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The infusion of algorithms into organizational fields—accelerated by advances in artificial intelligence—can have disruptive effects that trigger defensive responses. One important response involves establishing a boundary around an algorithm to delimit its interactions with its environment—in engineering terms, constructing an "envelope." Yet, we know little about the process through which such envelopes are constructed. We address this issue by exploring how institutional custodians construct envelopes around disruptive algorithms. We empirically examine custodians' responses to the high-frequency trading algorithms that disrupted the field of U.S. securities trading, focusing on the years 2009–2016. Our inductive analysis shows that custodians created an envelope with interconnected normative, governance, and practice "layers" that jointly constrained high-frequency trading. Each layer emerged as custodians "coupled" one element of the field (e.g., its values) to one aspect of the disruptive algorithms (e.g., their impacts). Our study contributes to research on the social dynamics of algorithms by generating novel theory of how envelopes around algorithms are constructed, and to research on institutional custodianship by highlighting the constructing of envelopes as a custodial response to a wide range of threats—including, but not restricted to, disruptive algorithms. [ABSTRACT FROM AUTHOR]

Growth mindset has been shown to predict academic achievement in a variety of student populations, though the strength of the relationship can vary depending on the characteristics of the students examined. Using a large-scale sample of middle school students from a diverse district in the United States, we examine how multiple facets of students' experiences and background characteristics may interact to impact the relation between mindset and academic achievement. We consider whether the risk factors of socioeconomic status (including a student's daily experience of that status) and recent school transition interacted with mindset in predicting academic achievement. We show that mindset is most predictive of academic achievement in students with two academic risk factors. These results highlight the importance of context when considering how mindset might be used to improve academic achievement for students at the greatest academic risk. [ABSTRACT FROM AUTHOR]

Objectives: Although invasive cervical cancer (ICC) rates have declined since the advent of screening, the annual age-adjusted ICC rate in the United States remains 7.5 per 100,000 women. Failure of recommended screening and management often precedes ICC diagnoses. The study aimed to evaluate characteristics of women with incident ICC, including potential barriers to accessing preventive care. Materials and Methods: We abstracted medical records for patients with ICC identified during 2008–2020 in five U.S. population-based surveillance sites covering 1.5 million women. We identified evidence of adverse social and medical conditions, including uninsured/underinsured, language barrier, substance use disorder, incarceration, serious mental illness, severe obesity, or pregnancy at diagnosis. We calculated descriptive frequencies and compared potential barriers by race/ethnicity, and among women with and without symptoms at diagnosis using chi-square tests. Results: Among 1,606 women with ICC (median age: 49 years; non-White: 47.4%; stage I: 54.7%), the majority (68.8%) presented with symptoms. Forty-six percent of women had at least one identified potential barrier; 15% had multiple barriers. The most common potential barriers among all women were being underinsured/uninsured (17.3%), and language (17.1%). Presence of any potential barrier was more frequent among non-White women and women with than without symptoms (p < 0.05). Conclusions: In this population-based descriptive study of women with ICC, we identified adverse circumstances that might have prevented women from seeking screening and treatment to prevent cancer. Interventions to increase appropriate cervical cancer screening and management are critical for reducing cervical cancer rates. [ABSTRACT FROM AUTHOR]

Objective: Qualitative research methods are based on the analysis of words rather than numbers; they encourage self-reflection on the investigator's part; they are attuned to social interaction and nuance; and they incorporate their subjects' thoughts and feelings as primary sources. Despite appearing well suited for research in child and adolescent psychiatry (CAP), qualitative methods have had relatively minor uptake in the discipline. We conducted a qualitative study of CAPs involved in qualitative research to learn about these investigators' lived experiences, and to identify modifiable factors to promote qualitative methods within the field of youth mental health. Methods: We conducted individual, semi-structured 1-h long interviews through Zoom. Using purposive sample, we selected 23 participants drawn from the US (n = 12) and from France (n = 11), and equally divided in each country across seniority level. All participants were current or aspiring CAPs and had published at least one peer-reviewed qualitative article. Ten participants were women (44%). We recorded all interviews digitally and transcribed them for analysis. We coded the transcripts according to the principles of thematic analysis and approached data analysis, interpretation, and conceptualization informed by an interpersonal phenomenological analysis (IPA) framework. Results: Through iterative thematic analysis we developed a conceptual model consisting of three domains: (1) Becoming a qualitativist: embracing a different way of knowing (in turn divided into the three themes of priming factors/personal fit; discovering qualitative research; and transitioning in); (2) Being a qualitativist: immersing oneself in a different kind of research (in turn divided into quality: doing qualitative research well; and community: mentors, mentees, and teams); and (3) Nurturing: toward a higher quality future in CAP (in turn divided into current state of qualitative methods in CAP; and advocating for qualitative methods in CAP). For each domain, we go on to propose specific strategies to enhance entry into qualitative careers and research in CAP: (1) Becoming: personalizing the investigator's research focus; balancing inward and outward views; and leveraging practical advantages; (2) Being: seeking epistemological flexibility; moving beyond bibliometrics; and the potential and risks of mixing methods; and (3) Nurturing: invigorating a quality pipeline; and building communities. Conclusions: We have identified factors that can support or impede entry into qualitative research among CAPs. Based on these modifiable findings, we propose possible solutions to enhance entry into qualitative methods in CAP (pathways), and to foster longer-term commitment to this type of research (identity). [ABSTRACT FROM AUTHOR]

Inspired by research on social movements, we extend the idea that activists look for opportunities to target firms to the realm of financially motivated shareholder activists. Focusing on activist hedge funds, we argue that hedge fund campaigns are more likely to succeed when boards are slow and less united and that, compared with more homogeneous boards, demographically diverse boards tend to act more slowly and with less unity. Although these attributes make demographically diverse boards more effective under "normal" circumstances, they become a liability in confrontations with activist hedge funds. We, therefore, hypothesize that when subject to governance and performance problems, firms become more likely targets of activist hedge funds when they also have demographically diverse boards. To further probe our theory, we explore the opportunity recognition of activist hedge funds in two ways. First, we posit that this opportunity will be recognized and exploited primarily by experienced activist hedge funds. Second, we argue that activist hedge funds' opportunity recognition is correct in so far that demographically diverse boards respond to activism campaigns in ways that are likely to benefit activist hedge funds. Using data on United States-based activism campaigns, we find support for our theory. By simultaneously studying problems and opportunities, this study establishes a foundation for examining when the disciplinary effect of shareholder activism may go awry and reveals why a strict business case for demographic diversity may be insufficient to align all shareholders behind board diversity. Supplemental Material: The online appendix is available at https://doi.org/10.1287/orsc.2023.1679. [ABSTRACT FROM AUTHOR]

As online social activities have become increasingly important for people's lives, understanding how migrants integrate into online spaces is crucial for providing a more complete picture of integration processes. We curate a high-quality data set to quantify patterns of new online social connections among immigrants in the United States. Specifically, we focus on Twitter and leverage the unique features of these data, in combination with a propensity score matching technique, to isolate the effects of migration events on social network formation. The results indicate that migration events led to an expansion of migrants' networks of friends on Twitter in the destination country, relative to those of similar users who did not move. Male migrants between 19 and 29 years old who actively posted more tweets in English after migration also tended to have more local friends after migration compared to other demographic groups, indicating the impact of demographic characteristics and language skills on integration. The percentage of migrants' friends from their country of origin decreased in the first few years after migration and increased again in later years. Finally, unlike for migrants' friends' networks, which were under their control, we did not find any evidence that migration events expanded migrants' networks of followers in the destination country. While following users on Twitter in theory is not a geographically constrained process, our work shows that offline (re)location plays a significant role in the formation of online networks. [ABSTRACT FROM AUTHOR]

Background: Although the Eating Disorder Examination-Questionnaire (EDE-Q) is one of the most widely used self-report assessments of eating disorder symptoms, evidence indicates potential limitations with its original factor structure and associated psychometric properties in a variety of populations, including sexual minority populations. The aims of the current investigation were to explore several previously published EDE-Q factor structures and to examine internal consistency and measurement invariance of the best-fitting EDE-Q model in a large community sample of cisgender gay men and cisgender lesbian women. Methods: Data were drawn from 1624 adults (1060 cisgender gay men, 564 cisgender lesbian women) who participated in The PRIDE Study, a large-scale longitudinal cohort study of sexual and gender minorities from the United States. A series of confirmatory factor analyses (CFAs) were conducted to explore the fit of eight proposed EDE-Q models; internal consistency (Cronbach's alphas, Omega coefficients) and measurement invariance (multi-group CFA) were subsequently evaluated. Results: A brief seven-item, three-factor (dietary restraint, shape/weight overvaluation, body dissatisfaction) model of the EDE-Q from Grilo et al. (Obes Surg. 23:657–662, 2013), consistently evidenced the best fit across cisgender gay men and lesbian women. The internal consistencies of the three subscales were adequate in both groups, and measurement invariance across the groups was supported. Conclusions: Taken together, these findings support the use of the seven-item, three-factor version of the EDE-Q for assessing eating disorder symptomatology in cisgender gay men and lesbian women. Future studies can confirm the current findings in focused examinations of the seven-item, three-factor EDE-Q in diverse sexual minority samples across race, ethnicity, socioeconomic status, and age ranges. Plain English summary: We asked cisgender gay men and lesbian women in The PRIDE Study to fill out a widely used survey about eating disorders, the Eating Disorder Examination-Questionnaire. We found that a version of this questionnaire based on seven questions including three parts—(1) dietary restraint, (2) shape and weight overvaluation, and (3) body dissatisfaction—had the best fit. These findings can assist doctors and scientists in understanding eating disorders in cisgender gay men and lesbian women. [ABSTRACT FROM AUTHOR]

Eating disorder (ED) risk is elevated among college populations in the United States. However, current research assessing the relative risk of ED symptomatology within Greek life has been mixed. We aimed to assess whether Greek Life Affiliation (GA) was associated with a greater risk for ED among college students in the United States as measured on the SCOFF questionnaire. Data were extracted from the Healthy Minds Study, which surveyed 44,785 American college students across 79 schools. The survey asked about GA, Greek life housing, and included the SCOFF questionnaire. This study utilized multiple logistic regressions and chi-square analyses (n = 44785) to analyze the data. GA failed to predict ED-risk in both women (aOR = 0.98 [95% CI = 0.90, 1.06]) and men (aOR = 1.07 [95% CI = 0.92, 1.24]). Similarly, among female [aOR = 1.00 [95% CI = 0.46, 2.12]) and male participants (aOR = 1.06 [95% CI = 0.59, 1.98]), sorority/fraternity housing also failed to predict ED-risk. Greek Life Affiliation is not associated with greater ED-risk among US college students. [ABSTRACT FROM AUTHOR]

Objective: The Eating Disorder Examination‐Questionnaire (EDE‐Q) is one of the most widely used self‐report assessments of eating disorder symptoms. However, evidence indicates potential problems with its original factor structure and associated psychometric properties in a variety of populations, including gender minority populations. The aim of the current investigation was to explore several previously published EDE‐Q factor structures and to examine internal consistency and measurement invariance of the best‐fitting EDE‐Q model in a large community sample of gender minority adults. Methods: Data were drawn from 1567 adults (337 transgender men, 180 transgender women, and 1050 gender‐expansive individuals) who participated in The PRIDE Study, a large‐scale longitudinal cohort study of sexual and gender minorities from the United States. A series of confirmatory factor analyses (CFAs) were conducted to explore the fit of eight proposed EDE‐Q models; internal consistency (Cronbach's alphas, Omega coefficients) and measurement invariance (multi‐group CFA) were subsequently evaluated. Results: A brief seven‐item, three‐factor (dietary restraint, shape/weight overvaluation, body dissatisfaction) model of the EDE‐Q consistently evidenced the best fit across gender minority groups (transgender men, transgender women, gender‐expansive individuals). The internal consistencies of the three subscales were adequate in all groups, and measurement invariance across the groups was supported. Discussion: Taken together, these findings support the use of the seven‐item, three‐factor version of the EDE‐Q for assessing eating disorder symptomatology in gender minority populations. Future studies can confirm the current findings in focused examinations of the seven‐item, three‐factor EDE‐Q in diverse gender minority samples across race, ethnicity, socioeconomic status, and age ranges. Public Significance Statement: Although transgender individuals have greater risk of developing an eating disorder, the factor structure of the Eating Disorder Examination‐Questionnaire, one of the most widely used eating disorder assessment measures, has not been explored in transgender adults. We found that a seven‐item model including three factors of dietary restraint, shape and weight overvaluation, and body dissatisfaction had the best fit among transgender and nonbinary adults. Key PointsWe assessed the Eating Disorder Examination‐Questionnaire in transgender men, transgender women, and gender‐expansive people.Confirmatory factor analysis of a seven‐item model had the best fit among gender minority people.The three factors included dietary restraint, shape and weight overvaluation, and body dissatisfaction.Internal consistencies of the three subscales and measurement invariance were adequate in all groups. [ABSTRACT FROM AUTHOR]

Migration, detention, and deportation are often rife with violence. This study sought to examine associations among pre-migration experiences, detention conditions, and mental health among Mexicans deported from the U.S. to Mexico between 2020 and 2021. Data from the Migrante Project (N=306, weighted N=14,841) were analyzed using descriptive statistics and unadjusted and adjusted multivariate regression models. The prevalence of a lifetime mental health diagnosis was 18.5%. Exposure to adverse conditions in detention (adjusted odds ratio [AOR]=17.56, p<.001) and having been detained in both immigration and non-immigration facilities (AOR=9.70, p=.042) were significantly associated with increased odds of experiencing abuse during migrants' most recent detention. Experiencing abuse during migrants' most recent detention was, in turn, associated with increased odds of a lifetime mental health diagnosis (AOR=4.72, p<.005). Targeted, trauma-informed mental health services are needed for deported Mexican migrants. [ABSTRACT FROM AUTHOR]

Background: The coronavirus (COVID-19) pandemic has killed more than six million people and disrupted health care systems globally. In the United States alone, more than one million people have died from COVID-19 infections. At the start of the pandemic, nearly all aspects of our lives paused to prevent the spread of the novel coronavirus. Many institutions of higher education transitioned to remote learning and enacted social distancing measures. This study examined the health needs and vulnerabilities of lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) college students at the start of the COVID-19 pandemic in the United States. Methods: We fielded a rapid-response online survey between April and June of 2020. We recruited 578 LGBTQ-identifying college students aged 18 years and older by reaching out to LGBTQ-serving organizations on 254 college campuses and via targeted social media advertising. Results: Approximately 40% of LGBTQ college students surveyed were dissatisfied with life at the start of the COVID-19 pandemic, and almost all (90%) were concerned that COVID-19 would threaten their mental health. Moreover, about 40% of LGBTQ college students reported unmet mental health needs, and 28% were worried about seeking care during the pandemic because of their LGBTQ identity. One out of four LGBTQ college students had to go back in the closet because of the pandemic, and approximately 40% were concerned about their finances or personal safety during the COVID-19 pandemic. Some of these adverse outcomes were prominent among younger students, Hispanic/Latinx students, and students with unsupportive families or colleges. Conclusions: Our study adds novel findings to the large body of research demonstrating that LGBTQ college students experienced distress and elevated mental health needs early in the pandemic. Future research should examine the long-term consequences of the pandemic among LGBTQ and other minoritized college students. Public health policymakers, health care providers, and college and university officials should provide LGBTQ students affirming emotional supports and services to ensure their success as the COVID-19 pandemic transitions to endemic. [ABSTRACT FROM AUTHOR]

Simple Summary: No consensus currently exists on immobilization protocols following shoulder surgery. The aim of this study was to identify patterns and types of sling used by surgeons from the United States and Europe for a variety of shoulder surgical procedures and further to identify factors associated with the variations. Four-hundred and ninety-nine surgeons with a median 15 years of experience responded, with 54.7% from the United States and 45.3% from Europe. United States surgeons reported higher abduction pillow sling use than European surgeons, whereas European surgeons reported more simple sling utilization. Increasing experience was negatively correlated with sling duration, meaning more experienced respondents tended to recommend shorter durations of sling use. Considerable variation exists in the immobilization patterns after a variety of shoulder surgical procedures advocated by surgeons with apparent influence from both geographic location and years of clinical experience. Future work is required to establish the most clinically beneficial protocols for immobilization following shoulder surgery. Background: There is currently no consensus on immobilization protocols following shoulder surgery. The aim of this study was to establish patterns and types of sling use for various surgical procedures in the United States (US) and Europe, and to identify factors associated with the variations. Methods: An online survey was sent to all members of the American Shoulder and Elbow Society (ASES) and European Society for Surgery of the Shoulder and Elbow (ESSSE). The survey gathered member data, including practice location and years in practice. It also obtained preferences for the type and duration of sling use after the following surgical procedures: arthroscopic Bankart repair, Latarjet, arthroscopic superior/posterosuperior rotator cuff repair (ARCR) of tears <3 cm and >3 cm, anatomic total shoulder arthroplasty (aTSA) and reverse TSA (rTSA), and isolated biceps tenodesis (BT). Relationships between physician location and sling type for each procedure were analyzed using Fisher's exact tests and post-hoc tests using Bonferroni-adjusted p-values. Relationships looking at years in practice and sling duration preferred were analyzed using Spearman's correlation tests. Results: In total, 499 surgeons with a median of 15 years of experience (IQR = 9–25) responded, with 54.7% from the US and 45.3% from Europe. US respondents reported higher abduction pillow sling use than European respondents for the following: Bankart repair (62% vs. 15%, p < 0.0001), Latarjet (53% vs. 12%, p < 0.001), ARCR < 3 cm (80% vs. 42%, p < 0.001) and >3 cm (84% vs. 61%, p < 0.001), aTSA (50% vs. 21%, p < 0.001) and rTSA with subscapularis repair (61% vs. 22%, p < 0.001) and without subscapularis repair (57% vs. 17%, p < 0.001), and isolated BT (18% vs. 7%, p = 0.006). European respondents reported higher simple sling use than US respondents for the following: Bankart repair (74% vs. 31%, p < 0.001), Latarjet (78% vs. 44%, p < 0.001), ARCR < 3 cm (50% vs. 17%, p < 0.001) and >3 cm (34% vs. 13%, p < 0.001), and aTSA (69% vs. 41%, p < 0.001) and rTSA with subscapularis repair (70% vs. 35%, p < 0.001) and without subscapularis repair (73% vs. 39%, p < 0.001). Increasing years of experience demonstrated a negative correlation with the duration of sling use after Bankart repair (r = −0.20, p < 0.001), Latarjet (r = −0.25, p < 0.001), ARCR < 3 cm (r = −0.14, p = 0.014) and >3 cm (r = −0.20, p < 0.002), and aTSA (r = −0.37, p < 0.001), and rTSA with subscapularis repair (r = −0.10, p = 0.049) and without subscapularis repair (r = −0.19, p = 0.022. Thus, the more experienced surgeons tended to recommend shorter durations of post-operative sling use. US surgeons reported longer post-operative sling durations for Bankart repair (4.8 vs. 4.1 weeks, p < 0.001), Latarjet (4.6 vs. 3.6 weeks, p < 0.001), ARCR < 3 cm (5.2 vs. 4.5 weeks p < 0.001) and >3 cm (5.9 vs. 5.1 weeks, p < 0.001), aTSA (4.9 vs. 4.3 weeks, p < 0.001), rTSR without subscapularis repair (4.0 vs. 3.6 weeks, p = 0.031), and isolated BT (3.7 vs. 3.3 weeks, p = 0.012) than Europe respondents. No significant differences between regions within the US and Europe were demonstrated. Conclusions: There is considerable variation in the immobilization advocated by surgeons, with geographic location and years of clinical experience influencing patterns of sling use. Future work is required to establish the most clinically beneficial protocols for immobilization following shoulder surgery. Level of Evidence: Level IV. [ABSTRACT FROM AUTHOR]

Declines in cervical intraepithelial neoplasia grades 2 to 3 and adenocarcinoma in situ (CIN2+) observed among young women suggest impact from human papillomavirus (HPV) vaccination. To further evaluate vaccine impact including cross‐protection and type replacement, we described high‐risk (HR)‐HPV type‐specific cervical precancer incidence rates among women aged 20 to 39 years, 2008 to 2016. We analyzed cross‐sectional population‐based data on 18 344 cases of CIN2+ from a 5‐site surveillance system. Diagnostic specimens were tested for individual HPV types, including 14 HR‐HPV types (HPV16/18/31/33/35/39/45/51/52/56/58/59/66/68). We estimated age‐specific annual HR‐HPV type‐specific CIN2+ incidence per 100 000 screened women for individual types, vaccine HR‐HPV types (HPV16/18) and nonvaccine HR‐HPV types (non‐HPV16/18). We evaluated trends using average annual percent changes (AAPC) and 95% confidence intervals (CI), and estimated total declines by comparing 2015‐2016 to 2008‐2009 using incidence rate ratios. Among 20‐24‐year‐olds, HPV16/18‐CIN2+ declined from 2008 through 2016 (AAPC: −21.3%, 95% CI: −28.1%, −13.8%), whereas no trend was observed for non‐HPV16/18‐CIN2+ (AAPC: −1.8%, 95% CI: −8.1%, 4.9%). After 2010, CIN2+ among 20‐24‐year‐olds was more often caused by nonvaccine vs vaccine HR‐HPV types. No significant declining trends were observed in older age groups. In 2015‐2016 compared with 2008‐2009, HPV16‐CIN2+ declined 78%, HPV18‐CIN2+ 72% and HPV31‐CIN2+ 51% among 20‐24‐year‐olds; no increases were observed in type‐specific CIN2+ incidence. Among 25‐29‐year‐olds, HPV16‐CIN2+ declined 18%; CIN2+ attributed to seven nonvaccine types increased significantly. No significant declines were observed in older groups. Significant declines in HPV16/18‐CIN2+ in 20‐24‐year‐olds and HPV16‐CIN2+ in 25‐29‐year‐olds corroborate impact of HPV vaccination. A declining trend in HPV31‐CIN2+ is consistent with cross‐protection from vaccination. [ABSTRACT FROM AUTHOR]

Alexander the Great is a historical figure who has caught the interest of the academic and artistic world. In cinema, we must highlight the films by the American directors Robert Rossen and Oliver Stone. This paper reflects on the idea of empire that is developed here considering that the United States is the current empire and that both filmmakers show a critical position with certain policies of their country. [ABSTRACT FROM AUTHOR]

This Essay presents a normative structure for advocating for international soft law standards that can help domestic jurisdictions provide content moderation for election misinformation. Relying on a comparison between the cases of Brazil and the U.S. (both facing recent democratic erosion), this Essay shows how Brazilian courts responded to challenges to democracy and how, in the U.S., content moderation generally depends on private actors. The theoretical analysis presented indicates that transnational and constitutional approaches are required both in the face of the de-territorial characteristics of social media disinformation and also as a prerequisite to conceiving a legitimate approach to private content moderation. This Essay argues that: jurisdictional contextual features cannot be ignored; basic regulations are desirable; content moderation cannot be solely left to private actors, especially considering the need for the protection of democracy; and, finally, that private moderation must also be democratized. [ABSTRACT FROM AUTHOR]

Objectives: To study age at death (AD) and its determinants in cohorts of middle-aged men followed-up until extinction. Material and methods: A total of 9063 middle-aged men enrolled in 10 cohorts of 6 countries (USA, Finland, the Netherlands, Italy, Greece and Japan) within the Seven Countries Study were examined and then followed up for 60 years until extinction. AD was computed and a small number of risk factors were tested through multiple linear regression as possibly related to attained AD. Results: AD ranged across cohorts from 71.8 years in East Finland and 80.5 years in Crete with levels roughly lower in the USA and Northern Europe and higher elsewhere. Across cohorts, the correlation coefficients of systolic blood pressure (R = −0.58) and of CVD prevalence (R = −0.65) versus average AD were the only significant ones. At the individual level in the pool of all cohorts, a multiple linear regression model showed that age, vigorous physical activity, never and ex-smokers were favorably related to AD, while the reverse was true for systolic blood pressure, heart rate, serum cholesterol, CVD prevalence and silent ECG abnormalities. BMI had a parabolic relationship with AD. The predicting power of single risk factors, expressed in years gained or lost, was relatively small, but arbitrary combinations of several of them produced large differences in AD. Conclusions: A small number of CVD risk factors were strongly associated with AD in a life-long follow-up. [ABSTRACT FROM AUTHOR]

A life-saving treatment, solid organ transplantation (SOT) has transformed the survival and quality of life of patients with end-organ dysfunction. The coronavirus disease (COVID-19) pandemic has impacted the practice of deceased and living donations worldwide by various resource shifting, including healthcare personnel and equipment such as ventilators and bed space. Our work explores the COVID-19 pandemic and global transplant data to create a statistical model for deducing the impact of COVID-19 on living donor and deceased donor transplants in the United States of America (USA). In severely impacted regions, transplant centers need to carefully balance the risks and benefits of performing a transplant during the COVID-19 pandemic. In our statistical model, the COVID cases are used as an explanatory variable (input) to living or deceased donor transplants (output). The model is shown to be statistically accurate for both estimation of the correlation structure, and prediction of future donors. The provided predictions are to be taken as probabilistic assertions, so that for each instant where the prediction is calculated, a statistical measure of accuracy (confidence interval) is provided. The method is tested on both low and high frequency data, that notoriously exhibit a different behavior. [ABSTRACT FROM AUTHOR]

When screening candidates, organizations often give preference to certain applicants on the basis of their familial ties. This "legacy preference," particularly widespread in college admissions, has been criticized for contributing to inequality and class reproduction. Despite this, studies continue to report that legacies are persistently admitted at higher rates than non-legacies. In this article, we develop a theoretical framework of three distinct sense-making strategies at play when decision-makers screen applicants into their organizations—the meritocratic, material, and diversity logics. We then apply this framework to investigate how legacy preferences either support or undermine each organizational logic using comprehensive data on the population of applicants seeking admission into one elite U.S. college. We find strong support for the material logic at the cost of the other two organizational logics: legacies make better alumni after graduation and have wealthier parents who are materially-positioned to be more generous donors than non-legacy parents. Contrary to the meritocratic logic, we find that legacies are neither more qualified applicants nor better students academically. From a diversity standpoint, legacies are less racially diverse than non-legacies. We conclude with a discussion of our study's implications for understanding the role of family relationships and nepotism in today's organizational selection processes. [ABSTRACT FROM AUTHOR]

Purpose: The postponement boundary problem entails that duties and cross-border trade complexity can lead companies to geographically postpone operations to downstream global facilities. The present study aims at investigating the problem to provide insights into the drivers behind the choice of different postponement strategies for global food supply chains. Design/methodology/approach: A single case study was conducted considering an Italian company exporting olive oil toward the United States. Two global postponement strategies, previously formalized in the literature, were tailored for food supply chains. A multi-methodological approach was adopted, combining data obtained through exploratory case research with empirically grounded analytical modeling. A sensitivity analysis was also performed, to investigate outcomes related to the considered problem when changing key parameters. Findings: Bulky and heavy packing materials account for a big percentage of finished products' volume and weight, and this can deeply affect strategies' cost-effectiveness. Postponing packaging operations could allow for taking advantage of lower tariffs levied on bulk goods, contributing to significantly lower duties to be paid. However, important trade-offs could arise related to the required investments, and the fiscal regulatory frameworks must be carefully examined. Originality/value: This study offers an empirical investigation of the postponement boundary problem, which is largely unexplored in the current literature. It also tackles an understudied empirical context as global food supply chains. It summarizes the drivers behind and explores the costs related to the implementation of different strategies, offering an original quantitative approach that could support practitioners' decision-making. Lastly, it formalizes five propositions that could pave the way for further research inquiries. [ABSTRACT FROM AUTHOR]

Measuring and forecasting migration patterns has important implications for understanding broader population trends, for designing policy effectively and for allocating resources. However, data on migration and mobility are often lacking, and those that do exist are not available in a timely manner. Social media data offer new opportunities to provide more up-to-date demographic estimates and to complement more traditional data sources. Facebook's Advertising Platform, for example, is a potentially rich data source of demographic information that is regularly updated. However, Facebook's users are not representative of the underlying population. This paper proposes a statistical framework to combine social media data with traditional survey data to produce timely 'nowcasts' of migrant stocks by state in the United States. The model incorporates bias adjustment of Facebook data, and a pooled principal component time series approach, to account for correlations across age, time and space. We use the model to estimate and project migrants from Mexico, India and Germany, three migrant groups with varying levels and trends of migration in the US. By comparing short-term projections with data from the American Community Survey, we show that the model predictions outperform alternatives that rely solely on either social media or survey data. [ABSTRACT FROM AUTHOR]

BACKGROUND While recent decades have seen gradual convergence in ethno-racial disparities in completed fertility in the United States, differences in the age pattern of first births remain. The role of nativity has not been fully understood. OBJECTIVE This paper examines how first births vary by nativity, and how this variation contributes to more significant racial and ethnic differentials. METHODS Using data from the National Survey of Family Growth (1997-2017), we jointly estimate the correlates of the timing of first births and childlessness. We assess differences between immigrants and US-born and child-migrant women across ethno-racial groups. RESULTS The unique first-birth patterns among foreign-born women have a notable impact on Hispanics, reducing differences from Whites in the average age at first birth and contributing to more significant differentials in childlessness. The impact of immigrant women on White and Black first births is more modest in scope. CONTRIBUTION Our work shows the importance of nativity for ethnic/racial disparities in the timing and quantum of fertility in the United States. We demonstrate how the migrant population is more determinant for Hispanic fertility patterns than for Black or White. We conclude by elaborating on the implications of these results for future research as the immigrant population in the United States becomes ethnically and racially more diverse. [ABSTRACT FROM AUTHOR]

Each year, hundreds of thousands of immigrants seek legal employment in the United States. Similar to many developed countries, the United States has established immigration policies to protect its citizens’ employment. This study empirically assesses, for the first time, the relationship between U.S. workers’ unemployment rates and immigrant work authorization outcomes, as determined by one key U.S. immigration program—the labor certification process. This program explicitly requires that no willing and qualified U.S. worker be available for the job position offered to a foreign worker. Through the analysis of 40 months of labor certification requests evaluated by U.S. Department of Labor agents, the authors find that, ironically, immigrant labor certification approvals are more likely when the quantity of unemployed U.S. workers within an occupation is high, ceteris paribus. Further, because of the U.S. government’s procedure of auditing applications, the authors are able to assess approval differences when government agents reach similar labor certification decisions using 1) employers’ accounts of their own compliance (e.g., “attestations”) or 2) supporting documentation collected when employers are audited. Only for evaluations of audited applications, in support of the literature on accounts and regulation, are approvals less likely when unemployment is high. The authors conclude by discussing the implications of their findings for theories and policies concerning labor market regulation, immigration, and employment. [ABSTRACT FROM AUTHOR]

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The 2019 coronavirus (COVID-19) pandemic has led to more than 235,000 deaths and 9 million reported positive cases in the United States. Most of the country implemented stay-at-home orders to prevent the spread of COVID-19, which has led to job losses and more than 40 million claims for unemployment insurance. The objective of this study was to estimate the potential impact of COVID-19-related closures in employment and healthcare access by sexual orientation. We used data from the 2015 to 2018 National Health Interview Survey and employment industry codes to describe the working adult population who may be vulnerable to COVID-19 job losses by sexual orientation. Multivariable logistic regression models identified the risk factors for working in a COVID-19-sensitive industry and differences in healthcare access by sexual orientation. We estimate that there may be approximately 1.7 million sexual minorities and 36.6 million heterosexual adults employed in industries that make them vulnerable to unemployment, uninsurance, and limited access to care. Nearly two-thirds of working adults—regardless of sexual orientation—are at risk of severe illness should they become infected with COVID-19. Almost half of the sexual minority and heterosexual adults in industries sensitive to COVID-19 may remain or become uninsured during the pandemic. Approximately 60% of sexual minorities and 40% of heterosexual adults in COVID-19-sensitive industries are renting their home or apartment (rather than owning their home). Because sexual minority adults vulnerable to the COVID-19 pandemic are renting or within family income ranges for premium tax credits in the individual insurance marketplaces, policymakers should consider expanding protections for renters and broadening special enrollment periods for people seeking coverage in the federal and state-based marketplaces. [ABSTRACT FROM AUTHOR]

Background: Limited research has been conducted that explores the occupational experience of hearing voices, including the impact it has on romantic and/or sexual relationships. This study aims to address this gap by capturing the experience of romantic and sexual relationships for those who hear voices. Method: A phenomenological approach was used to gather data from a survey, electronic diaries, and interviews of three voice hearers who were interested or actively in a casual or serious relationship. Results: All of the participants reported that the voices in some way impacted their past or current romantic and sexual relationships. The dynamic relationship between voices and occupation could directly or indirectly impact the experience of occupation with their partner. Voices with personas were found to have varying levels of participation in occupations, with some becoming co-occupations between the participant and their voices. Support from their partner was valued, though varied by participant, with some of the participants seeking outside support from peers with shared experiences. Conclusion: This research challenges the idea of the individual having full agency during occupational performance. Because voices can actively participate during co-occupations, occupational therapists need to inquire about their voices during evaluation and include them during interventions. [ABSTRACT FROM AUTHOR]

Chagas disease caused by the protozoan parasite Trypanosoma cruzi is endemic in 21 Latin American countries and the southern United States and now is spreading into several other countries due to migration. Despite the efforts to control the vector throughout the Americas, currently, there are almost seven million infected people worldwide, causing ~10,000 deaths per year, and 70 million people at risk to acquire the infection. Chagas disease treatment is restricted only to two parasiticidal drugs, benznidazole and nifurtimox, which are effective during the acute and early infections but have not been found to be as effective in chronic infection. No prophylactic or therapeutic vaccine for human use has been communicated at this moment. Here, we evaluate in a mouse model a therapeutic DNA vaccine combining Cruzipain (Cz), a T. cruzi cysteine protease that proved to be protective in several settings, and Chagasin (Chg), which is the natural Cz inhibitor. The DNAs of both antigens, as well as a plasmid encoding GM-CSF as adjuvant, were orally administrated and delivered by an attenuated Salmonella strain to treat mice during the acute phase of T. cruzi infection. The bicomponent vaccine based on Salmonella carrying Cz and Chg (SChg+SCz) was able to improve the protection obtained by each antigen as monocomponent therapeutic vaccine and significantly increased the titers of antigen- and parasite-specific antibodies. More importantly, the bicomponent vaccine triggered a robust cellular response with interferon gamma (IFN-γ) secretion that rapidly reduced the parasitemia during the acute phase and decreased the tissue damage in the chronic stage of the infection, suggesting it could be an effective tool to ameliorate the pathology associated to Chagas disease. [ABSTRACT FROM AUTHOR]

Since the outbreak in China in late 2019, the novel coronavirus (COVID‐19) has spread around the world and has come to dominate online conversations. By linking 2.3 million Twitter users to locations within the United States, we study in aggregate how political characteristics of the locations affect the evolution of online discussions about COVID‐19. We show that COVID‐19 chatter in the United States is largely shaped by political polarization. Partisanship correlates with sentiment toward government measures and the tendency to share health and prevention messaging. Cross‐ideological interactions are modulated by user segregation and polarized network structure. We also observe a correlation between user engagement with topics related to public health and the varying impact of the disease outbreak in different U.S. states. These findings may help inform policies both online and offline. Decision‐makers may calibrate their use of online platforms to measure the effectiveness of public health campaigns, and to monitor the reception of national and state‐level policies, by tracking in real‐time discussions in a highly polarized social media ecosystem. [ABSTRACT FROM AUTHOR]

Introduction: Professionalism is a vital component of quality patient care. While competency in professionalism is Accreditation Council for Graduate Medical Education (ACGME)-mandated, the methods used to evaluate professionalism are not standardized, calling into question the validity of reported measurements. We aimed to determine the type and frequency of methods used by United States (US) -based emergency medicine (EM) residencies to assess accountability (Acc) and professional values (PV), as well as how often graduating residents achieve competency in these areas. Methods: We created a cross-sectional survey exploring assessment and perceived competency in Acc and PV, and then modified the survey for content and clarity through feedback from emergency physicians not involved in the study. The final survey was sent to the clinical competency committee (CCC) chair or program director (PD) of the 185 US-based ACGME-accredited EM residencies. We summarized results using descriptive statistics and Fisher's exact testing. Results: A total of 121 programs (65.4%) completed the survey. The most frequently used methods of assessment were faculty shift evaluation (89.7%), CCC opinion (86.8%), and faculty summative evaluation (76.4%). Overall, 37% and 42% of residency programs stated that nearly all (greater than 95%) of their graduating residents achieve mastery of Acc and PV non-technical skills, respectively. Only 11.2% of respondents felt their programs were very effective at determining mastery of nontechnical skills. Conclusion: EM residency programs relied heavily on faculty shift evaluations and summative opinions to determine resident competency in professionalism, with feedback from peers, administrators, and other staff less frequently incorporated. Few residency programs felt their current methods of evaluating professionalism were very effective. [ABSTRACT FROM AUTHOR]

Aim: To examine the generalizability of results from glucagon‐like peptide‐1 receptor agonist (GLP‐1 RA) cardiovascular outcome trials (CVOTs) in the US type 2 diabetes (T2D) population. Materials and methods: Patients enrolled or eligible for inclusion in four CVOTs (EXSCEL, LEADER, REWIND, and SUSTAIN‐6) were examined in reference to a retrospective clinical database weighted to match the age and sex distribution of the US adult T2D population. We descriptively compared key baseline characteristics of the populations enrolled in each trial to those of the reference population and estimated the proportions of individuals in the reference population represented by those in the trials for each characteristic. We also estimated the proportions of individuals in the reference population that might have been enrolled in each trial based upon meeting the trial inclusion and exclusion (I/E) criteria. Results: No trial's enrolled population perfectly matched the reference population in key characteristics. The EXSCEL population most closely matched in mean age (62.7 vs. 60.5 years) and percentage with estimated glomerular filtration rate <60 (18.6 vs. 17.3%), while REWIND most closely matched in HbA1c, sex distribution, and proportion with a prior myocardial infarction. Based on I/E criteria, 42.6% of the reference population were eligible for enrolment in REWIND, versus 15.9% in EXSCEL, 13.0% in SUSTAIN‐6, and 12.9% in LEADER. Conclusions: Although none of the trials are fully representative of the general population, among the four trials examined, results from baseline REWIND were found to be more generalizable to the US adult T2D population than those of other GLP‐1 RA CVOTs. [ABSTRACT FROM AUTHOR]

Background: Hyponatraemia induced by antidepressant drugs is a rare but potentially life-threatening adverse reaction. Whether it is associated with all or only some antidepressant drugs is still unclear. This needs to be clarified to guide antidepressant therapies, especially in patients with electrolytic imbalances.Objectives: The primary objective of this study was to quantify the strength of association between the use of different antidepressant drugs and hyponatraemia by using information reported to the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS). The secondary objective was to investigate the putative relationship between different antidepressant pharmacological targets and the risks of hyponatraemia induced by antidepressant drugs using the 'pharmacovigilance-pharmacodynamic' method.Methods: We used the FAERS database to conduct a case/non-case analysis on spontaneous reports, focusing on events of hyponatraemia/syndrome of inappropriate antidiuretic hormone secretion (SIADH) reported in connection with the use of antidepressant drugs. Risk was expressed as a measure of disproportionality using the reporting odds ratio while adjusting for sex, age and concomitant medications associated with hyponatraemia/SIADH. We assessed to what extent the receptor-binding properties of antidepressant drugs could associate with the reporting odds ratios of hyponatraemia/SIADH of antidepressant drugs, building a linear regression model that included as independent variables the binding affinities (pKi) to the serotonin transporter, dopamine transporter, norepinephrine transporter, and serotonin 5-HT2C, 5-HT2A and 5-HT1A, and α1- and α2-adrenergic receptors.Results: There were 2233 reports identified. The adjusted reporting odds ratio for the association between antidepressant drug use and hyponatraemia was 1.91 (95% confidence interval 1.83-2.00). The association was strongest for mirtazapine, followed by selective serotonin reuptake inhibitors, and lowest with serotonin-modulating antidepressant drugs. A significant linear correlation was found between the adjusted reporting odds ratios for hyponatraemia and pKi for the adrenergic receptors α1 and α2.Conclusions: Hyponatraemia is reported at a disproportionately higher level with classes of antidepressant drugs (noradrenergic and specific serotonergic antidepressant [mirtazapine] and serotonin modulators [vortioxetine]) that are in general considered to have a better profile of tolerability in terms of hyponatraemia. With regard to the presented results, the risk of hyponatraemia with mirtazapine appears to be greater than what was reported in the literature; however, confounding by indication cannot be ruled out. Our pharmacovigilance-pharmacodynamic analysis also indicates that inhibition of the serotonin transporter may not be involved in the hyponatraemia linked to the use of antidepressant drugs. [ABSTRACT FROM AUTHOR]

The aim of this research was to inquire if foreign microfinance institutions (MFIs), interested in entering the US microfinance market because of its location advantages, should glocalize their microcredit policies. Research found that women in the USA are a no better risk for microcredit than men, and there are no differences in the repayment of microloans between men and women. The payment behaviour of women and men related to certain specific variables was also investigated. A survey sent to 203 MFIs was used, to which 17.73 per cent responded. Findings show that, in the USA, there are no strong incentives, motivations or external pressures which influence women to pay microcredits better than men. Therefore, international MFIs entering the USA should glocalize their microcredit policies in relation to women as well as their product design and policies for granting microloans. [ABSTRACT FROM AUTHOR]

Information about the 12th meeting of the Panel on Science and Technology which was held in the U.S. on January 26-28, 1971 is presented. The convention focused on issues concerning the application of basic science, applied research and the world economy information management, and international policy. Moreover, it emphasized the role of science and technology for the benefit of humanity.

The article discusses the author's perspective on the stand of the U.S. Congress to space exploration programs of the federal government. He points that those who make the space policy and administer the program must work closely with the scientific community. He emphasizes the responsibilities of the Congress on making basic space policy and implementing it through legislation and appropriation of necessary budget. He adds that the contributions of the citizens and the Congress are both important for the scientific developments.

Objective: The aim of this study was to compare 22 Fr unipolar resectoscope with the traditional 26 Fr unipolar resectoscope in endometrial polypectomy performed under paracervical block anesthesia. Methods: The trial took place in Gynecologic Unit, Department of Surgery, Tor Vergata University Hospital, Rome. Inclusion criteria were: diagnosis of endometrial polyps <3cm at office hysteroscopy; agreement of patients to perform surgery under paracervical block anesthesia but not in office setting. Patients with ASA physical status classes III or more and with contraindication to operative hysteroscopy were excluded. Before the procedure, the recruited patients were randomly assigned to two groups, 35 to the 22 Fr unipolar resectoscope group (group A) and 35 to the 26 Fr unipolar resectoscope group (group B). Primary endpoint was the time spent for cervical dilatation and resection. Secondary endpoints were pain during and after surgery, efficacy of paracervical block, use of analgesic drugs during and after the procedure, patients' satisfaction, correlation between pain and menopause or parity. Statistical analysis was performed by the SPSS software, and the tests used were Pearson Chi-Square, One-way ANOVA and Mann-Whitney test. A p value <.05 was considered significant. Results: The mean time for cervical dilatation was two minutes in group A (26 Fr) and five minutes in group B (22 Fr, p=.001). Operative mean time was four minutes in group A and seven minutes in group B (p=.001). Pain during dilatation was analogous (VAS=6, p=.054), while during the procedure it was higher in group B (VAS=1 vs VAS=2, p=.003). Sufentanil was administered during resection in 19 patients of group A and in 22 patients of group B (p=.754). General anesthesia was never necessary. Postoperative pain was higher in group B (p=.01). Nine patients of group B needed analgesics, as opposed to no patient of group A (p=.002). Conclusions: The 22 Fr unipolar resectoscope appears advantageous compared to the 26 Fr resectoscope in the resection of endometrial polyps <3 cm, in terms of cervical dilatation and operative time, pain and need of postoperative analgesics. Paracervical block is useful and safe in compliant patients at high risk for general anesthesia. [ABSTRACT FROM AUTHOR]

Although coccidioidomycosis in Arizona and California has been well-characterized, much remains unknown about its epidemiology in states where it is not highly endemic. We conducted enhanced surveillance in 14 such states in 2016 by identifying cases according to the Council of State and Territorial Epidemiologists case definition and interviewing patients about their demographic characteristics, clinical features, and exposures. Among 186 patients, median time from seeking healthcare to diagnosis was 38 days (range 1-1,654 days); 70% had another condition diagnosed before coccidioidomycosis testing occurred (of whom 83% were prescribed antibacterial medications); 43% were hospitalized; and 29% had culture-positive coccidioidomycosis. Most (83%) patients from nonendemic states had traveled to a coccidioidomycosis-endemic area. Coccidioidomycosis can cause severe disease in residents of non-highly endemic states, a finding consistent with previous studies in Arizona, and less severe cases likely go undiagnosed or unreported. Improved coccidioidomycosis awareness in non-highly endemic areas is needed. [ABSTRACT FROM AUTHOR]

Background/objectives: We studied the ecologic relationships of food groups, macronutrients, eating patterns, and an a priori food pattern score (Mediterranean Adequacy Index: MAI) with long-term CHD mortality rates in the Seven Countries Study.Subjects/methods: Sixteen cohorts (12,763 men aged 40-59 years) were enrolled in the 1960s in seven countries (US, Finland, The Netherlands, Italy, Greece, former Yugoslavia: Croatia/Serbia, Japan). Dietary surveys were carried out at baseline and only in a subsample of each cohort. The average food consumption of each cohort was chemically analyzed for individual fatty acids and carbohydrates.Results: Ecologic correlations of diet were computed across cohorts for 50-year CHD mortality rates; 97% of men had died in cohorts with 50-year follow-up. CHD death rates ranged 6.7-fold among cohorts. At baseline, hard fat was greatest in northern Europe, olive oil in Greece, meat in the US, sweet products in northern Europe and the US, and fish in Japan. The MAI was high in Mediterranean and Japanese cohorts. The 50-year CHD mortality rates of the cohorts were closely positively ecologically correlated (r = 0.68-0.92) with average consumption of hard fat, sweet products, animal foods, saturated fat, and sucrose, but not with naturally occurring sugars. Vegetable foods, starch, and the a priori pattern MAI were inversely correlated (r = -0.59 to -0.91) with CHD mortality rates.Conclusions: Long-term CHD mortality rates had statistically significant ecologic correlations with several aspects of diet consumed in the 1960s, the traditional Mediterranean and Japanese patterns being rich in vegetable foods, and low in sweet products and animal foods. [ABSTRACT FROM AUTHOR]

Background: Understanding patients' decision control preferences is important in providing quality cancer care. Patients' decisional control preference can be either active (patients prefer to make decisions themselves), shared (collaborative between patient, their physician, and/or family), or passive (patients prefer that the decisions are made by either the physician and/or their family). Aim: To determine the frequency and predictors of passive decision control preferences among advanced cancer patients. We also determined the concordance between actual decision-making and decision control preferences and its association with patient satisfaction. Design: In this cross-sectional survey of advanced cancer patients referred to palliative care across 11 countries, we evaluated sociodemographic variables, Control Preference Scale, and satisfaction with the decisions and care. Results: A total of 1490 participants were evaluable. Shared, active, and passive decision control preferences were 33%, 44%, and 23%, respectively. Passive decision control preferences (odds ratio, p value) was more frequent in India (4.34, <0.001), Jordan (3.41, <0.001), and France (3.27, <0.001). Concordance between the actual decision-making and decision control preferences was highest in the United States (k = 0.74) and lowest in Brazil (0.34). Passive decision control preference was significantly associated with (odds ratio per point, p value) better performance status (0.99/point, 0.017), higher education (0.64, 0.001), and country of origin (Brazil (0.26, <0.0001), Singapore (0.25, 0.0003), South Africa (0.32, 0.0002), and Jordan (2.33, 0.0037)). Conclusion: Passive decision control preferences were less common (23%) than shared and active decision control preference even among developing countries. Significant predictors of passive decision control preferences were performance status, education, and country of origin. [ABSTRACT FROM AUTHOR]

Reliable subnational mortality estimates are essential in the study of health inequalities within a country. One of the difficulties in producing such estimates is the presence of small populations among which the stochastic variation in death counts is relatively high, and thus the underlying mortality levels are unclear. We present a Bayesian hierarchical model to estimate mortality at the subnational level. The model builds on characteristic age patterns in mortality curves, which are constructed using principal components from a set of reference mortality curves. Information on mortality rates are pooled across geographic space and are smoothed over time. Testing of the model shows reasonable estimates and uncertainty levels when it is applied both to simulated data that mimic U.S. counties and to real data for French départements. The model estimates have direct applications to the study of subregional health patterns and disparities. [ABSTRACT FROM AUTHOR]

Background: Previous studies have described the clinical impact of infection in alcoholic hepatitis (AH) but none have comprehensively explored the aetiopathogenesis of infection in this setting. We examined the causes, consequences and treatment of infection in a cohort of patients with AH.Methods: We undertook a retrospective cohort study of patients with AH admitted between 2009 and 2014 to seven centres in Europe and the USA. Clinical and microbiological data were extracted from medical records. Survival was analysed with Kaplan-Meier analysis and Cox proportional hazards analysis to control the data for competing factors. Propensity score matching was used to examine the efficacy of prophylactic antibiotics administered in the absence of infection.Results: We identified 404 patients with AH. Of these, 199 (49%) showed clinical or culture evidence of infection. Gut commensal bacteria, particularly Escherichia coli and Enterobacter species, were most commonly isolated in culture. Fungal infection was rarely seen. Cultured organisms and antibiotic resistance differed markedly between centres. Infection was an independent risk factor for death (hazard ratio for death at 90 days 2.33, 95% confidence interval 1.63-3.35, p < 0.001). Initiation of antibiotic therapy on admission in the absence of infection did not reduce mortality or alter the incidence of subsequent infections. Corticosteroid use increased the incidence of infection but this did not impact on survival.Conclusions: In this large real-world cohort of patients with AH, infection was common and was associated with reduced short-term survival. Gram-negative, gut commensal bacteria were the predominant infective organisms, consistent with increased translocation of gut bacteria in AH; however, the characteristics of infection differ between centres. Infection should be actively sought and treated, but we saw no benefits of prophylactic antibiotics. [ABSTRACT FROM AUTHOR]

Study Design:Online survey study. Objective:To determine physical therapists’ utilization of thrust joint manipulation (TJM) and their comfort level in using TJM between the cervical, thoracic, and lumbar regions of the spine. We hypothesized that physical therapists who use TJM would report regular use and comfort providing it to the thoracic and lumbar spines, but not so much for the cervical spine. Background:Recent surveys of first professional physical therapy degree programs have found that TJM to the cervical spine is not taught to the same degree as to the thoracic and lumbar spines. Methods:We developed a survey to capture the required information and had a Delphi panel of 15 expert orthopedic physical therapists review it and provide constructive feedback. A revised version of the survey was sent to the same Delphi panel and consensus was obtained on the final survey instrument. The revised survey was made available to any licensed physical therapists in the U.S.A. using an online survey system, from October 2014 through June 2015. Results:Of 1014 responses collected, 1000 completed surveys were included for analysis. There were 478 (48%) males; the mean age of respondents was 39.7 ± 10.81 years (range 24–92); and mean years of clinical experience was 13.6 ± 10.62. A majority of respondents felt that TJM was safe and effective when applied to lumbar (90.5%) and thoracic (91.1%) spines; however, a smaller percentage (68.9%) felt that about the cervical spine. More therapists reported they would perform additional screening prior to providing TJM to the cervical spine than they would for the lumbar and thoracic spines. Therapists agreed they were less likely to provide and feel comfortable with TJM in the cervical spine compared to the thoracic and lumbar spines. Finally, therapists who are male; practice in orthopedic spine setting; are aware of manipulation clinical prediction rules; and have manual therapy certification, are more likely to use TJM and be comfortable with it in all three regions. Conclusion:Results indicate that respondents do not believe TJM for the cervical spine to be as safe and efficacious as that for the lumbar and thoracic spines. Further, they are more likely to perform additional screening, abstain from and do not feel comfortable performing TJM for the cervical spine. Clinical Relevance:Our research reveals there is a discrepancy between utilization of TJM at different spinal levels. This research provides an opportunity to address variability in clinical practice among physical therapists utilizing TJM. [ABSTRACT FROM PUBLISHER]

In this article, I demonstrate that the apparently much higher fertility of Hispanic/Mexican women in the United States is almost exclusively the product of period estimates obtained for immigrant women and that period measures of immigrant fertility suffer from three serious sources of bias that together significantly overstate fertility levels: difficulties in estimating the size of immigrant groups; the tendency for migration to occur at a particular stage in life; and, most importantly, the tendency for women to have a birth soon after migration. When these sources of bias are taken into consideration, the fertility of native Hispanic/Mexican women is very close to replacement level. In addition, the completed fertility of immigrant women in the United States is dramatically lower than the level obtained from period calculations. Findings are consistent with classical theories of immigrant assimilation but are a striking departure from the patterns found in previous studies and published statistics. The main implication is that without a significant change in immigration levels, current projections based on the premise of high Hispanic fertility are likely to considerably exaggerate Hispanic population growth, its impact on the ethno-racial profile of the country, and its potential to counteract population aging. [ABSTRACT FROM AUTHOR]

Copyright of Reumatología Clínica is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Humans are exposed to thousands of man-made chemicals in the environment. Some chemicals mimic natural endocrine hormones and, thus, have the potential to be endocrine disruptors. Most of these chemicals have never been tested for their ability to interact with the estrogen receptor (ER). Risk assessors need tools to prioritize chemicals for evaluation in costly in vivo tests, for instance, within the U.S. EPA Endocrine Disruptor Screening Program. OBJECTIVES: We describe a large-scale modeling project called CERAPP (Collaborative Estrogen Receptor Activity Prediction Project) and demonstrate the efficacy of using predictive computational models trained on high-throughput screening data to evaluate thousands of chemicals for ER-related activity and prioritize them for further testing. METHODS: CERAPP combined multiple models developed in collaboration with 17 groups in the United States and Europe to predict ER activity of a common set of 32,464 chemical structures. Quantitative structure--activity relationship models and docking approaches were employed, mostly using a common training set of 1,677 chemical structures provided by the U.S. EPA, to build a total of 40 categorical and 8 continuous models for binding, agonist, and antagonist ER activity. All predictions were evaluated on a set of 7,522 chemicals curated from the literature. To overcome the limitations of single models, a consensus was built by weighting models on scores based on their evaluated accuracies. RESULTS: Individual model scores ranged from 0.69 to 0.85, showing high prediction reliabilities. Out of the 32,464 chemicals, the consensus model predicted 4,001 chemicals (12.3%) as high priority actives and 6,742 potential actives (20.8%) to be considered for further testing. CONCLUSION: This project demonstrated the possibility to screen large libraries of chemicals using a consensus of different in silico approaches. This concept will be applied in future projects related to other end points. [ABSTRACT FROM AUTHOR]

China is engaged in longstanding cyber espionage against the U.S., as well as other nations, to collect sensitive public and private information in support of national objectives laid out in its 12th Five Year Plan. Foreign governments citing China's malfeasance have rebuked these activities, a claim vehemently denied by Beijing. In response, China is leveraging the "Three Warfares" an integrated three-prong information warfare strategy to combat these accusations by leveraging Media, Legal, and Psychological components designed to influence the international community. While the United States has threatened the imposition of economic sanctions, Beijing has successfully parried consequential actions by arresting U.S.-identified hackers, thereby demonstrating its commitment toward preserving a stable and peaceful cyberspace. These interrelated "Three Warfares" disciplines have targeted the cognitive processes of the U.S. leadership, as well as the international public's perception of China as a global threat, thereby having successfully forestalled the implementation of any effective punitive or economic deterrence strategy to include the imposition of cyber sanctions. [ABSTRACT FROM AUTHOR]

This article draws on original survey data to assess the prevalence of perceived discrimination among Latin American immigrants to Durham, North Carolina, a “new immigrant destination” in the Southeastern United States. Even though discrimination has a wide-ranging impact on social groups, from blocked opportunities, to adverse health outcomes, to highlighting and reifying intergroup boundaries, research among immigrant Latinos is rare, especially in new destinations. Our theoretical framework and empirical analysis expand social constructivist approaches that view ethnic discrimination as emerging from processes of competition and incorporation. We broaden prior discussions by investigating the specific social forces that give rise to perceived discrimination. In particular, we examine the extent to which perceptions of unequal treatment vary by gender, elaborating on the situational conditions that differentiate discrimination experiences for men and women. We also incorporate dimensions unique to the contemporary Latino immigrant experience, such as legal status, family migration dynamics, and transnationalism. [ABSTRACT FROM AUTHOR]

The article discusses a study on the impact of the global climate change on the national security, infrastructure, economy, and public health in the U.S. Topics include a survey on the concerns of Americans on climate change, the definition of national security according to the U.S. National Security Strategy (NSS), the protection of critical infrastructure (CI), and an investigation on American CI by the American Society of Civil Engineers (ASCE).

Close parent-child relationships are viewed as important for the development of global self-esteem. Cross-sectional research supports this hypothesis, but longitudinal studies provide inconsistent prospective effects. The current study uses data from Germany (N = 982) and the United States (N = 451) to test longitudinal relations between parent-child closeness and adolescent self-esteem. The authors used self-, parent-, and observer-reported parent-child closeness and self-reported self-esteem from ages 12 to 16. Results replicated concurrent correlations found in the literature, but six longitudinal models failed to show prospective relations. Thus, the longitudinal effect of parent-child closeness and self-esteem is difficult to detect with adolescent samples. These findings suggest the need for additional theorizing about influences on adolescent self-esteem development and longitudinal research with younger samples. [ABSTRACT FROM AUTHOR]

Non-monetary transfers of time represent a largely unknown, yet pivotal component, of the support system in the United States. We map flows of time transfers, by age and sex, related to informal childcare and adult care in the US. We develop methods to estimate intra- and inter-household time transfers using data from the American Time Use Survey (2011-2013). We summarize the results in matrices of time flows by age and sex for the general US population, as well as for the 'sandwich generation.' Most time transfers flow downwards from parents to young children, with relevant gender differences. The time produced by the sandwich generation is directed toward a more diverse population spectrum, including substantial intra-generational transfers to spouses. Extrapolations based on our findings reveal a projected rise in demand, relative to supply, of informal care, indicating that, to maintain current levels of care, US society will have to rely more heavily either on the market or on an increased effort of caregivers. [ABSTRACT FROM AUTHOR]