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Claims that education research is flawed and that it has little or no impact on school practices have been circulating for at least 75 years, and this chorus of criticism has intensified in the past three decades. Yet the validity of such claims has not been investigated, write Biddle and Saha. The authors interviewed 120 school principals (81 in the United States and 39 in Australia) to find out whether these educators value and use education research. Their findings indicated that most principals held positive opinions about education research, were actively interested in research that was relevant to their professional needs, were at least minimally familiar with important education research topics, learned about education research from a wide variety of sources, and applied research knowledge in their schools. The authors recommend that educators work to dispel the myth that education research has no impact--but at the same time, that schools enhance educators' ability to apply research through improved professional training. (Contains 1 figure.)

• Proposed a novel reverse logistics network for LIB recycling under uncertainty. • Developed a two-stage stochastic model to facilitate strategic decision-making. • Applied simple average approximation to solve the model. • Quantified the impact of uncertainty on recycling operation and government policy. Recycling waste LIBs can be a promising option to tackle the increasing demand of Li-ion batteries (LIBs) in the United States due to the electric vehicle boom and transition towards clean energy. However, the recycling infrastructure is in its infancy in the United States, and there are inherent uncertainties in the collection volume of waste LIBs and the recovered material value that may hinder the path toward sustainable operations. The goal of this study is to maximize the recycling profit of a reverse logistics supply chain network developed considering uncertainties in feedstock volume and sales price as well as other economic challenges unique to the US market. In this study, a two-stage stochastic model is proposed to facilitate strategic decision-making. Additionally, this study quantifies the impact of uncertainties on recycling operations and government policies adopted to promote large-scale recycling of waste LIB materials in the US. [Display omitted] [ABSTRACT FROM AUTHOR]

Contends that as long as the structural location of schooling in less developed societies is related to the effects of foreign penetration, the educational achievement process whereby this learning is improved will differ from that found in the developed societies. (BRR)

Importance: No US national data are available on the prevalence and correlates of DSM-5-defined major depressive disorder (MDD) or on MDD specifiers as defined in DSM-5.Objective: To present current nationally representative findings on the prevalence, correlates, psychiatric comorbidity, functioning, and treatment of DSM-5 MDD and initial information on the prevalence, severity, and treatment of DSM-5 MDD severity, anxious/distressed specifier, and mixed-features specifier, as well as cases that would have been characterized as bereavement in DSM-IV.Design, Setting, and Participants: In-person interviews with a representative sample of US noninstitutionalized civilian adults (≥18 years) (n = 36 309) who participated in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions III (NESARC-III). Data were collected from April 2012 to June 2013 and were analyzed in 2016-2017.Main Outcomes and Measures: Prevalence of DSM-5 MDD and the DSM-5 specifiers. Odds ratios (ORs), adjusted ORs (aORs), and 95% CIs indicated associations with demographic characteristics and other psychiatric disorders.Results: Of the 36 309 adult participants in NESARC-III, 12-month and lifetime prevalences of MDD were 10.4% and 20.6%, respectively. Odds of 12-month MDD were significantly lower in men (OR, 0.5; 95% CI, 0.46-0.55) and in African American (OR, 0.6; 95% CI, 0.54-0.68), Asian/Pacific Islander (OR, 0.6; 95% CI, 0.45-0.67), and Hispanic (OR, 0.7; 95% CI, 0.62-0.78) adults than in white adults and were higher in younger adults (age range, 18-29 years; OR, 3.0; 95% CI, 2.48-3.55) and those with low incomes ($19 999 or less; OR, 1.7; 95% CI, 1.49-2.04). Associations of MDD with psychiatric disorders ranged from an aOR of 2.1 (95% CI, 1.84-2.35) for specific phobia to an aOR of 5.7 (95% CI, 4.98-6.50) for generalized anxiety disorder. Associations of MDD with substance use disorders ranged from an aOR of 1.8 (95% CI, 1.63-2.01) for alcohol to an aOR of 3.0 (95% CI, 2.57-3.55) for any drug. Most lifetime MDD cases were moderate (39.7%) or severe (49.5%). Almost 70% with lifetime MDD had some type of treatment. Functioning among those with severe MDD was approximately 1 SD below the national mean. Among 12.9% of those with lifetime MDD, all episodes occurred just after the death of someone close and lasted less than 2 months. The anxious/distressed specifier characterized 74.6% of MDD cases, and the mixed-features specifier characterized 15.5%. Controlling for severity, both specifiers were associated with early onset, poor course and functioning, and suicidality.Conclusions and Relevance: Among US adults, DSM-5 MDD is highly prevalent, comorbid, and disabling. While most cases received some treatment, a substantial minority did not. Much remains to be learned about the DSM-5 MDD specifiers in the general population. [ABSTRACT FROM AUTHOR]

This study presents a GIS-based model developed for urban site-specific bioenergy production potential on marginal land parcels. The model is applied on a metropolitan region level, encompassing 101 cities and towns surrounding Boston in the northeastern United States. The ‘marginal’ land use category includes vacant and abandoned lands, portions of public and private lots, and degraded lands, with poor soil quality. Four different energy crops—miscanthus, switchgrass, poplar, and willow—were considered as biomass feedstocks for bioenergy production. A total marginal land area of 71,200 ha (712 km 2 ) was identified that can be suitably used for bioenergy production, representing 20% of the total land area of the region. Spatial analysis revealed greatest marginal land densities close to the urban core. Statistical analysis found a weak positive correlation between population density and marginal land availability. Short-rotation hybrid poplar was identified as the highest yielding bioenergy crop for this region. Bioenergy potential calculations revealed that poplar can potentially yield up to 22 PJ (HHV) of yearly primary energy for this region that can be used for heat, conversion to transportation fuels, and/or electricity production. This is equivalent to >50% of current biomass primary energy use in Massachusetts and could potentially fulfill all of the core city of Boston’s heating demand. Hauling of biomass from the periphery to the urban core would add an estimated maximum of $7.20 per ton delivered. While the results reflect a maximum utilization scenario for marginal land, several logistical and social considerations are discussed that would impact practical implementation. [ABSTRACT FROM AUTHOR]

This study explores the relationship between tourism development and economic growth in a high tourist arrival country such as the US by adopting the wavelet transform approach using monthly data over the period 1996M01–2015M08. Three innovative techniques that are continuous wavelet, wavelet coherence power spectrum, and wavelet-based Granger causality that consider the decomposition of time series of different time frequencies are utilized to conduct the study. The results of autoregressive distributed lag and combine cointegration tests show that there is a significant long-run relationship occurring between tourism development and economic growth in the US. Furthermore, the results indicate that there is a unidirectional causal influence of economic growth on tourism development in the short run whereas in the long run the opposite causal relationship is evident in the US. Thus, it can be recommended that government needs to increase and promote tourism demand and further provide and nurture the expansion of tourism supply with the advancement of economic growth. [ABSTRACT FROM AUTHOR]

Importance: Lack of current and comprehensive trend data derived from a uniform, reliable, and valid source on alcohol use, high-risk drinking, and DSM-IV alcohol use disorder (AUD) represents a major gap in public health information.Objective: To present nationally representative data on changes in the prevalences of 12-month alcohol use, 12-month high-risk drinking, 12-month DSM-IV AUD, 12-month DSM-IV AUD among 12-month alcohol users, and 12-month DSM-IV AUD among 12-month high-risk drinkers between 2001-2002 and 2012-2013.Design, Setting, and Participants: The study data were derived from face-to-face interviews conducted in 2 nationally representative surveys of US adults: the National Epidemiologic Survey on Alcohol and Related Conditions, with data collected from April 2001 to June 2002, and the National Epidemiologic Survey on Alcohol and Related Conditions III, with data collected from April 2012 to June 2013. Data were analyzed in November and December 2016.Main Outcomes and Measures: Twelve-month alcohol use, high-risk drinking, and DSM-IV AUD.Results: The study sample included 43 093 participants in the National Epidemiologic Survey on Alcohol and Related Conditions and 36 309 participants in the National Epidemiologic Survey on Alcohol and Related Conditions III. Between 2001-2002 and 2012-2013, 12-month alcohol use, high-risk drinking, and DSM-IV AUD increased by 11.2%, 29.9%, and 49.4%, respectively, with alcohol use increasing from 65.4% (95% CI, 64.3%-66.6%) to 72.7% (95% CI, 71.4%-73.9%), high-risk drinking increasing from 9.7% (95% CI, 9.3%-10.2%) to 12.6% (95% CI, 12.0%-13.2%), and DSM-IV AUD increasing from 8.5% (95% CI, 8.0%-8.9%) to 12.7% (95% CI, 12.1%-13.3%). With few exceptions, increases in alcohol use, high-risk drinking, and DSM-IV AUD between 2001-2002 and 2012-2013 were also statistically significant across sociodemographic subgroups. Increases in all of these outcomes were greatest among women, older adults, racial/ethnic minorities, and individuals with lower educational level and family income. Increases were also seen for the total sample and most sociodemographic subgroups for the prevalences of 12-month DSM-IV AUD among 12-month alcohol users from 12.9% (95% CI, 12.3%-17.5%) to 17.5% (95% CI, 16.7%-18.3%) and 12-month DSM-IV AUD among 12-month high-risk drinkers from 46.5% (95% CI, 44.3%-48.7%) to 54.5% (95% CI, 52.7%-56.4%).Conclusions and Relevance: Increases in alcohol use, high-risk drinking, and DSM-IV AUD in the US population and among subgroups, especially women, older adults, racial/ethnic minorities, and the socioeconomically disadvantaged, constitute a public health crisis. Taken together, these findings portend increases in many chronic comorbidities in which alcohol use has a substantial role. [ABSTRACT FROM AUTHOR]

Importance: Heroin use is an urgent concern in the United States. Little is know about the course of heroin use, heroin use disorder, and associated factors.Objective: To examine changes in the lifetime prevalence, patterns, and associated demographics of heroin use and use disorder from 2001-2002 to 2012-2013 in 2 nationally representative samples of the US adult general population.Design, Setting, and Participants: This survey study included data from 43 093 respondents of the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and 36 309 respondents of the 2012-2013 NESARC-III. Data were analyzed from February 2 to September 15, 2016.Main Outcomes and Measures: Lifetime heroin use and DSM-IV heroin use disorder.Results: Among the 79 402 respondents (43.3% men; 56.7% women; mean [SD] age, 46.1 [17.9] years), prevalence of heroin use and heroin use disorder significantly increased from 2001-2002 to 2012-2013 (use: 0.33% [SE, 0.03%] vs 1.6% [SE, 0.08%]; disorder: 0.21% [SE, 0.03%] vs 0.69% [SE, 0.06%]; P < .001). The increase in the prevalence of heroin use was significantly pronounced among white (0.34% [SE, 0.04%] in 2001-2002 vs 1.90% [SE, 0.12%] in 2012-2013) compared with nonwhite (0.32% [SE, 0.05%] in 2001-2002 vs 1.05% [SE, 0.10%] in 2012-2013; P < .001) individuals. The increase in the prevalence of heroin use disorder was more pronounced among white individuals (0.19% [SE, 0.03%] in 2001-2002 vs 0.82% [SE, 0.08%] in 2012-2013; P < .001) and those aged 18 to 29 (0.21% [SE, 0.06%] in 2001-2002 vs 1.0% [0.17%] in 2012-2013; P = .01) and 30 to 44 (0.20% [SE, 0.04%] in 2001-2002 vs 0.77% [0.10%] in 2012-2013; P = .03) years than among nonwhite individuals (0.25% [SE, 0.04%] in 2001-2002 vs 0.43% [0.07%] in 2012-2013) and older adults (0.22% [SE, 0.04%] in 2001-2002 vs 0.51% [SE, 0.07%] in 2012-2013). Among users, significant differences were found across time in the proportion of respondents meeting DSM-IV heroin use disorder criteria (63.35% [SE, 4.79%] in 2001-2001 vs 42.69% [SE, 2.87%] in 2012-2013; P < .001). DSM-IV heroin abuse was significantly more prevalent among users in 2001-2002 (37.02% [SE, 4.67%]) than in 2012-2013 (19.19% [SE, 2.34%]; P = .001). DSM-IV heroin dependence among users was similar in 2001-2002 (28.22% [SE, 3.95%]) and in 2012-2013 (25.02% [SE, 2.20%]; P = .48). The proportion of those reporting initiation of nonmedical use of prescription opioids before initiating heroin use increased across time among white individuals (35.83% [SE, 6.03%] in 2001-2002 to 52.83% [SE, 2.88%] in 2012-2013; P = .01).Conclusions and Relevance: The prevalence of heroin use and heroin use disorder increased significantly, with greater increases among white individuals. The nonmedical use of prescription opioids preceding heroin use increased among white individuals, supporting a link between the prescription opioid epidemic and heroin use in this population. Findings highlight the need for educational campaigns regarding harms related to heroin use and the need to expand access to treatment in populations at increased risk for heroin use and heroin use disorder. [ABSTRACT FROM AUTHOR]

Importance: Current information on the prevalence and sociodemographic and clinical profiles of individuals in the general population with DSM-5 drug use disorder (DUD) is limited. Given the present societal and economic context in the United States and the new diagnostic system, up-to-date national information is needed from a single uniform data source.Objective: To present nationally representative findings on the prevalence, correlates, psychiatric comorbidity, disability, and treatment of DSM-5 DUD diagnoses overall and by severity level.Design, Setting, and Participants: In-person interviews were conducted with 36,309 adults in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III, a cross-sectional representative survey of the United States. The household response rate was 72%; person-level response rate, 84%; and overall response rate, 60.1%. Data were collected April 2012 through June 2013 and analyzed from February through March 2015.Main Outcomes and Measures: Twelve-month and lifetime DUD, based on amphetamine, cannabis, club drug, cocaine, hallucinogen, heroin, nonheroin opioid, sedative/tranquilizer, and/or solvent/inhalant use disorders.Results: Prevalences of 12-month and lifetime DUD were 3.9% and 9.9%, respectively. Drug use disorder was generally greater among men, white and Native American individuals, younger and previously or never married adults, those with lower education and income, and those residing in the West. Significant associations were found between 12-month and lifetime DUD and other substance use disorders. Significant associations were also found between any 12-month DUD and major depressive disorder (odds ratio [OR], 1.3; 95% CI, 1.09-1.64), dysthymia (OR, 1.5; 95% CI, 1.09-2.02), bipolar I (OR, 1.5; 95% CI, 1.06-2.05), posttraumatic stress disorder (OR, 1.6; 95% CI, 1.27-2.10), and antisocial (OR, 1.4; 95% CI, 1.11-1.75), borderline (OR, 1.8; 95% CI, 1.41-2.24), and schizotypal (OR, 1.5; 95% CI, 1.18-1.87) personality disorders. Similar associations were found for any lifetime DUD with the exception that lifetime DUD was also associated with generalized anxiety disorder (OR, 1.3; 95% CI, 1.06-1.49), panic disorder (OR, 1.3; 95% CI, 1.06-1.59), and social phobia (OR, 1.3; 95% CI, 1.09-1.64). Twelve-month DUD was associated with significant disability, increasing with DUD severity. Among respondents with 12-month and lifetime DUD, only 13.5% and 24.6% received treatment, respectively.Conclusions and Relevance: DSM-5 DUD is a common, highly comorbid, and disabling disorder that largely goes untreated in the United States. These findings indicate the need for additional studies to understand the broad relationships in more detail; estimate present-day economic costs of DUDs; investigate hypotheses regarding etiology, chronicity, and treatment use; and provide information to policy makers about allocation of resources for service delivery and research. Findings also indicate an urgent need to destigmatize DUD and educate the public, clinicians, and policy makers about its treatment to encourage affected individuals to obtain help. [ABSTRACT FROM AUTHOR]

Importance: Laws and attitudes toward marijuana in the United States are becoming more permissive but little is known about whether the prevalence rates of marijuana use and marijuana use disorders have changed in the 21st century.Objective: To present nationally representative information on the past-year prevalence rates of marijuana use, marijuana use disorder, and marijuana use disorder among marijuana users in the US adult general population and whether this has changed between 2001-2002 and 2012-2013.Design, Setting, and Participants: Face-to-face interviews conducted in surveys of 2 nationally representative samples of US adults: the National Epidemiologic Survey on Alcohol and Related Conditions (data collected April 2001-April 2002; N = 43,093) and the National Epidemiologic Survey on Alcohol and Related Conditions-III (data collected April 2012-June 2013; N = 36,309). Data were analyzed March through May 2015.Main Outcomes and Measures: Past-year marijuana use and DSM-IV marijuana use disorder (abuse or dependence).Results: The past-year prevalence of marijuana use was 4.1% (SE, 0.15) in 2001-2002 and 9.5% (SE, 0.27) in 2012-2013, a significant increase (P < .05). Significant increases were also found across demographic subgroups (sex, age, race/ethnicity, education, marital status, income, urban/rural, and region). The past-year prevalence of DSM-IV marijuana use disorder was 1.5% (0.08) in 2001-2002 and 2.9% (SE, 0.13) in 2012-2013 (P < .05). With few exceptions, increases in the prevalence of marijuana use disorder between 2001-2002 and 2012-2013 were also statistically significant (P < .05) across demographic subgroups. However, the prevalence of marijuana use disorder among marijuana users decreased significantly from 2001-2002 (35.6%; SE, 1.37) to 2012-2013 (30.6%; SE, 1.04).Conclusions and Relevance: The prevalence of marijuana use more than doubled between 2001-2002 and 2012-2013, and there was a large increase in marijuana use disorders during that time. While not all marijuana users experience problems, nearly 3 of 10 marijuana users manifested a marijuana use disorder in 2012-2013. Because the risk for marijuana use disorder did not increase among users, the increase in prevalence of marijuana use disorder is owing to an increase in prevalence of users in the US adult population. Given changing laws and attitudes toward marijuana, a balanced presentation of the likelihood of adverse consequences of marijuana use to policy makers, professionals, and the public is needed. [ABSTRACT FROM AUTHOR]

Background: Most general thoracic operations in the United States are performed by general surgeons. Results obtained by those identified as general surgeons are often compared with those identified as thoracic surgeons. Methods: We interrogated the American College of Surgeons National Surgical Quality Improvement Project database over a 5-year period to compare outcomes in patients who underwent similar operations by surgeons identified as either thoracic surgeons or general surgeons. We employed propensity-score matching to minimize confounding when estimating the effect of surgeon identity on postoperative outcomes. Results: During the study period, thoracic surgeons performed 3,263 major pulmonary or esophageal operations, and general surgeons performed 15,057 similar operations. Compared with patients operated on by general surgeons, patients operated on by thoracic surgeons had significant excess multivariate comorbidities, including insulin-dependent diabetes mellitus, chronic obstructive pulmonary disease, concurrent pneumonia, congestive heart failure, previous cardiac surgery, dialysis-dependent renal failure, disseminated cancer, prior sepsis, and previous operation within 30 days. Likewise, patients in highest risk categories had operations performed by thoracic surgeons more commonly than by general surgeons. Unadjusted comparisons for mortality and serious morbidity showed significantly worse mortality and pulmonary complications in patients operated on by thoracic surgeons. However, with propensity matching according to surgeon type, thoracic surgeons had significantly fewer serious adverse outcomes compared with general surgeons, and this decreased morbidity occurred in a higher risk cohort. Conclusions: Our results show that patients operated on by thoracic surgeons have higher acuity compared with patients operated on by general surgeons. When patients are matched for comorbidities and serious preoperative risk factors, thoracic surgeons have improved outcomes, especially with regard to infectious complications and composite morbidity. [ABSTRACT FROM AUTHOR]

Background: Practice guidelines reflect published literature. Because of the ever changing literature base, it is necessary to update and revise guideline recommendations from time to time. The Society of Thoracic Surgeons recommends review and possible update of previously published guidelines at least every three years. This summary is an update of the blood conservation guideline published in 2007. Methods: The search methods used in the current version differ compared to the previously published guideline. Literature searches were conducted using standardized MeSH terms from the National Library of Medicine PUBMED database list of search terms. The following terms comprised the standard baseline search terms for all topics and were connected with the logical ‘OR’ connector—Extracorporeal circulation (MeSH number E04.292), cardiovascular surgical procedures (MeSH number E04.100), and vascular diseases (MeSH number C14.907). Use of these broad search terms allowed specific topics to be added to the search with the logical ‘AND’ connector. Results: In this 2011 guideline update, areas of major revision include: 1) management of dual anti-platelet therapy before operation, 2) use of drugs that augment red blood cell volume or limit blood loss, 3) use of blood derivatives including fresh frozen plasma, Factor XIII, leukoreduced red blood cells, platelet plasmapheresis, recombinant Factor VII, antithrombin III, and Factor IX concentrates, 4) changes in management of blood salvage, 5) use of minimally invasive procedures to limit perioperative bleeding and blood transfusion, 6) recommendations for blood conservation related to extracorporeal membrane oxygenation and cardiopulmonary perfusion, 7) use of topical hemostatic agents, and 8) new insights into the value of team interventions in blood management. Conclusions: Much has changed since the previously published 2007 STS blood management guidelines and this document contains new and revised recommendations. [Copyright &y& Elsevier]

Using a three-region supercritical water flow model, the core-wide in-phase stability of the U.S. reference supercritical water-cooled reactor (SCWR) design is investigated. The reactor core is simulated as three channels according to the radial power distribution. A method based on A modes (reactivity modes) expansion of neutronic kinetic equations is applied. A constant pressure drop boundary condition between the feedwater pump and the turbine control valve is assumed. Cases with and without water rods heating are studied. It is found that the stability of the U.S. reference SCWR design is sensitive to the flow restrictions in the hot fluid or the steam line. As long as the restriction in the steam line is small, the design will be stable. A pressure loss coefficient of 0.25 is assumed for the exit valve on the steam line in this analysis. With this value, the SCWR is stable with a large margin. It is concluded that the presence of water rods heating will reduce the stability margin and increase the flow rate sensitivity while maintaining the power sensitivity level. The decay ratios for the three density wave oscillation modes, i.e., single hot channel, coupled neutronic out-of-phase and in-phase, are compared at steady-state conditions. It is found that the single hot channel oscillation mode is the most limiting one in the absence of the water rods heating, while the in-phase oscillation mode is most limiting in the presence of water rods heating. [ABSTRACT FROM AUTHOR]

The past decade has shown a great increase in the number of direct to consumer shipments of products and packages. As a result, parcel delivery companies like DHL, FedEx, UPS, and the USPS have strengthened their presence in air transport to deliver products faster and through larger distances. Using cargo planes, they route packages from various destinations to large airport hubs, where they sort millions of packages and ship them to their destinations. There is a continuous need to quantify what happens to these packages as they are handled both manually during collection and delivery and on large high-speed conveying and sortation equipment at hubs. The dynamic events during these moves can cause damage. The information collected in this study helps packaging engineers design protective packaging. This study measured and compared shock and drop events for these carriers during next-day and two-day shipping service between Michigan and California. Data are presented in terms of drop heights associated with the 90, 95, and 99th percentile of occurrence for DHL, FedEx, UPS. and USPS. Impact orientation is also discussed. The data from this study are beneficial to new test methods being developed for drop testing of single parcel shipments by ASTM. [ABSTRACT FROM AUTHOR]

The single hot-channel thermal-hydraulic stability model is expanded to investigate the effects of heat transport from fuel rods and to water rods on supercritical water-cooled reactor (SCWR) stability. Furthermore, the stability margin of the SCWR is compared with that of a typical boiling water reactor (BWR) by conducting a sensitivity study on operating conditions. The fuel thermal-dynamic effect is studied by coupling a lumped-parameter fuel model with the three-region coolant thermal-hydraulics model. It is found that the fuel heat capacity would dampen the oscillations in the coolant channel and therefore increase the stability of the system. Also, heating of the water rods, which could be allowed in the core, would improve single-channel stability. The stability sensitivity to power and flow rate conditions is analyzed for the U.S. reference SCWR design and compared with a typical BWR. The SCWR is found to be more sensitive to power and flow rate changes than the typical BWR. The water rod heating cannot significantly improve this sensitivity feature of the SCWR stability. The traditional stability measure of oscillation amplitude decay ratio does not capture the extent to which a stability margin exists in a particular design of the SCWR. The robustness of stability should be ascertained by examining accommodation of the potential variation and/or uncertainty about the nominal conditions. [ABSTRACT FROM AUTHOR]

The drastic change of fluid density in the reactor core of a supercritical water-cooled reactor (SCWR) gives rise to a concern about density-wave stability. Using a single-channel thermal-hydraulic model, stability boundary maps for the U.S. reference SCWR design have been constructed for both steady state and sliding pressure startup conditions. The supercritical water flow in the reactor core has been simulated using a three-region model: a heavy fluid with constant density, a mixture of heavy fluid and light fluid similar to a homogeneous-equilibrium two-phase mixture, and a light fluid, which behaves like an ideal gas or superheated steam. Two important nondimensional numbers, namely, a pseudosubcooling number Npsub and an expansion number Nexp, have been identified for the supercritical region. The stability map in the supercritical region is then plotted in the plane made of these two numbers. The U.S. reference SCWR design operates in a stable region with a large margin. Sensitivity studies produced results consistent with the findings of the earlier research clone for the subcritical two-phase flow. During the sliding pressure startup of the SCWR, a two-phase steam-water mixture at subcritical pressure will appear in the reactor core. A nonhomogeneous (e.g., drift-flux) nonequilibrium two-phase flow model was applied. The characteristic equation was numerically integrated, and stability boundary maps were plotted on the traditional subcooling number versus phase change number (or Zuber number) plane. These maps have been used to develop a sliding pressure SCWR startup strategy avoiding thermal-hydraulic flow instabilities. [ABSTRACT FROM AUTHOR]

Background: The media has devoted significant attention to anecdotes of individuals who post messages on Facebook prior to suicide. However, it is unclear to what extent social media is perceived as a source of help or how it compares to other sources of potential support for mental health problems.Objective: This study aimed to evaluate the degree to which military veterans with depression use social media for help-seeking in comparison to other more traditional sources of help.Methods: Cross-sectional self-report survey of 270 adult military veterans with probable major depression. Help-seeking intentions were measured with a modified General Help-Seeking Questionnaire. Facebook users and nonusers were compared via t tests, Chi-square, and mixed effects regression models. Associations between types of help-seeking were examined using mixed effects models.Results: The majority of participants were users of social media, primarily Facebook (n=162). Mean overall help-seeking intentions were similar between Facebook users and nonusers, even after adjustment for potential confounders. Facebook users were very unlikely to turn to Facebook as a venue for support when experiencing either emotional problems or suicidal thoughts. Compared to help-seeking intentions for Facebook, help-seeking intentions for formal (eg, psychologists), informal (eg, friends), or phone helpline sources of support were significantly higher. Results did not substantially change when examining users of other social media, women, or younger adults.Conclusions: In its current form, the social media platform Facebook is not seen as a venue to seek help for emotional problems or suicidality among veterans with major depression in the United States. [ABSTRACT FROM AUTHOR]

Background: Schizophrenia is a rare but devastating condition, affecting about 1% of the world's population and resulting in about 2% of the US health care expenditure. Major impediments to appropriate and timely care include misconceptions, high levels of stigma, and lack of public awareness. Facebook offers novel opportunities to understand public awareness and information access related to schizophrenia, and thus can complement survey-based approaches to assessing awareness that are limited in scale, robustness, and temporal and demographic granularity.Objective: The aims of this study were to (1) construct an index that measured the awareness of different demographic groups around schizophrenia-related information on Facebook; (2) study how this index differed across demographic groups and how it correlated with complementary Web-based (Google Trends) and non-Web-based variables about population well-being (mental health indicators and infrastructure), and (3) examine the relationship of Facebook derived schizophrenia index with other types of online activity as well as offline health and mental health outcomes and indicators.Methods: Data from Facebook's advertising platform was programmatically collected to compute the proportion of users in a target demographic group with an interest related to schizophrenia. On consultation with a clinical expert, several topics were combined to obtain a single index measuring schizophrenia awareness. This index was then analyzed for differences across US states, gender, age, ethnic affinity, and education level. A statistical approach was developed to model a group's awareness index based on the group's characteristics.Results: Overall, 1.03% of Facebook users in the United States have a schizophrenia-related interest. The schizophrenia awareness index (SAI) is higher for females than for males (1.06 vs 0.97, P<.001), and it is highest for the people who are aged 25-44 years (1.35 vs 1.03 for all ages, P<.001). The awareness index drops for higher education levels (0.68 for MA or PhD vs 1.92 for no high school degree, P<.001), and Hispanics have the highest level of interest (1.57 vs 1.03 for all ethnic affinities, P<.001). A regression model fit to predict a group's interest level achieves an adjusted R2=0.55. We also observe a positive association between our SAI and mental health services (or institutions) per 100,000 residents in a US state (Pearson r=.238, P<.001), but a negative association with the state-level human development index (HDI) in United States (Pearson r=-.145, P<.001) and state-level volume of mental health issues in United States (Pearson r=-.145, P<.001).Conclusions: Facebook's advertising platform can be used to construct a plausible index of population-scale schizophrenia awareness. However, only estimates of awareness can be obtained, and the index provides no information on the quality of the information users receive online. [ABSTRACT FROM AUTHOR]

Although social disparities in morbidity and mortality are well-documented, little is known how socioeconomic status (SES) shapes diabetes-concordant comorbidity (DCC). This study examines socioeconomic inequalities in DCC among adults with diabetes in the United States. The study incorporated a cross-sectional nationally representative household health survey. This study used data from the National Health Interview Survey, 1997–2018. The analysis included 56,192 adults aged 30 or above with diabetes. Multinomial logistic regression was used to obtain relative risk ratios in gender-stratified models after adjusting for sociodemographic covariates. The multivariable-adjusted analyses suggest that across all SES indicators and in both men and women, individuals with lower SES had greater odds of DCC than individuals with higher SES. The associations of SES indicators with DCC were larger in magnitude among women than in men. For example, compared to individuals with a college or higher degree, men with less than a high school degree were 2.06 times (95% confidence interval = 1.76–2.41) and women with less than a high school degree were 3.19 times (95% confidence interval = 2.67–3.82) more likely to have 3 or more DCCs. Similar associations were observed for other indicators of SES. Study findings suggest strong social status and gender-based patterns in DCC. Identifying population groups with poor social status may be useful for informing interventions aiming to improve healthcare services of diabetes-related complications. [ABSTRACT FROM AUTHOR]

Background: Children undergoing cardiac surgical procedures may require postoperative surgical or catheter-based reintervention before discharge. We examined racial/ethnic variations in reintervention and associated in-hospital death., Methods: Children undergoing cardiac surgical procedures from 2004 to 2015 were identified in the Pediatric Health Information Systems (PHIS) database. Regression analysis measured associations between race/ethnicity, in-hospital death, and postoperative cardiac surgical or catheter-based reintervention (surgical/catheter reintervention)., Results: Of 124,263 patients, 8265 (6.7%) had a surgical/catheter reintervention. Black patients had fewer reinterventions (5.9% vs 6.7%) and higher in-hospital mortality (3.9% vs 2.7%, P < .01) than White patients. After adjusting for sociodemographic and illness severity indicators, Black patients remained less likely to receive surgical/catheter reintervention (adjusted hazard ratio [aHR], 0.89; 95% CI, 0.82-0.98) despite having similar risk of death after reintervention (adjusted odds ratio, 1.17; 95% CI, 0.98-1.41) compared with White patients. The risk of death without surgical/catheter reintervention was also higher for Black (aHR, 1.26; 95% CI, 1.08-1.47) and other race/ethnicity (aHR, 1.33; 95% CI, 1.13-1.57) patients than for White patients. Similar trends were demonstrated when mechanical circulatory support and cardiac transplantation were included as reinterventions., Conclusions: Patients of Black and other race/ethnicity undergoing pediatric cardiac surgical procedures are more likely to die without postoperative cardiac reintervention than White patients. Black patients are also less likely to receive reintervention despite no significant difference in mortality with reintervention. Further studies should evaluate etiologies and methods of addressing these disparities., (Copyright © 2024 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

A new, simple, rapid and sensitive fluorescence-based method has been developed and validated for the estimation of rotigotine (RTG) in bulk and nanoformulations. RTG is a dopamine agonist approved by both the United States Food and Drug Administration and the European Medicines Agency for the treatment of Parkinson's disease and restless leg syndrome. To date, no fluorescence-based analytical method has been reported for the estimation of RTG in any pharmaceutical dosage forms. The developed method is validated as per the International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use guidelines. A solution of the pure drug in phosphate buffer pH 6.4 exhibited strong fluorescence emission (λ em ) at a wavelength of 298 nm when excited (λ ex ) at a wavelength of 277 nm. The developed method demonstrated good linearity over a range of 250-2500 ng/mL. Limit of detection and limit of quantitation values were found to be 36.25 ng/mL and 109.85 ng/mL respectively. The developed method was found to be accurate, precise, specific and robust. The validated method was successfully applied for the estimation of entrapment efficiency and drug loading of in-house intranasal RTG-loaded chitosan nanoparticles., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: Although lower-complexity cardiac malformations constitute the majority of adult congenital heart disease (ACHD), the long-term risks of adverse cardiovascular events and relationship with conventional risk factors in this population are poorly understood. We aimed to quantify the risk of adverse cardiovascular events associated with lower-complexity ACHD that is unmeasured by conventional risk factors., Methods: A multitiered classification algorithm was used to select individuals with lower-complexity ACHD and individuals without ACHD for comparison among >500 000 British adults in the UK Biobank. ACHD diagnoses were subclassified as isolated aortic valve and noncomplex defects. Time-to-event analyses were conducted for the primary end points of fatal or nonfatal acute coronary syndrome, ischemic stroke, heart failure, and atrial fibrillation and a secondary combined end point for major adverse cardiovascular events. Maximum follow-up time for the study period was 22 years with retrospectively and prospectively collected data from the UK Biobank., Results: We identified 2006 individuals with lower-complexity ACHD and 497 983 unexposed individuals in the UK Biobank (median age at enrollment, 58 [interquartile range, 51-63] years). Of the ACHD-exposed group, 59% were male, 51% were current or former smokers, 30% were obese, and 69%, 41%, and 7% were diagnosed or treated for hypertension, hyperlipidemia, and diabetes mellitus, respectively. After adjustment for 12 measured cardiovascular risk factors, ACHD remained strongly associated with the primary end points, with hazard ratios ranging from 2.0 (95% CI, 1.5-2.8; P<0.001) for acute coronary syndrome to 13.0 (95% CI, 9.4-18.1; P<0.001) for heart failure. ACHD-exposed individuals with ≤2 cardiovascular risk factors had a 29% age-adjusted incidence rate of major adverse cardiovascular events, in contrast to 13% in individuals without ACHD with ≥5 risk factors., Conclusions: Individuals with lower-complexity ACHD had a higher burden of adverse cardiovascular events relative to the general population that was unaccounted for by conventional cardiovascular risk factors. These findings highlight the need for closer surveillance of patients with mild to moderate ACHD and further investigation into management and mechanisms of cardiovascular risk unique to this growing population of high-risk adults.

Purpose: Boundary roughness of a pulmonary nodule is an important indication of its malignancy. The irregularity of the shape of a nodule is represented in terms of a few diagnostic characteristics such as spiculation, lobulation, and sphericity. Quantitative characterization of these diagnostic characteristics is essential for designing a content-based image retrieval system and computer-aided system for diagnosis of lung cancer., Methods: This paper presents differential geometry-based techniques for computation of spiculation, lobulation, and sphericity using the binary mask of the segmented nodule. These shape features are computed in 3D considering complete nodule., Results: The performance of the proposed and competing methods is evaluated in terms of the precision, mean similarity, and normalized discounted cumulative gain on 891 nodules of Lung Image Database Consortium and Image Database Resource Initiative. The proposed methods are comparable to or better than gold standard technique. The reproducibility of proposed feature extraction techniques is evaluated using RIDER coffee break data set. The mean and standard deviation of the percent change of spiculation, lobulation, and sphericity are [Formula: see text], [Formula: see text], and [Formula: see text] %, respectively., Conclusion: The prior works of computation of spiculation, lobulation, and sphericity require a set of four ground truths from radiologists and, hence, can not be used in practice. The proposed methods do not require ground truth information of nodules from radiologists, and hence, it can be used in real-life computer-aided diagnosis system for lung cancer.

Bell peppers (Capsicum annuum) harbour a large dsRNA virus. The linear genome (14.7 kbp) of two isolates from Japanese and USA bell pepper cultivars were completely sequenced and compared. They shared extensive sequence identity and contained a single, long ORF encoding a 4815 aa protein. This polyprotein contained conserved motifs of putative viral methyltransferase (MTR), helicase 1 (Hel-1), UDP-glycosyltransferase and RNA-dependent RNA polymerase. This unique arrangement of conserved domains has not been reported in any of the known endornaviruses. Hence this virus, for which the name Bell pepper endornavirus (BPEV) is proposed, is a distinct species in the genus Endornavirus (family Endornaviridae). The BPEV-encoded polyprotein contains a cysteine-rich region between the MTR and Hel-1 domains, with conserved CXCC motifs shared among several endornaviruses, suggesting an additional functional domain. In agreement with general endornavirus features, BPEV contains a nick in the positive-strand RNA molecule. The virus was detected in all bell pepper cultivars tested and transmitted through seed but not by graft inoculations. Analysis of dsRNA patterns and RT-PCR using degenerate primers revealed putative variants of BPEV, or closely related species, infecting other C. annuum genotypes and three other Capsicum species (C. baccatum, C. chinense and C. frutescens).

Since the 1970s, there has been a trend on the part of physicians and other health practitioners to promote breastfeeding in the United States, a movement that has not been as successful as hoped, since the majority of mothers in this country continue to feed their babies formula. Several socioeconomic factors are considered to be barriers to the success of breastfeeding promotion today. Yet, even among those who promote breastfeeding there exists a notable constraint in dealing with the issue of sexuality and breastfeeding. Indeed, as the female breast is eroticized in Western society, breastfeeding promotional messages have often exhibited a tacit conformity to social conventions regarding female sexuality. When analyzing selected works of advice literature written by health care practitioners from the 1970s to the present, it will be clear that breastfeeding promotional information often reflects dominant views of the sexuality of the female breast and her body.

Research ethics is currently becoming the focus of attention as advancements in science are more in the public spotlight. Notoriety brings attention not only to the achievements, but to some of the more pressing issues that have risen to the surface in the debate on research ethics. Such issues include: conflicts of interest and industrial funding, research misconduct, and the need of ethics training for biomedical scientists.

Biomedical engineering is responsible for many of the dramatic advances in modern medicine. This has resulted in improved medical care and better quality of life for patients. However, biomedical technology has also contributed to new ethical dilemmas and has challenged some of our moral values. Bioengineers often lack adequate training in facing these moral and ethical problems. These include conflicts of interest, allocation of scarce resources, research misconduct, animal experimentation, and clinical trials for new medical devices. This paper is a compilation of our previous published papers on these topics, and it summarizes many complex ethical issues that a bioengineer may face during his or her research career or professional practice. The need for ethics training in the education of a bioengineering student is emphasized. We also advocate the adoption of a code of ethics for bioengineers.

Technology has created moral dilemmas in recent years creating an increased interest in the field of bioethics, which affects engineers in biomedicine, physicians, other health-care professionals, and society in general. For example devices like the kidney dialysis machine or Nuclear Magnetic Resonance (NMR) diagnostic scanner demonstrate state-of-the-art capabilities, yet they are very expensive. Therefore, standards of the past involving health care and allocation of resources are changing, and professionals must be aware of this change, as well as the responsibility for complete testing and review during the research and development process of medical devices. In this paper, we illustrate technological impact and stress the necessity of an understanding of ethics in order to deal effectively with product liability, conflicts of interests, and allocation of scarce resources. Hopefully, this will result in awareness and education in ethics and professional responsibilities.

Because of the growth of medical technology, Clinical Engineers have increased responsibilities in respect to this new technology and so to modern medicine itself. This results in a need to ensure that an ethical consciousness of responsibilities to patients, physicians, and institutions grows within Clinical Engineers as they move into evermore important roles within the health care system. Clinical Engineers must have clearly defined roles, as well as authority acknowledged and supported by other health care professionals. Most importantly, Clinical Engineers themselves must recognize the seriousness of their professional responsibilities as they contribute to the maintenance of equipment, use and design instrumentation, and fulfill roles in administration, management, and research. As members of the health care team, Clinical Engineers must be prepared to face ethical issues arising from defective or inadequate equipment, hazards and incidents, scarcity and resources, conflict of interest, confidentiality, clinical research, "truth-telling," and care of the terminally ill.