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Abstract Background The Fire service Organizational Culture of Safety (FOCUS) survey is an assessment tool comprised of psychometrically validated metrics of safety climate, safety behavior, and downstream outcomes (organizational and injury) that are specific to the U.S. fire and rescue service. Methods This analysis consists of a descriptive summary of two independent survey waves (FOCUS 1.0 and 2.0). The fire departments included in these survey waves were from convenience sampling (n 1.0 = 275; n 2.0 = 170). In addition to department level characteristics, we examined individual level characteristics for firefighters and EMS providers in participating departments (n 1.0 = 22,719; n 2.0 = 16,882). We conducted regression analyses to examine the associations between safety climate and safety behaviors, organizational outcomes, and safety outcomes. All analyses were stratified by organization type (career, volunteer). Results Our analysis indicated that a majority of respondents were males (90.7%FOCUS 1.0; 90.4%FOCUS 2.0), non-officers (68.4%FOCUS 1.0; 66.4%FOCUS 2.0), and non-Hispanic Whites (70.8%FOCUS 1.0; 69.5%FOCUS 2.0). For both samples there was a higher prevalence of injuries among individuals in career departments (n FOCUS 1.0 = 3778 [17.5%]; n FOCUS 2.0 = 3072 [18.7%]) than volunteer departments (n FOCUS 1.0 = 103 [8.8%]; n FOCUS 2.0 = 34 [7.4%]). We observed an approximate 10-point difference between the mean scores of Management Commitment to Safety for career and volunteer departments in both samples. We observed associations for two organizational outcomes, Safety Behavior and Job Satisfaction, with Management Commitment to Safety and Supervisor Support for Safety overall and when stratified by organization type. We observed a decrease in the odds of injuries associated with a one-unit increase in Management Commitment to Safety (OR1.0 overall: 0.98, 95% CI 0.97–0.99; OR2.0 volunteer: 0.90, 95% CI 0.85–0.95) and Supervisor Support for Safety (OR1.0 overall: 0.95, 95% CI 0.93–0.97; OR1.0 career: 0.95, 95% CI 0.92–0.98). Conclusions From our current study, and a prior analysis of a geographically stratified random sample of U.S. fire departments, we identified that from all the organizational outcomes, job satisfaction was most consistently associated with FOCUS safety climate. Further, firefighters in our samples consistently rated Supervisor Support for Safety higher than Management Commitment to Safety. Future interventions should support fire departments in improving their departmental Management Commitment to Safety and maintaining their Supervisor for Safety.

Abstract We present a hydrogen/deuterium exchange workflow coupled to tandem mass spectrometry (HX-MS2) that supports the acquisition of peptide fragment ions alongside their peptide precursors. The approach enables true auto-curation of HX data by mining a rich set of deuterated fragments, generated by collisional-induced dissociation (CID), to simultaneously confirm the peptide ID and authenticate MS1-based deuteration calculations. The high redundancy provided by the fragments supports a confidence assessment of deuterium calculations using a combinatorial strategy. The approach requires data-independent acquisition (DIA) methods that are available on most MS platforms, making the switch to HX-MS2 straightforward. Importantly, we find that HX-DIA enables a proteomics-grade approach and wide-spread applications. Considerable time is saved through auto-curation and complex samples can now be characterized and at higher throughput. We illustrate these advantages in a drug binding analysis of the ultra-large protein kinase DNA-PKcs, isolated directly from mammalian cells.

Dual-mobility (DM) implants have been used in total hip arthroplasty since 1974. Modular DM implants have seen an increase in use in primary and revision total hip arthroplasties given the theoretical decreased dislocation rate. DM constructs have 2 articulation sites, one between the acetabular shell and a polyethylene liner, as well as one between the liner and the femoral head component. However, dislocations with modular DM implant dislocations can still occur. These dislocations occur via an extraprosthetic or intraprosthetic mechanism. Intraprosthetic dislocation is a phenomenon in which the smaller femoral head dissociates from the polyethylene liner. We present a case of intraprosthetic dislocation in an 81-year-old female with migration of the polyethylene liner into her gluteal muscles after 2 attempted closed reductions.

Climate hazards threaten the health and wellbeing of people living in urban areas. This study characterized reported climate hazards, adaptation action, and barriers to adaptation in 124 Latin American cities, and associations of climate hazards with urban social and built environment characteristics. We examined cities that responded to a global environmental disclosure system and that were included in the Urban Health in Latin America (SALURBAL) Project database.The cities studied reported a median of three climate hazards. The most reported hazards were storms (61%) water scarcity (57%) extreme temperature (52%) and wildfires (51%). Thirty-eight percent of cities reported four or more distinct types of hazards. City size, density, GDP, and greenness were related to hazard reports, and although most cities reported taking actions to reduce vulnerability to climate change, 23% reported no actions at all. The most frequently reported actions were hazard mapping and modeling (47%) and increasing vegetation or greenspace coverage (45%). Other actions, such as air quality initiatives and urban planning, were much less common (8% and 3%, respectively). In terms of challenges in adapting to climate change, 35% of cities reported no challenges. The most frequently reported challenges were urban environment and development (43%) and living conditions (35%). Access to data, migration, public health, and safety/security were rarely reported as challenges. Our results suggest that climate hazards are recognized, but that adaptation responses are limited and that many important challenges to response action are not fully recognized.This study contributes to understanding of local priorities, ongoing actions, and required support for urban climate vulnerability assessment and adaptation responses. Findings suggest the need for future research documenting local perceptions of climate hazards and comparison with documented climate hazards.

Abstract Background Up to a third of global road traffic deaths, and one in five in Mexico, are attributable to alcohol. In 2013, Mexico launched a national sobriety checkpoints program designed to reduce drink-driving in municipalities with high rates of alcohol-related collisions. Our study measured the association between the sobriety checkpoints program and road traffic mortality rates in 106 urban municipalities. Methods We leveraged data from the Salud Urbana en America Latina (SALURBAL), which compiles health and environmental data from cities with over 100,000 residents. Death data from 2005 to 2019 (i.e., outcome) were from official vital statistics. Among 106 Mexican municipalities defined as priority areas for intervention, 54 adopted the program (i.e., treatment) in 2013, 16 municipalities did so in 2014, 16 in 2015, 10 in 2016, 7 in 2017, and 2 in 2019. We used a difference-in-difference approach with inverse probability weighting adapted to a context where program adoption is staggered over time. Results There was a 12.3% reduction in road traffic fatalities per 10,000 passenger vehicles in the post-treatment period compared to the pre-treatment period (95% Confidence Interval, − 17.8; − 6,5). There was a clear trend of decline in mortality in municipalities that adopted the program (vs. comparison) particularly after year 2 of the program. Conclusions In this study of 106 municipalities in Mexico, we found a 12.3% reduction in traffic fatalities associated with the adoption of sobriety checkpoints. There was a clear trend indicating that this association increased over time, which is consistent with sustained changes in drink-driving behavior. These findings provide support and insight for efforts to implement and evaluate the impact of sobriety checkpoint policies across Latin America.

Images from the Voyager 2 mission revealed the small Uranian satellite Miranda to be a complex, dynamic world. This is exemplified by signs of recent geological activity, including an extensive fault system and the mysterious coronae. This has led to speculation that Miranda may have been tectonically active within the geologically recent past and could have hosted a subsurface liquid water ocean at the time. In this work, we aim to constrain the thickness ranges for the ice shell and potential subsurface ocean on Miranda. Here, we present the results for our geological mapping of craters, ridges, and furrows on the surface. We also present the results for our comparison of the geographic distribution of these features to the predicted geographic distribution of maximum tidal stress based on stress models. We model eccentricity tidal stress, ice shell thickening stress, true polar wander stress, and obliquity tidal stress and compare the predicted surface stress pattern for each to what pattern can be inferred from the surface geology. Our results show that a thin crust (≤30 km) is most likely to result in sufficient stress magnitude to cause brittle failure of ice on Miranda’s surface. Our results also suggest the plausible existence of a ≥100 km thick ocean on Miranda within the last 100–500 million yr. This has implications for the dynamical history of Miranda and its status as a potential ocean world.

In this article, we summarize the work of the NASA Outer Planets Assessment Group (OPAG) Roadmaps to Ocean Worlds (ROW) group. The aim of this group is to assemble the scientific framework that will guide the exploration of ocean worlds, and to identify and prioritize science objectives for ocean worlds over the next several decades. The overarching goal of an Ocean Worlds exploration program as defined by ROW is to "identify ocean worlds, characterize their oceans, evaluate their habitability, search for life, and ultimately understand any life we find." The ROW team supports the creation of an exploration program that studies the full spectrum of ocean worlds, that is, not just the exploration of known ocean worlds such as Europa but candidate ocean worlds such as Triton as well. The ROW team finds that the confirmed ocean worlds Enceladus, Titan, and Europa are the highest priority bodies to target in the near term to address ROW goals. Triton is the highest priority candidate ocean world to target in the near term. A major finding of this study is that, to map out a coherent Ocean Worlds Program, significant input is required from studies here on Earth; rigorous Research and Analysis studies are called for to enable some future ocean worlds missions to be thoughtfully planned and undertaken. A second finding is that progress needs to be made in the area of collaborations between Earth ocean scientists and extraterrestrial ocean scientists.

Background: Primary total knee arthroplasty (TKA) has been historically associated with considerable blood loss. Allogenic transfusions, the standard of care for blood loss following TKA, carry inherent risks. With the expanding use of robotic technology in TKA, one theoretical advantage is decreased blood loss and postoperative blood transfusions requirements. The purpose of this study was to compare postoperative hemoglobin levels and the percentage of patients requiring a transfusion of allogenic packed red blood cells after conventional TKA (CTKA) vs robot-assisted TKA (RATKA). Methods: This is a retrospective review of 486 consecutive patients undergoing either CTKA or RATKA between October 30, 2018, and June 25, 2020, by a single fellowship-trained arthroplasty surgeon. Mako SmartRobotics (Stryker, Kalamazoo, MI) was used for RATKA cases. Primary outcomes included preoperative vs postoperative hemoglobin values and postoperative blood transfusion rates between the 2 groups. Results: The mean hemoglobin on postoperative day 1 was 10.7 gm/dl (±1.3) in the CTKA group and 10.9 gm/dl (±1.3) in the RATKA group, P = .24. The largest decline in hemoglobin from preoperative to within 2 days postoperatively was 3.1 gm/dl (±1.1) in the CTKA group and 3.1 gm/dl (±1.1) in the RATKA group, P = .92. The percentage of patients requiring a blood transfusion was 1.1% in the CTKA group and 1.3% in the RATKA group, P = .79. Conclusions: RATKA and CTKA groups did not have significant differences in postoperative hemoglobin changes or the need for postoperative blood transfusions.

In a study exploring how organizational identification impacted college retention and performance outcomes at a university in the United States, we found the mere act of taking the survey emerged as an unexpectedly strong result. Using propensity score matching, we found that those who took the voluntary survey during the first week of school were 6%, 9%, and 11% more likely to retain by the second, third, and fourth semesters, respectively. Participation in a short survey had notable retention predictive power 18 months later. These results provoke a series of questions on retention much more broadly considered and invite us to recalibrate our understanding of mechanisms for improving retention.

Purpose: The purpose of this paper is to comprehensively explore the association between low self-control and college student retention. Design/methodology/approach: Cross-sectional survey data were obtained from 369 undergraduate students in the USA and combined with follow-up data on retention. Factor analysis was used to develop and validate the abbreviated eight-item low self-control instrument. Propensity score matching, an analytic technique that permits the assertion of causality without the need for experimental design, was used to examine the relationship between low self-control and second-semester college retention. Use of propensity score matching permitted the pairing of survey respondents under the defined circumstance of low self-control with those respondents not having low self-control under multiple relevant covariates. Findings: The results showed a relationship between low self-control and college retention. Specifically, in the matched sample, those students with low self-control were 8 percent less likely to be retained at the institution at the onset of the second year than their counterparts with higher self-control. Practical implications: The results of the study prompt the important question of how colleges and universities can alter their structures and processes to better support students with low self-control. Key managerial and administrative implications from the findings of this study revolve around the recognition, motivation, and subsequent performance appraisals of those students with low self-control. Originality/value: This study extends the quite limited research on how low self-control correlates with retention and subsequently offers insights on how to further support students with low self-control as a way to improve retention outcomes. Additionally, the validated eight-item survey provides a quick, low-cost assessment tool for interested researchers and managers.

As watersheds are complex systems that are difficult to directly study, the streams that drain them are often sampled to search for watershed “signals.” These signals include the presence and/or abundance of isotopes, types of sediment, organisms (including pathogens), chemical compounds associated with ephemeral biogeochemical processes or anthropogenic impacts, and so on. Just like watersheds can send signals via the streams that drain from them, we present a conceptual analysis that suggests plant canopies (equally complex and hard-to-study systems) may send similar signals via the precipitation that drains down their stems (stemflow). For large, tall, hard-to-access tree canopies, this portion of precipitation may be modest, often

Objectives To evaluate variability in life expectancy at birth in small areas, describe the spatial pattern of life expectancy, and examine associations between small-area socioeconomic characteristics and life expectancy in a mid-sized city of a middle-income country.Design Cross-sectional, using data from death registries (2015–2018) and socioeconomic characteristics data from the 2010 national population census.Participants/setting 40 898 death records in 99 small areas of the city of Córdoba, Argentina. We summarised variability in life expectancy at birth by using the difference between the 90th and 10th percentile of the distribution of life expectancy across small areas (P90-P10 gap) and evaluated associations with small-area socioeconomic characteristics by calculating a Slope Index of Inequality in linear regression.Primary outcome Life expectancy at birth.Results The median life expectancy at birth was 80.3 years in women (P90-P10 gap=3.2 years) and 75.1 years in men (P90-P10 gap=4.6 years). We found higher life expectancies in the core and northwest parts of the city, especially among women. We found positive associations between life expectancy and better small-area socioeconomic characteristics, especially among men. Mean differences in life expectancy between the highest versus the lowest decile of area characteristics in men (women) were 3.03 (2.58), 3.52 (2.56) and 2.97 (2.31) years for % adults with high school education or above, % persons aged 15–17 attending school, and % households with water inside the dwelling, respectively. Lower values of % overcrowded households and unemployment rate were associated with longer life expectancy: mean differences comparing the lowest versus the highest decile were 3.03 and 2.73 in men and 2.57 and 2.34 years in women, respectively.Conclusion Life expectancy is substantially heterogeneous and patterned by socioeconomic characteristics in a mid-sized city of a middle-income country, suggesting that small-area inequities in life expectancy are not limited to large cities or high-income countries.

IntroductionDespite global progress on many measures of child health, rates of neonatal mortality remain high in the developing world. Evidence suggests that substantial improvements can be achieved with simple, low-cost interventions within family and community settings, particularly those designed to change knowledge and behaviour at the community level. Using social network analysis to identify structurally influential community members and then targeting them for intervention shows promise for the implementation of sustainable community-wide behaviour change.Methods and analysisWe will use a detailed understanding of social network structure and function to identify novel ways of targeting influential individuals to foster cascades of behavioural change at a population level. Our work will involve experimental and observational analyses. We will map face-to-face social networks of 30 000 people in 176 villages in Western Honduras, and then conduct a randomised controlled trial of a friendship-based network-targeting algorithm with a set of well-established care interventions. We will also test whether the proportion of the population targeted affects the degree to which the intervention spreads throughout the network. We will test scalable methods of network targeting that would not, in the future, require the actual mapping of social networks but would still offer the prospect of rapidly identifying influential targets for public health interventions.Ethics and disseminationThe Yale IRB and the Honduran Ministry of Health approved all data collection procedures (Protocol number 1506016012) and all participants will provide informed consent before enrolment. We will publish our findings in peer-reviewed journals as well as engage non-governmental organisations and other actors through venues for exchanging practical methods for behavioural health interventions, such as global health conferences. We will also develop a 'toolkit' for practitioners to use in network-based intervention efforts, including public release of our network mapping software.Trial registration numberNCT02694679; Pre-results.

Millions of California voters regularly turn out in November but abstain from primary elections.A randomized Get Out the Vote experiment conducted in the state’s 2014 primary contestshows that this dormant electorate can be mobilized if campaigns target these unlikely voters.Here, we extend these findings to examine whether the electoral context of the district shapes theeffectiveness of a primary mobilization effort. To do so, we develop two conceptualizations ofcampaign context. The first is based on a district’s typical level of competitiveness. The secondlooks at total spending levels in the current campaign. Theories of voter information processingpredict differential responsiveness by voters to mobilization efforts in these different contexts.To test these predictions, we analyze a field experiment that sends direct mail to 149,596 registeredlow-propensity California voters. Consistent with theory, we find that voter mobilizationmailings have different effects in these two distinct contexts. Although mobilization efforts alwaysincrease turnout, in districts that are typically competitive we find that mobilization effortsare more effective. In contrast, in districts that saw large amounts of spending in the 2014 race,the same treatments are less effective. This suggests that a campaign looking for the largest marginalreturn should target races that have been competitive in prior races but that are receivinglittle attention in the present contest.

BackgroundIntimate partner violence (IPV) is a complex global problem, not only because it is a human rights issue, but also because it is associated with chronic mental and physical illnesses as well as acute health outcomes related to injuries for women and their children. Attitudes, beliefs, and norms regarding IPV are significantly associated with the likelihood of both IPV experience and perpetration.MethodsWe investigated whether IPV acceptance is correlated across socially connected individuals, whether these correlations differ across types of relationships, and whether social position is associated with the likelihood of accepting IPV. We used sociocentric network data from 831 individuals in rural Honduras to assess the association of IPV acceptance between socially connected individuals across 15 different types of relationships, both within and between households. We also investigated the association between network position and IPV acceptance.ResultsWe found that having a social contact that accepts IPV is strongly associated with IPV acceptance among individuals. For women the clustering of IPV acceptance was not significant in between-household relationships, but was concentrated within households. For men, however, while IPV acceptance was strongly clustered within households, men's acceptance of IPV was also correlated with people with whom they regularly converse, their mothers and their siblings, regardless of household. We also found that IPV was more likely to be accepted by less socially-central individuals, and that the correlation between a social contact's IPV acceptance was stronger on the periphery, suggesting that, as a norm, it is held on the periphery of the community.ConclusionOur results show that differential targeting of individuals and relationships in order to reduce the acceptability and, subsequently, the prevalence of IPV may be most effective. Because IPV norms seem to be strongly held within households, the household is probably the most logical unit to target in order to implement change. This approach would include the possible benefit of a generational effect. Finally, in social contexts in which perpetration of IPV is not socially acceptable, the most effective strategy may be to implement change not at the center but at the periphery of the community.

Background: Mental health is an important contributor to the global burden of disease, and depression is the most prevalent mental disorder in Latin America and the Caribbean (LAC). Informal jobs, often characterized by precarious working conditions, low wages, and limited employment benefits, are also highly prevalent in LAC and may be associated with poorer mental health. Our study tests the association between informal employment and major depressive symptoms in LAC cities. Methods: We used individual-level data collected by the Development Bank of Latin America via their “Encuesta CAF” (ECAF) 2016, a cross-sectional household survey of 11 LAC cities (N = 5430). Depressive symptoms were measured using the 10-item Center for Epidemiologic Studies Short Depression Scale with possible total score ranging from 0 to 30. Scores were dichotomized, with a score >‾ 16 indicating the presence of major depressive symptoms. Informal employment was defined based on self-reported lack of contribution to the social security system. We used generalized estimating equation (GEE) log-binomial models to estimate the association between informal employment and depressive symptoms overall and by gender. Models were adjusted for age, education, and household characteristics. Results: Overall, individuals employed in informal jobs had a 27% higher prevalence of major depressive symptoms (Prevalence Ratio [PR]: 1.27; 95% Confidence Interval [CI]: 1.00, 1.62) compared to those in formal jobs. The prevalence of depressive symptoms among individuals with informal jobs was higher compared to those with formal jobs in both women (PR: 1.36, 95% CI: 1.06, 1.74) and men (PR: 1.22; 95% CI: 0.90, 1.65). Conclusions: Informal employment in LAC was associated with a higher prevalence of major depressive symptoms. It is important to develop policies aiming at reducing informal jobs and increasing universal social protection for informal workers.

In the poultry value chain, live animal markets are common hotspots for dispersing multiple infectious diseases. This work was initiated to assess biosecurity practices in the poultry market. For this purpose, a survey was conducted in 8 live poultry markets in Yaoundé, in combination with a questionnaire-based survey with the stakeholders of the livestock markets. The data collected were analyzed using descriptive statistics. The results revealed that all the markets (100%) were not only used for selling live poultry, and the birds were not confined. In all the markets (100%), poultry was sold without any disinfection observed, and no program was implemented to fight against rodents. The introduction of birds into the market without quarantine was observed at 33.9%; 46.9% of traders and slaughtering persons were working together in closed proximity, birds were kept in wooden cages on the ground in all the market (85.8%) and, when transported inter-urbanely the birds were kept in plastic cages (100%). Cages were piled on top of one another (61.4%) had poultry of different breeds (30.3%) and of different ages (100%). All traders do not put on clean uniforms reserved for their poultry selling activities only, and they do not carry out any medical check-ups. Most customers (72.8%) slaughtered their birds in the market, and the unsold birds (100%) were not returned. Stray dogs, rodents, and cats were found in the market (100%). It was concluded that there is a limited application of biosecurity measures in the live poultry markets in Yaoundé, which, therefore, represents a risk of the dissemination of high pathogenic avian/zoonosis diseases. Live bird market stakeholders should be educated on adhering to biosecurity measures and practices. [ABSTRACT FROM AUTHOR]