versus multiplex ASD cases (n = 587) in 677 participants (340 families). Whether or not controlling for maternal age, results support a significant interaction of linear paternal age and sex of the child on simplex family type. Female ASD cases were significantly more likely to be simplex as paternal age increased, but the increase for males was not significant. Findings suggest that ASD arising from non-familial, de novo events may be far less prominent in males than in females, even if more prevalent in males, due to the substantially larger number of male cases attributable to other, more strongly male-biased risk factors. (Contains 2 figures and 3 tables.)

Background: Sources of sexual health information exert strong influence on adolescents' sexual behavior. Purpose: The current study was undertaken to understand how family serve as sexual information sources, the messages adolescents recall from family, and how family learning experiences affect sexual behavior among at-risk adolescents. Methods: Individual interviews were conducted with 69 teens, ages 15-18 years, from an alternative high school and a juvenile correctional facility to capture adolescents' early sexual health learning experiences involving family and evaluate their association with teens' recent sexual behavior. Sexual learning narratives were compared among gender and sexual experience groups. Results: Many participants identified family as sexual health information sources. Primary messages recalled: risks of sex, protection, and relationship advice. Many adolescents portrayed learning experiences as negative, cautionary, lacking detail and not always balanced with positive messages. Participants who reported four or more sexual risks were the only group to identify pornography as a sexual health information source. Participants who reported fewer than four sexual risks were most likely to identify family sexual health information sources. Discussion: Participants identified family members as sources of sexual health information, with variations by gender. Negative/cautionary messages require teens to seek additional sexual information elsewhere (primarily friends/media). Males, in particular, appear to often lack familial guidance/education. Translation to Health Education Practice: Sexual health messages should be tailored to adolescents' needs for practical and sex-positive guidance regarding mechanics of sex and formation of healthy relationships, and balanced with cautions regarding negative consequences. (Contains 2 tables.)

Statewide physical fitness testing is gaining popularity in the United States because of increased childhood obesity levels, the relations between physical fitness and academic performance, and the hypothesized relations between adult characteristics and childhood physical activity, physical fitness, and health behaviors. Large-scale physical fitness testing can be fraught with problems unless properly planned and conducted. Legislators, administrators, teachers, and parents should consider the following 10 essential issues when conducting large-scale physical fitness testing: purpose of testing, proper planning, training, quality of the data, reporting, support, costs, interpretation, programmatic matters, and policies and politics. (Contains 2 figures and 1 table.)

Mary Perkins Ryan remains one of the least recognized of the twentieth-century figures in the modern renewal of Catholic education in the United States. The reasons are many but none satisfactory. Ryan was an intellectual without a scholarly credential. She was an educator without an affiliation to an academic institution. She was a leading voice for professional standards in church religious education without ever serving in either a parish or diocesan role. Ryan worked alongside the giants of twentieth-century Catholic educational history - Gerard Sloyan, Johannes Hofinger, Gabriel Moran, Berard Marthaler, Maria Harris, Gloria Durka, and Thomas Groome. Their shadow cast long and may be the reason why despite her leadership in the American liturgical movement and her visionary stance on adult religious education, Ryan still remains on the margins of Catholic educational history. The purpose of this article is to illustrate how Ryan's intellectual corpus, which includes twenty-four authored works and two decades of editorial direction at The Living Light and Professional Approaches for Christian Educators (PACE), justifies her place alongside the more established figures of her time. It is to reclaim a leadership role for Ryan as a visionary in the modern renewal of Catholic education and in so doing to move her contributions from the margins to the main text of that history.

This article shares the opinions of several leaders in technology education regarding the need for a national curriculum for technology literacy. Laura Johnson Hummell, a North Carolina middle school technology education teacher and doctoral candidate at East Carolina University, believes that the United States should have a national curriculum for technological literacy to avoid the inconsistencies that currently exist. Ethan B. Lipton, Ph.D., DTE, Assistant Vice President for Academic Affairs/Dean, Educational Support Services at California State University in Los Angeles, says while the implementation of a national curriculum may initially appear inviting, it is not the solution because it is inconsistent with past and current views in the United States that continue to place the responsibility for curricular decisions related to all subjects at the state and local levels. Mellissa Morrow, Director of Career and Technical Education Sarasota County School Board, Sarasota, Florida, states that a national curriculum for technological literacy is critical if technology educators hope to move forward with widespread implementation of "Standards for Technological Literacy." Jerry Streichler, DTE, a member of the ITEA Academy of Fellows, believes that the goal of implementing a "national curriculum" will be frustrated by timing and political hurdles. Karen Zuga, Program Director, Division of Elementary, Secondary, and Informal Education at the National Science Foundation in Arlington, Virginia, says he has never been an advocate of a national curriculum, and even though there appear to be some advantages to having one, he is still opposed to a "one size fits all" approach to education.

The current state of physical fitness in American youth is unknown. While evidence exists that obesity levels are increasing in children and youth, data on declines in physical fitness measures (i.e., cardiorespiratory and musculoskeletal fitness) are lacking. Tracking of physical fitness components has been poorly done. Surveillance of behaviors known to relate to health-related fitness (e.g., physical activity, sedentariness) and actual health-related fitness outcomes (e.g., cardiorespiratory fitness, body composition, musculoskeletal health, and, perhaps, blood lipids, cholesterol, etc.) are important to measure. Both behaviors and outcomes are important to measure--if they are not measured, people perceive them as "not" important. In this paper, the author asserts that it is time that well defined, valid measures of health-related fitness components are identified and procedures are developed that permit surveillance and tracking of physical fitness components in children and youth. Development of surveillance systems should include many interested parties, the medical profession, professional organizations (e.g., AAHPERD and ACSM), governmental agencies (e.g., PCPFS, CDC, and HHS), teachers, epidemiologists, research scientists, measurement experts, and parents. It will be difficult to arrive at the appropriate process and measures to obtain. Nonetheless, it is an important task. It is time to initiate surveillance that results in meaningful data with which to make evidenced-based decisions about fitness levels that impact curricular and health decisions. (Contains 4 tables and 4 figures.)

Breast cancer (BC) is among the most frequently diagnosed malignant cancers in women in the United States. Diet and nutrition supplementation are closely related to BC onset and progression, and inulin is commercially available as a health supplement to improve gut health. However, little is known with respect to inulin intake for BC prevention. We investigated the effect of an inulin-supplemented diet on the prevention of estrogen receptor-negative mammary carcinoma in a transgenic mouse model. Plasma short-chain fatty acids were measured, the gut microbial composition was analyzed, and the expression of proteins related to cell cycle and epigenetics-related genes was measured. Inulin supplementation greatly inhibited tumor growth and significantly delayed tumor latency. The mice that consumed inulin had a distinct microbiome and higher diversity of gut microbial composition compared to the control. The concentration of propionic acid in plasma was significantly higher in the inulin-supplemented group. The protein expression of epigenetic-modulating histone deacetylase 2 (Hdac2), Hdac8, and DNA methyltransferase 3b decreased. The protein expression of factors related to tumor cell proliferation and survival, such as Akt, phospho-PI3K, and NF-kB, also decreased with inulin administration. Furthermore, sodium propionate showed BC prevention effect in vivo through epigenetic regulations. These studies suggest that modulating microbial composition through inulin consumption may be a promising strategy for BC prevention. [ABSTRACT FROM AUTHOR]

This paper summarizes recent events concerning the evaluation of doctoral programs in kinesiology and physical education. An overview is provided of issues related to the evaluation process used by the National Research Council (NRC). The American Academy of Kinesiology and Physical Education (AAKPE) has developed a proposal to have our field included in the upcoming evaluation of doctoral programs conducted by the NRC currently scheduled for 2007. Also described is an overview of the plan by the AAKPE to conduct its own evaluation of doctoral programs in 2005. Finally, a listing of the 62 identified doctoral programs in our field is presented along with some program characteristics. (Contains 1 table.)

We used an optimized configuration of the delayed-response task to explore the ability of young infants to remember which of 2 locations was correct across 12 trials after a 1- to 2-sec delay. Performance improved with age, particularly after 5.5 months. These findings suggest an onset of appreciable working memory for many infants in the middle of their 6th month. (Contains 2 figures and 1 table.)

The objective of this study was to determine the clinical features that moderate a later age at ASD diagnosis in females in a large sample of females with ASD. Within two large and independent ASD datasets (> 20,000 females), females were first diagnosed with ASD 14-months later relative to males. This later age at diagnosis was moderated by a mild or atypical presentation, wherein repetitive behaviors were limited, IQ and language were broadly intact, and recognized symptoms emerged later in development. Females are at risk for a later age at ASD diagnosis and treatment implementation, and modification of early childhood ASD screening methods for females may be warranted. [ABSTRACT FROM AUTHOR]

Purpose: This article provides a review of current trends in social work licensure and regulation in the United States. Methods: Topics include practice regulation, the purpose of licensure, the gap between social work education and regulation, and practice mobility. Results: Recommendations for advancing licensure and regulation practices for the future are also provided. Conclusion: Includes narrowing the gap between Council on Social Work Education standards and Association of Social Work Boards exam content, improving licensure preparation in educational settings, resolving macro practice concerns about social work licensure, developing consistency across license titles, providing transparency in exam pass rate demographics, achieving practice mobility, and advancing empirical research on testing and practice competence. [ABSTRACT FROM AUTHOR]

We examined the concurrent relations of children's reactive and proactive aggression with their experience of peer victimization. Extending previous research, we assessed these relations at both the child and classroom levels. We predicted that reactive aggression would relate positively to peer victimization, proactive aggression would relate negatively to peer victimization, and that these relations would vary with classroom levels of aggression. Participants included 1,291 fourth- and fifth-grade children (681 girls; M age = 10.14 years) and their 72 teachers from 9 schools in one public school district in the Mid-Atlantic United States. Children completed self-report measures of peer victimization and teachers completed measures of aggression for each child in their classrooms. Via two-level regression (level 1 = child; level 2 = classroom), reactive aggression related positively to peer victimization and proactive aggression related negatively to peer victimization. The positive relation between reactive aggression and peer victimization was only significant in classrooms with low levels of reactive aggression. The negative relation between proactive aggression and peer victimization was only significant in classrooms with low levels of proactive aggression. Our hypotheses were supported and offered further evidence for differential relations of reactive and proactive aggression with peer victimization at the child level, while demonstrating the important role of classroom norms for aggression in moderating these relations. [ABSTRACT FROM AUTHOR]

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The number of newly diagnosed children with type 1 diabetes is increasing and continuous glucose monitoring (CGM) management tools are a popular choice among children and young people. These tools provide continuous visualisation of blood glucose and allow for tighter glycaemic control. Using an anonymous survey, this USbased study examined sleep deprivation and alarm fatigue in parents and caregivers of children with type 1 diabetes using CGM. The survey adapted the Alarm Fatigue Scale and the Pittsburgh Sleep Quality Index. The authors conclude that healthcare professionals should offer caregivers support options for coping with the detrimental effects of continuous monitoring. [ABSTRACT FROM AUTHOR]

Background: Research has indicated disagreement between physicians, caregivers, and adolescents with special health care needs regarding appropriate risk counseling.Objective: The study examines caregivers' perceptions of adolescent risk counseling. We hypothesize caregivers of adolescents with special healthcare needs will perceive a lower rate of risk counseling.Methods: Data come from the 2016 National Survey of Children's Health. The sample included 13,542 adolescents. Analysis completed using logistic regression with odds ratios.Results: The results indicate no difference in caregiver perceptions of risk counseling for adolescents with special healthcare needs. Gender, race/ethnicity, and relationship between caregiver and provider influenced perception of receipt of risk counseling, regardless of health status.Conclusions: Although adolescents with special healthcare needs perceive their risk behavior counseling to be lacking in quantity/quality, caregivers perceive such counseling does occur. These results highlight the need for comprehensive risk counseling for groups at risk of known health disparities.Practice Implications: Physicians and providers should be provided with the training and resources needed to be comfortable to engage in risk counseling. Adolescents need the opportunity to see their provider privately, and education to advocate for information risky behaviors. Parents, providers, and adolescents should be included in future risk counseling intervention plans. [ABSTRACT FROM AUTHOR]

Multiple studies have shown the microbiota to be abnormal in patients with spondyloarthritis (SpA). The purpose of this study was to explore the genetic contributions of these microbiota abnormalities. We analyzed the impact of HLA-B27 on the microbiota of children at risk for SpA and compared the microbiota of HLA-B27+ pediatric offspring of ankylosing spondylitis (AS) patients with that of HLA-B27+ children with SpA. Human DNA was obtained from the offspring for determination of HLA-B27 status and polygenic risk score (PRS). Fecal specimens were collected from both groups for sequencing of the V4 region of the 16S ribosomal RNA gene. Among the offspring of AS patients, there was slight clustering by HLA-B27 status. After adjusting for multiple comparisons, five operational taxonomic units (OTUs) representing three unique taxa distinguished the HLA-B27+ from negative children: Blautia and Coprococcus were lower in the HLA-B27+ offspring, while Faecalibacterium prausnitzii was higher. HLA-B27+ offspring without arthritis were compared to children with treatment-naïve HLA-B27+ SpA. After adjustments, clustering by diagnosis was present. A total of 21 OTUs were significantly associated with diagnosis state, including Bacteroides (higher in SpA patients) and F. prausnitzii (higher in controls). Thus, our data confirmed associations with B. fragilis and F. prausnitzii with juvenile SpA, and also suggest that the mechanism by which HLA-B27 is associated with SpA may not involve alterations of the microbiota. [ABSTRACT FROM AUTHOR]

Background: Although multiple risk factors for development of pneumonia in patients with trauma sustained in a motor vehicle accident have been studied, the effect of prehospital time on pneumonia incidence post-trauma is unknown.Research Question: Is prolonged prehospital time an independent risk factor for pneumonia?Study Design and Methods: We retrospectively analyzed prospectively collected clinical data from 806,012 motor vehicle accident trauma incidents from the roughly 750 trauma hospitals contributing data to the National Trauma Data Bank between 2010 and 2016.Results: Prehospital time was independently associated with development of pneumonia post-motor vehicle trauma (P < .001). This association was primarily driven by patients with low Glasgow Coma Scale scores. Post-trauma pneumonia was uncommon (1.5% incidence) but was associated with a significant increase in mortality (P < .001, 4.3% mortality without pneumonia vs 12.1% mortality with pneumonia). Other pneumonia risk factors included age, sex, race, primary payor, trauma center teaching status, bed size, geographic region, intoxication, comorbid lung disease, steroid use, lower Glasgow Coma Scale score, higher Injury Severity Scale score, blood product transfusion, chest trauma, and respiratory burns.Interpretation: Increased prehospital time is an independent risk factor for development of pneumonia and increased mortality in patients with trauma caused by a motor vehicle accident. Although prehospital time is often not modifiable, its recognition as a pneumonia risk factor is important, because prolonged prehospital time may need to be considered in subsequent decision-making. [ABSTRACT FROM AUTHOR]

What skills and dispositions are most important for higher education assessment professionals to be successful in their work? Emerging professionals and their instructors must be cognizant of what skills and dispositions are necessary in order to be adequately prepared for this work. Utilizing a survey instrument that was developed based on recent research and validated by a panel of experts in higher education assessment, we surveyed 213 higher education assessment professionals from across the United States, assessing their perceptions on the importance of 92 skills and 52 dispositions. We analyzed responses by utilizing descriptive statistics for closed-ended items and thematic analysis of open-ended items. A discussion of the findings, including what skills and dispositions were deemed most important, as well as implications for future research and professional identity are discussed. [ABSTRACT FROM AUTHOR]

Background: Selective dorsal rhizotomy (SDR) is a neurosurgical intervention to reduce spasticity in children with cerebral palsy. Parents researching SDR for their child may be influenced by framing of SDR in news media articles they read. This study examined framing of SDR in English‐language news media. Methods: Content analysis of English‐language news media articles including the search term 'rhizotomy' in the Factiva database published July 2015 to July 2018 in online or print form in Canada, New Zealand, Australia, United States of America and the United Kingdom. Results: One hundred and eighty‐six articles were identified describing 91 different children (45 male), almost all with cerebral palsy, median age 4 years old. One hundred and twenty‐six articles were written prior to surgery; in many articles, SDR surgery involved travel overseas and/or fundraising. SDR was described universally in positive terms with little discussion of risks. Content of articles variably included the specialized nature of SDR, parental frustration with their local health system and their hope for positive outcomes. There was geographical variation in both numbers of articles and content. Conclusions: SDR is a common focus in cerebral palsy news media articles in some countries. Framing in these articles supports SDR as a beneficial and specialized procedure and may lead families to believe they need to work outside their local health systems. As news media are likely an important influence on families' attitudes to SDR, clinicians should be aware of this influence. [ABSTRACT FROM AUTHOR]

Introduction. This study was a mixed-methods, multisite design, which aimed to determine incidence and severity of depression, anxiety, and stress in Doctor of Physical Therapy (DPT) students and to explore the lived experience of students managing mental illness while completing their academic requirements. Methods. Surveys were emailed to DPT programs and forwarded to students. Students enrolled in 238 DPT programs across the United Sates were eligible for inclusion. A total of 1,238 students completed both surveys. Of those who completed the surveys, 20 volunteers were randomly selected for and completed telephone interviews. Doctor of Physical Therapy students (N = 1,228) completed 2 surveys, including the Depression, Anxiety, and Stress Scale (DASS); 20 of these students volunteered to interview. Students who volunteered were invited to participate based on the DASS results. A total of 20 semi-structured interviews were completed. Results. Doctor of Physical Therapy students were found to have higher DASS scores than their age-matched peers in Depression t(1,227) = 2.91, P = .029; Anxiety t(1,227) = 7.33, P ≤ .005; and Stress t(1,227) = 10.76, P ≤ .005. First-year students were found to have significantly higher levels of anxiety (P = .001) and stress (P = .019) as compared with third-year students. Four major themes emerged from the interview data. Theme 4-Fear of Failure Drives Perfection was familiar to the construct of social perfectionism (SP), which has been linked to maladaptive tendencies and mental health disorders, including suicidal ideation. Discussion/Conclusions. Doctor of Physical Therapy students have statistically higher DASS scores when compared with their age-matched peers. First-year students seem to be at higher risk for developing anxiety and stress. The construct of SP may influence the depression, anxiety, and stress described by DPT students. Doctor of Physical Therapy programs may want to consider methods to identify maladaptive perfectionism and strategies to enhance students' ability to manage factors affecting their mental health based on the qualitative findings of this study. [ABSTRACT FROM AUTHOR]

Background and Objectives Adopting healthy behaviors is often influenced by message framing; gain-framed messages emphasize the benefits of engaging in a behavior, whereas loss-framed messages highlight the consequences of not engaging in a behavior. Research has begun to uncover the underlying affective pathways involved in message framing. In the current study, we examined the role of affect in message framing to encourage exercise program enrollment among older adults. Research Design and Methods We mailed flyers to 126 volunteers assigned to a gain- or loss-framed condition and measured their affective reactions to the flyer and enrollment intentions. After the call, participants had the opportunity to contact us to enroll. Results Gain versus loss framing led to more positive affect toward the flyer, which predicted intentions and enrollment effort. In indirect effect analyses, frame indirectly influenced intentions and enrollment effort via positive affect. Discussion and Implications Although message framing plays an indirect role in influencing behavior, affect plays a central role. [ABSTRACT FROM AUTHOR]

Existing research on spousal care focuses on one spouse receiving care from the other, which fails to address the complexity that is created when both spouses experience some impairments. Our study included situations in which one or both spouses have functional impairments when examining the extent to which spouses from the same couple hold a (dis)similar level of functional impairment and whether such within‐couple (dis)similarity has an impact on the spousal care arrangement. A subsample of 1170 older married couples was selected from the 2014 Health and Retirement Study. Descriptive statistics were used for describing the level of each spouse's functional impairment regarding the number of limitations in activities (activities of daily living [ADL]) or instrumental ADL (IADL). Logistic regressions were used to examine whether spousal dissimilarity in functional impairment (dissimilar, similarly low, similarly high) was associated with spousal care arrangement. Within couples with one functionally impaired spouse, the impaired spouse was more likely to receive spousal care when reporting a higher level of ADL/IADL impairment. Within couples with two functionally impaired spouses, the more impaired person was more likely to receive spousal care (without giving back) when spouses reported dissimilar level of IADL impairment; spouses were more likely to report mutual care when they had similarly high levels of IADL impairment. By documenting the role of spousal dissimilarities in functioning for determining spousal care arrangement, our study can inform couple‐based interventions that capitalize on each spouse's capabilities and resources. [ABSTRACT FROM AUTHOR]

Objective: Hypotension following endotracheal intubation in the ICU is associated with poor outcomes. There is no formal prediction tool to help estimate the onset of this hemodynamic compromise. Our objective was to derive and validate a prediction model for immediate hypotension following endotracheal intubation. Methods: A multicenter, prospective, cohort study enrolling 934 adults who underwent endotracheal intubation across 16 medical/surgical ICUs in the United States from July 2015-January 2017 was conducted to derive and validate a prediction model for immediate hypotension following endotracheal intubation. We defined hypotension as: 1) mean arterial pressure <65 mmHg; 2) systolic blood pressure <80 mmHg and/or decrease in systolic blood pressure of 40% from baseline; 3) or the initiation or increase in any vasopressor in the 30 minutes following endotracheal intubation. Results: Post-intubation hypotension developed in 344 (36.8%) patients. In the full cohort, 11 variables were independently associated with hypotension: increasing illness severity; increasing age; sepsis diagnosis; endotracheal intubation in the setting of cardiac arrest, mean arterial pressure <65 mmHg, and acute respiratory failure; diuretic use 24 hours preceding endotracheal intubation; decreasing systolic blood pressure from 130 mmHg; catecholamine and phenylephrine use immediately prior to endotracheal intubation; and use of etomidate during endotracheal intubation. A model excluding unstable patients' pre-intubation (those receiving catecholamine vasopressors and/or who were intubated in the setting of cardiac arrest) was also developed and included the above variables with the exception of sepsis and etomidate. In the full cohort, the 11 variable model had a C-statistic of 0.75 (95% CI 0.72, 0.78). In the stable cohort, the 7 variable model C-statistic was 0.71 (95% CI 0.67, 0.75). In both cohorts, a clinical risk score was developed stratifying patients' risk of hypotension. Conclusions: A novel multivariable risk score predicted post-intubation hypotension with accuracy in both unstable and stable critically ill patients. Study registration: Clinicaltrials.gov identifier: NCT02508948 and Registered Report Identifier: RR2-10.2196/11101. [ABSTRACT FROM AUTHOR]

To our knowledge, environmental isolation of Burkholderia pseudomallei, the causative agent of melioidosis, from the continental United States has not been reported. We report a case of melioidosis in a Texas resident. Genomic analysis indicated that the isolate groups with B. pseudomallei isolates from patients in the same region, suggesting possible endemicity to this region. [ABSTRACT FROM AUTHOR]

Background: Recent studies that compared patient spending in hospital-owned physician practices versus physician-owned groups did not compare quality of care. Past studies had incomplete measures of physician-hospital integration, or lacked patient-level data.Objective: To measure the association between physician-hospital integration and both spending and quality using patient-level data and explicit physician-hospital contracting information.Design: Retrospective review of claims data from 2014 through 2016. Adjustments were made for patient, physician, and regional characteristics.Patients: Patients aged 19 to 64 enrolled in a Blue Cross Blue Shield Texas Preferred Provider Organization in the four largest metropolitan areas in Texas who could be attributed to a physician practice based on claims.Main Outcomes and Measures: Annual spending per patient was compared for patients treated by a physician practice that is billing through a hospital, versus billing through an independent physician practice; spending was also subdivided by BETOS category, by site and type of care, and percent of patients with positive spending by subcategory. Quality measures included readmission within 30 days of discharge for hospitalized patients, appropriate care for diabetic patients, and screening mammography for women ages 50-64.Results: Estimates suggest that patients in a preferred provider organization incur spending which is 5.8 percentage points higher when treated by doctors in hospital-owned versus physician-owned practices (95% CI 1.7 to 9.9; p = 0.006). Spending is significantly higher for durable medical equipment, imaging, unclassified services, and outpatient care. The spending difference appears attributable to greater service utilization rather than higher prices. There was no consistent difference in care quality for hospital-owned versus physician-owned practices.Conclusions and Relevance: We find that financial integration between physicians and hospitals raises patient spending, but not care quality. Given that higher spending raises the price of health insurance, policy makers should carefully consider policies that limit consolidation of hospitals and physicians. [ABSTRACT FROM AUTHOR]

Determines the physical activity behaviors and stage of readiness for physical activity among older adults in the U.S. Perceived benefits of physical activity; Correlation between age and physical activity involvement; Implications for improving the involvement of adults in physical activity.

We report the case of a young male refugee from Afghanistan who presented after a violent suicide attempt, likely precipitated in part by discrimination and social isolation experienced after immigrating to the United States. Common psychiatric comorbidities associated with immigration from war-torn nations are reviewed with a particular emphasis on how adequate screening and additional resources for vulnerable refugees during and after immigration continues to be an unmet need. Our findings suggest that there is a critical need and additional studies should be conducted, not only to identify at risk refugee populations but also to prevent potentially violent behavior. Our findings also suggest a lack of an optimal screening tool and shed light on the struggles of refugees, particularly those from Afghanistan. [ABSTRACT FROM AUTHOR]

Conotruncal heart defects (CTDs) are among the most common and severe groups of congenital heart defects. Despite evidence of an inherited genetic contribution to CTDs, little is known about the specific genes that contribute to the development of CTDs. We performed gene-based genome-wide analyses using microarray-genotyped and imputed common and rare variants data from two large studies of CTDs in the United States. We performed two case-parent trio analyses (N = 640 and 317 trios), using an extension of the family-based multi-marker association test, and two case-control analyses (N = 482 and 406 patients and comparable numbers of controls), using a sequence kernel association test. We also undertook two meta-analyses to combine the results from the analyses that used the same approach (i.e. family-based or case-control). To our knowledge, these analyses are the first reported gene-based, genome-wide association studies of CTDs. Based on our findings, we propose eight CTD candidate genes (ARF5, EIF4E, KPNA1, MAP4K3, MBNL1, NCAPG, NDFUS1 and PSMG3). Four of these genes (ARF5, KPNA1, NDUFS1 and PSMG3) have not been previously associated with normal or abnormal heart development. In addition, our analyses provide additional evidence that genes involved in chromatin-modification and in ribonucleic acid splicing are associated with congenital heart defects. [ABSTRACT FROM AUTHOR]

With the declining ability to use lethal injection in executions, states are beginning to take serious consideration of using nitrogen gas in capital punishment. The Article first examines the recent shift away from lethal injection and whether nitrogen hypoxia use will survive under current legal jurisprudence. Next, the Article identifies human studies on accidental deaths from nitrogen. Third, the Article examines the recent rise in nitrogen use in suicides and by right-to-die advocates. Finally, the Article compares the use of nitrogen as an execution method with its use as a euthanizing agent in veterinary medicine. The Article concludes that using nitrogen hypoxia is a feasible method of capital punishment. [ABSTRACT FROM AUTHOR]

The article discusses communication in organizations and looks at the effectiveness of contingency theory in analyzing operational research. The author critiques earlier research in this area, specifically by Boehm, Zedeck, and Tushman. She uses data from 90 of 100 subunits of a midwest state Extension Service. Questionnaires were sent out to assess work-related communications and information exchanges between the subunits, environmental conditions within each subunit, and the effectiveness of each office.

The article discusses the effects of World War II on the marketing of milk. According to the author, at the time of publication, per capita consumption of milk in the United States is under the daily recommendation by nutrition experts. The author notes that after the war, there was a shift in consumer buying habits, from having milk delivered, to buying milk at the store. Also noted is a reduction in the cost of distribution, innovation in the methods of distribution and new methods of packaging such as paper milk containers and multiple court containers.