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Background: Pediatric intestinal pseudo‐obstruction (PIPO) encompasses a variety of rare, heterogeneous, and disabling disorders that severely affect gastrointestinal motility and are associated with high morbidity and mortality. PIPO management is complex and focuses on maintaining an optimal nutritional status, improving gut function, relieving symptoms, and treating complications. Nutritional issues prevail, and PIPO patients often experience severe undernutrition and faltering growth. Thus, nutritional management plays a pivotal role for achieving the most favorable clinical outcomes. The calorie and nutrient intake of each patient needs to be tailored to age, extent and severity of gut involvement and nutritional needs to support an optimal nutritional status. After defining the extent and severity of gut dysmotility, an experienced team should perform a careful nutritional assessment. An oral diet should always be encouraged and might include bite and dissolve solids, liquid diet or simple oral stimulation. If oral caloric intake is inadequate, liquid gastric feeds should provide the subsequent step. In the presence of severe gastric dysmotility, continuous post‐pyloric feeding represents a viable option. In the most severe cases, parenteral nutrition (PN) is required to meet appropriate nutritional requirements. Purpose: Pediatric data on this topic are scarce and mainly extrapolated from adult studies. In this review, we discuss current evidence and knowledge regarding nutritional options, implications of the use of different feed types, including a blended diet, and the use of PN. Moreover, based on our experience and the evidence from the literature, we propose a flow chart to guide the nutritional management of PIPO patients. [ABSTRACT FROM AUTHOR]

Healthy honey bee colonies follow predictable patterns of weight change through the season, gaining weight when resources are abundant and losing weight during periods of scarcity. Divergence from this pattern can indicate trouble in the colony, necessitating beekeeper intervention. While colony weight monitoring has long been used to evaluate colony progress and diagnose potential problems, research has been limited by the labor associated with manual weight measurements. The introduction of next generation colony weight monitoring permits the collection of hive weight data continuously and remotely, enhancing the range of questions that can be answered with these data. However, there is currently no central guide for researchers aiming to use hive scales in their research. Here, we review the literature and describe current methods used to process and analyze within-day, or diel, and seasonal colony weight changes. Diel weight dynamics are based around the circadian rhythm of the colony, resulting from the departure and arrival of foragers and the intake, consumption, and dehydration of food stores. Seasonal weight dynamics can be used to assess colony survival and productivity, often in relation to large-scale patterns of climate, landscape, and floral resource phenology. In addition to describing methods, we highlight future applications of hive weight monitoring, including monitoring weight across ecological gradients and physiological time, coupling of weight monitoring with other colony monitoring techniques, and the practical use of weight monitoring in commercial beekeeping operations. This paper serves as a tool for those wishing to conduct research using colony weight monitoring, and guides the future of remote weight monitoring in honey bee research. [ABSTRACT FROM AUTHOR]

Introduction: Improved understanding of the distribution of traditional risk factors of cigarette smoking among youth who have ever used or are susceptible to e-cigarettes and cigarettes will inform future longitudinal studies examining transitions in use.Methods: Multiple logistic regression analysis was conducted using data from youth (ages 12-17 years) who had ever heard of e-cigarettes at baseline of the PATH Study (n = 12,460) to compare the distribution of risk factors for cigarette smoking among seven mutually exclusive groups based on ever cigarette/e-cigarette use and susceptibility status.Results: Compared to committed never users, youth susceptible to e-cigarettes, cigarettes, or both had increasing odds of risk factors for cigarette smoking, with those susceptible to both products at highest risk, followed by cigarettes and e-cigarettes. Compared to e-cigarette only users, dual users had higher odds of nearly all risk factors (aOR range = 1.6-6.8) and cigarette only smokers had higher odds of other (non-e-cigarette) tobacco use (aOR range = 1.5-2.3), marijuana use (aOR = 1.9, 95%CI = 1.4-2.5), a high GAIN substance use score (aOR = 1.9, 95%CI = 1.1-3.4), low academic achievement (aOR range = 1.6-3.4), and exposure to smoking (aOR range = 1.8-2.1). No differences were observed for externalizing factors (depression, anxiety, etc.), sensation seeking, or household use of non-cigarette tobacco.Conclusions: Among ever cigarette and e-cigarette users, dual users had higher odds of reporting traditional risk factors for smoking, followed by single product cigarette smokers and e-cigarette users. Understanding how e-cigarette and cigarette users differ may inform youth tobacco use prevention efforts and advise future studies assessing probability of progression of cigarette and e-cigarette use. [ABSTRACT FROM AUTHOR]

Managed bees are critical for crop pollination worldwide. As the demand for pollinator-dependent crops increases, so does the use of managed bees. Concern has arisen that managed bees may have unintended negative impacts on native wild bees, which are important pollinators in both agricultural and natural ecosystems. The goal of this study was to synthesize the literature documenting the effects of managed honey bees and bumble bees on wild bees in three areas: (1) competition for floral and nesting resources, (2) indirect effects via changes in plant communities, including the spread of exotic plants and decline of native plants, and (3) transmission of pathogens. The majority of reviewed studies reported negative effects of managed bees, but trends differed across topical areas. Of studies examining competition, results were highly variable with 53% reporting negative effects on wild bees, while 28% reported no effects and 19% reported mixed effects (varying with the bee species or variables examined). Equal numbers of studies examining plant communities reported positive (36%) and negative (36%) effects, with the remainder reporting no or mixed effects. Finally, the majority of studies on pathogen transmission (70%) reported potential negative effects of managed bees on wild bees. However, most studies across all topical areas documented the potential for impact (e.g. reporting the occurrence of competition or pathogens), but did not measure direct effects on wild bee fitness, abundance, or diversity. Furthermore, we found that results varied depending on whether managed bees were in their native or non-native range; managed bees within their native range had lesser competitive effects, but potentially greater effects on wild bees via pathogen transmission. We conclude that while this field has expanded considerably in recent decades, additional research measuring direct, long-term, and population-level effects of managed bees is needed to understand their potential impact on wild bees. [ABSTRACT FROM AUTHOR]

The expansion of modern agriculture has led to the loss and fragmentation of natural habitat, resulting in a global decline in biodiversity, including bees. In many countries, farmers can participate in cost-share programs to create natural habitat on their farms for the conservation of beneficial insects, such as bees. Despite their dependence on bee pollinators and the demonstrated commitment to environmental stewardship, participation in such programs by Wisconsin cranberry growers has been low. The objective of this study was to understand the barriers that prevent participation by Wisconsin cranberry growers in cost-share programs for on-farm conservation of native bees. We conducted a survey of cranberry growers (n = 250) regarding farming practices, pollinators, and conservation. Although only 10% of growers were aware of federal pollinator cost-share programs, one third of them were managing habitat for pollinators without federal aid. Once informed of the programs, 50% of growers expressed interest in participating. Fifty-seven percent of growers manage habitat for other wildlife, although none receive cost-share funding to do so. Participation in cost-share programs could benefit from outreach activities that promote the programs, a reduction of bureaucratic hurdles to participate, and technical support for growers on how to manage habitat for wild bees. [ABSTRACT FROM AUTHOR]

Objectives: We describe e-cigarette sales trends and market share from US convenience stores and mass market retailers. Methods: We used Nielsen Scantrack to calculate US e-cigarette sales market share from convenience and mass market channels during the 4-week period ending 1/19/13 through the period ending 12/19/15. Internet searches were used to supplement Nielsen product information. Results: From 2013 to 2015, rechargeable e-cigarette brands VUSE and MarkTen experienced the largest growth in Nielsen channels. E-liquid and tank type brands Vapin Plus and Haus experienced growth although their Nielsen market share is small compared to other brands. Sales of brands with high labeled nicotine content (according to packaging or website) increased. Fruit-flavored sales increased rapidly in Nielsen, yet still represent a minority of market share in these channels. Discussion: Market-leading e-cigarette brands changed substantially in Nielsen channels from 2013 to 2015. Brand leaders in these channels are now owned by tobacco companies. Changes in labeled nicotine content and fruit-flavored products and product types suggest that as e-cigarette use increases, convenience store and mass market channels are offering new products to meet consumer preferences; however, Nielsen channels do not represent the entire e-cigarette marketplace. [ABSTRACT FROM AUTHOR]

Introduction: While risk factors for cigarette smoking among youth and young adults are well-documented, less is known about the correlates of initiation of other tobacco products. This study aims to provide estimates and correlates of initiation among U.S. youth and young adults.Methods: Data on youth aged 12-17 (n = 10,072) and young adults aged 18-24 (N = 5,727) who provided information on cigarettes, electronic nicotine delivery systems (ENDS), cigars, pipe, hookah and smokeless tobacco use in Wave 1 (W1: 2013-2014)-Wave 4 (W4: 2016-2018) of the nationally-representative PATH Study were used to calculate ever use initiation and correlates of initiation by W4.Results: Nearly 6 million youth and 2.5 million young adults used tobacco for the first time between W1-W4. Approximately one quarter of youth and young adult ENDS never users initiated ENDS between W1-W4 of the PATH Study. Among youth, use of other tobacco products, ever substance use, and high externalizing problems were associated with initiation of most products. Among young adults, use of other tobacco products and ever substance use were associated with initiation of most products. In both youth and young adults, Hispanics were more likely to initiate hookah use than their non-Hispanic White counterparts. While male sex was a risk factor for most tobacco product initiation across both age groups, it was not associated with hookah initiation.Conclusions: Cigarette and non-cigarette products shared many correlates of initiation, although there are noteworthy demographic differences. Findings can help tailor product specific interventions to reach populations at risk during preliminary stages of use. [ABSTRACT FROM AUTHOR]

Honey bees are the most important managed pollinator worldwide and are vital to the success of modern agriculture. Native, wild bees are also important pollinators in both natural and agricultural systems, and are highly sensitive to habitat in the surrounding landscape. Few studies, however, have considered how managed honey bees, and their effectiveness as crop pollinators, may be influenced by variation in the surrounding landscape. If honey bees are influenced by areas outside of the crop fields in which they are placed, their effectiveness as crop pollinators could be diminished. The goal of this study was to determine whether the relationship between honey bee hive density and crop yield varies with the composition of the surrounding landscape. We collected historical (2000–2011) data on yield and honey bee hive stocking density from 38 commercial cranberry growers in central Wisconsin. Using mixed-model regression analyses we found that cranberry yield was strongly, positively correlated with hive density but this effect diminished as the proportion of the surrounding landscape in woodland increased. Thus, at cranberry marshes in low-woodland landscapes (e.g., <42% woodland within 1 km), increasing the density of honey bees increased yields by about1000 kg/hive, while cranberry marshes in high woodland landscapes saw no effect of adding honey bees. These results suggest that honey bees, like wild bees, are influenced by non-crop areas in the surrounding landscape and that landscape context should be considered when making management recommendations for the use of honey bees for crop pollination. [ABSTRACT FROM AUTHOR]

Bees provide vital pollination services to the majority of flowering plants in both natural and agricultural systems. Unfortunately, both native and managed bee populations are experiencing declines, threatening the persistence of these plants and crops. Agricultural chemicals are one possible culprit contributing to bee declines. Even fungicides, generally considered safe for bees, have been shown to disrupt honey bee development and impair bumble bee behavior. Little is known, however, how fungicides may affect bumble bee colony growth. We conducted a controlled cage study to determine the effects of fungicide exposure on colonies of a native bumble bee species (Bombus impatiens). Colonies of B. impatiens were exposed to flowers treated with field-relevant levels of the fungicide chlorothalonil over the course of one month. Colony success was assessed by the number and biomass of larvae, pupae, and adult bumble bees. Bumble bee colonies exposed to fungicide produced fewer workers, lower total bee biomass, and had lighter mother queens than control colonies. Our results suggest that fungicides negatively affect the colony success of a native bumble bee species and that the use of fungicides during bloom has the potential to severely impact the success of native bumble bee populations foraging in agroecosystems. [ABSTRACT FROM AUTHOR]

Background: Smokeless tobacco use is becoming an increasingly important public health issue in the US and may influence cigarette smoking behavior. Systematic information on transitions between smokeless tobacco and cigarette use in the US is limited. Methods: We conducted a systematic review of published literature on transitions between smokeless tobacco and cigarette use in the US. We searched PubMed, Web of Science and EbscoHost databases for all published articles from January 2000 to March 2014 that presented estimates of transitions in US youth and adult study populations over time between at least one of the following tobacco use states: exclusive cigarette smoking, exclusive smokeless tobacco use, dual use of both products, and use of neither product. We excluded non-English language studies, studies published before 2000, clinical trials, controlled cessation programs, and clinical studies or evaluations of smokeless tobacco cessation programs. Results: The review identified six studies on US populations published since 2000 with longitudinal data on some or all of the transitions that users can undergo between smokeless tobacco and cigarette use. There was considerable heterogeneity across studies in design and tobacco use definitions. Despite these differences, the existing data indicate that switching behaviors from exclusive smoking to exclusive smokeless tobacco use are limited (adults: 0%-1.4%, adolescents: 0.8%-3.8%) but may be more common from exclusive smokeless tobacco use to exclusive smoking (adults: 0.9%-26.6%, adolescents: 16.6%-25.5%). Among adults, exclusive cigarette smoking was generally stable and consistent (79.7% to 87.6%) over follow-up across studies but less stable in adolescents (46.8%-78.7%). Exclusive smokeless tobacco use was less stable than exclusive cigarette smoking over time (adults: 59.4%-76.6%, adolescents: 26.2%-44.8%). Conclusion: This review provides published estimates of the proportions of adults and adolescents transitioning between tobacco use categories from the most recently available studies on longitudinal transitions between smokeless tobacco and cigarettes in the US. These data can be used to track tobacco use behaviors and evaluate their effect on public health; however, the data for these studies were generally collected more than a decade ago. Additional research including nationally representative longitudinal estimates using consistent definitions and designs, would improve understanding of current tobacco transition behaviors. [ABSTRACT FROM AUTHOR]

Background: Contact Isolation is a common hospital infection prevention method that may improve infectious outcomes but may also hinder healthcare delivery. Methods: To evaluate the impact of Contact Isolation on compliance with individual and composite process of care quality measures, we formed four retrospective diagnosis-based cohorts from a 662-bed tertiary-care medical center. Each cohort contained patients evaluated for one of four Centers for Medicare and Medicaid Services (CMS) Hospital Compare process measures including Acute Myocardial Infarction (AMI), Congestive Heart Failure (CHF), Pneumonia (PNA) and Surgical Care Improvement Project (SCIP) from January 1, 2007 through May 30, 2009. Results: The 6716-admission cohort included 1259 with AMI, 834 with CHF, 1377 with PNA and 3246 in SCIP. Contact Isolation was associated with not meeting 4 of 23 individual hospital measures (4 of 10 measures were not met for care provided while patients are typically isolated). Contact Isolation was independently associated with lower compliance with the composite pneumonia process-of-care measure (OR 0.3, 95% CI 0.1-0.7). AMI, CHF and SCIP composite measures were not impacted by Contact Isolation. Conclusions: Contact Isolation was associated with lower adherence to some pneumonia quality of care process measures of care on inpatient wards but did not impact CHF, AMI or SCIP measures. [ABSTRACT FROM AUTHOR]

The objective of this study was to qualitatively evaluate young Egyptians' perceptions, attitudes, knowledge and behaviour towards injuries before implementation of an extensive questionnaire about injuries among Egyptian youth. In 2008, five focus groups of three to nine participants each were conducted in Cairo, Egypt in Arabic to evaluate young Egyptians' attitudes towards injuries, injury prevention, and their understanding of ‘accidents’ and fatalism. Participants were 14–26 years of age and were from medium to high socioeconomic status. Focus group participants noted that the concept of (‘accident’) signified an event determined by destiny, whereas (‘injury’) was the result of human actions. The results of these focus groups indicate that young, educated Egyptians are interested in injury prevention programmes despite low confidence in the preventability of injuries. [ABSTRACT FROM PUBLISHER]

The article presents a study of flavored tobacco use among U.S. youth using data from the Population Assessment of Tobacco and Health (PATH) Study and longitudinal cohort analysis of adults and youths in the country. Results confirmed the widespread appeal of flavored products among youth tobacco users, suggesting the need to consider efforts to reduce the use of flavored tobacco products among youth in addition to proven tobacco control and prevention initiatives.

Background: Femoroacetabular impingement (FAI) is often a chronic problem, which can lead to a decrease in mental well-being. Purpose/Hypothesis: The purpose of this study was to determine patient mental health improvement after hip arthroscopy and if this improvement correlated with improved outcomes. It was hypothesized that patients with low mental health (LMH) status would improve after hip arthroscopy for FAI and that their patient-reported outcomes (PROs) would significantly improve after surgery. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent hip arthroscopy with labral repair between 2008 and 2015 were included. The minimum follow-up was 2 years. PROs included the modified Harris Hip Score (mHHS), Hip Outcome Score–Activities of Daily Living (HOS-ADL), HOS–Sports (HOS-Sports), and 12-Item Short Form Health Survey (SF-12). The minimal clinically important difference and Patient Acceptable Symptom State (PASS) were determined for HOS-ADL, HOS-Sports, and the mHHS based on previously published studies. Patients who scored <46.5 on the SF-12 Mental Component Summary (MCS) were in the LMH group, and those who scored ≥46.5 were in the high mental health (HMH) group. Results: In total, 120 (21%) of the 566 patients were in the LMH group and 446 (79%) patients were in the HMH group preoperatively. There was no difference in age or sex between groups. Patients in the LMH group had lower mHHS, HOS-ADL, and HOS-Sports at the mean 4-year follow-up and were less likely to reach PASS for the scores. Postoperatively, 84% (478/566) of the entire group was in the HMH group. A total of 88 (73%) of the LMH group improved to HMH. A multiple linear regression model for change in MCS identified independent predictors of changes in preoperative MCS to be LMH group preoperatively, change in HOS-Sports, and change in mHHS (r 2 = 0.4; P <.001). Conclusion: HMH was achieved in 84% of the patients after hip arthroscopy for FAI. Improvement in MCS was correlated with function and activity, as indicated by a significant correlation with HOS-ADL and HOS-Sports. A small percentage of patients did see a decline in their MCS score. This study showed that patients with LMH scores before hip arthroscopy for FAI can improve to normal/high mental health, and this correlated with higher PROs. [ABSTRACT FROM AUTHOR]

Background: Smokeless tobacco use is becoming an increasingly important public health issue in the US and may influence cigarette smoking behavior. Systematic information on transitions between smokeless tobacco and cigarette use in the US is limited.Methods: We conducted a systematic review of published literature on transitions between smokeless tobacco and cigarette use in the US. We searched PubMed, Web of Science and EbscoHost databases for all published articles from January 2000 to March 2014 that presented estimates of transitions in US youth and adult study populations over time between at least one of the following tobacco use states: exclusive cigarette smoking, exclusive smokeless tobacco use, dual use of both products, and use of neither product. We excluded non-English language studies, studies published before 2000, clinical trials, controlled cessation programs, and clinical studies or evaluations of smokeless tobacco cessation programs.Results: The review identified six studies on US populations published since 2000 with longitudinal data on some or all of the transitions that users can undergo between smokeless tobacco and cigarette use. There was considerable heterogeneity across studies in design and tobacco use definitions. Despite these differences, the existing data indicate that switching behaviors from exclusive smoking to exclusive smokeless tobacco use are limited (adults: 0%-1.4%, adolescents: 0.8%-3.8%) but may be more common from exclusive smokeless tobacco use to exclusive smoking (adults: 0.9%-26.6%, adolescents: 16.6%-25.5%). Among adults, exclusive cigarette smoking was generally stable and consistent (79.7% to 87.6%) over follow-up across studies but less stable in adolescents (46.8%-78.7%). Exclusive smokeless tobacco use was less stable than exclusive cigarette smoking over time (adults: 59.4%-76.6%, adolescents: 26.2%-44.8%).Conclusion: This review provides published estimates of the proportions of adults and adolescents transitioning between tobacco use categories from the most recently available studies on longitudinal transitions between smokeless tobacco and cigarettes in the US. These data can be used to track tobacco use behaviors and evaluate their effect on public health; however, the data for these studies were generally collected more than a decade ago. Additional research including nationally representative longitudinal estimates using consistent definitions and designs, would improve understanding of current tobacco transition behaviors. [ABSTRACT FROM AUTHOR]

Objectives. To examine patterns of smokeless tobacco (SLT) use, by type, in wave 1 (2013-2014) of the Population Assessment of Tobacco and Health Study in the United States. Methods. We analyzed data from 32 320 adults (aged ≥ 18 years) to assess the use of pouched snus and other SLT products (loose snus, moist snuff, dip, spit, and chewing tobacco). Results. Overall, SLT use was most common among men, younger adults, non-Hispanic Whites, and nonurban respondents. Pouched snus users were more likely to report nondaily and polytobacco use than users of other SLT products. Respondents who used SLT some days were more likely to be current established cigarette smokers than those who used SLT every day (57.9% vs 20.2%). Furthermore, current established smokers who used SLT some days were more likely to smoke every day and had a higher median number of cigarettes smoked per day than smokers who used SLT every day. Conclusions. Polytobacco use, especially cigarette smoking, is common among SLT users. Pouched snus users are more likely to report nondaily snus use and polytobacco use than users of other SLT products. [ABSTRACT FROM AUTHOR]

Introduction This study examines predictors of trajectories of cigarette and e-cigarette use among a cohort of US adolescents transitioning into young adulthood. Comparing trajectories of each tobacco product is important to determine if different intervention targets are needed to prevent progression to daily use. Methods Latent trajectory class analyses identified cigarette and e-cigarette use (never, ever excluding past 12-month, past 12-month (excluding past 30-day (P30D)), P30D 1–5 days, P30D 6+ days) trajectory classes, separately, among US youth (12–17; N = 10,086) using the first 4 waves (2013–2017) of data from the nationally representative PATH Study. Weighted descriptive analyses described the class characteristics. Weighted multinomial logistic regression analyses examined demographic, psychosocial, and behavioral predictors of class membership. Results Younger adolescents 12–15 years had lower tobacco use compared to 16–17 year olds and less stable classes. In the 16–17 year group, there were five unique trajectories of cigarette smoking, including a Persistent High Frequency class. Four e-cigarette use trajectories were identified; but not a persistent use class. Shared predictors of class membership for cigarettes and e-cigarettes included mental health problems, other tobacco use, marijuana use, and poorer academic achievement. Male sex and household tobacco use were unique e-cigarette trajectory class predictors. Conclusions There was no evidence that initiation with e-cigarettes as the first product tried was associated with cigarette progression (nor cigarettes as first product and e-cigarette progression). Interventions should focus on well-established risk factors such as mental health and other substance use to prevent progression of use for both tobacco products. Implications Using nationally representative data and definitions of use that take into account frequency and recency of use, longitudinal 4-year trajectories of e-cigarette and cigarette use among US adolescents transitioning into young adulthood were identified. Results among 16–17-year olds revealed a class of persistent high frequency cigarette smoking that was not identified for e-cigarette use. Cigarette use progression was not associated with e-cigarettes as the first product tried. Risk factors for progression of use of both products included mental health and other substance use, which are important prevention targets for both tobacco products. [ABSTRACT FROM AUTHOR]

Background: The role of hip arthroscopy in the treatment of patients with borderline hip dysplasia is controversial and evolving. Purpose: To evaluate outcomes at a minimum 10-year follow-up in patients who underwent hip arthroscopy for femoroacetabular impingement in a hip with borderline dysplasia. Study Design: Case series; Level of evidence, 4. Methods: All hips that underwent labral repair between June 2006 and March 2009 for femoroacetabular impingement with borderline dysplasia were included if they had a lateral center-edge angle of 20° to 25°, had primary hip arthroscopy for the diagnosis of femoroacetabular impingement, and were aged 18 to 70 years. Patients were excluded if they had previous hip surgery, avascular necrosis, or fracture. Kaplan-Meier survivorship was performed, with survivorship defined as avoidance of conversion to total hip arthroplasty (THA). Results: A total of 45 patients met the inclusion criteria, and 38 were contacted at a minimum 10 years postoperatively (84%; mean ± SD, 12 ± 1.3 years). There were 23 women and 15 men with an average age of 41 ± 9.6 years (range, 25-69). Twenty patients were ≥40 years of age. In this patient cohort, survivorship was 87% at 5 years and 79% at 10 years for conversion to THA. Of the 38 patients included, 9 were converted to THA (24%), and 3 required revision hip arthroscopy (7%). Patient age, Tönnis grade, microfracture of cartilage lesions, and Tönnis angle >15° were associated with conversion to THA. No statistically significant differences were found between those who underwent conversion to THA and those who did not regarding lateral center-edge angle, Sharp angle, or alpha angle. Significant improvements were seen at follow-up of 12 years (range, 10-13) for the modified Harris Hip Score (58 to 83; P =.002), Hip Outcome Score–Activities of Daily Living (70 to 87; P =.003), Hip Outcome Score–Sport (47 to 76; P =.004), and Western Ontario and McMaster Universities Osteoarthritis Index (31 to 10; P =.001). At follow-up, >80% maintained the minimal clinically important difference for the Hip Outcome Score (Activities of Daily Living and Sport) with no differences between patients aged <40 and ≥40 years. Conclusion: Risk factors for conversion to THA after hip arthroscopy in the borderline dysplastic hip included older age, higher Tönnis grades, grade 4 chondral lesions that were microfractures, and Tönnis angle >15°. In those patients who did not convert to THA, improvement in outcome measures was seen at 10 years. Careful patient selection is critical to the success of this procedure. [ABSTRACT FROM AUTHOR]

Introduction: The prevalence of food insecurity (FI) and insulin rationing among patients with diabetes who present to the emergency department (ED) is unclear. We examined the prevalence of food insecurity and subtherapeutic insulin use among patients who presented to the ED with a blood glucose level of greater than 250 milligrams per deciliter. Methods: This was a single-center, cross-sectional survey of clinically stable, hyperglycemic adults in the ED for food insecurity using the Hunger Vital Sign screening tool. Patients who were insulin dependent were asked about insulin usage and rationing. Results: Of the 85 eligible patients, 76 (89.4%) were enrolled; 35 (46%) screened positive for food insecurity. Food insecure patients were 1.9 times more likely to be hospitalized than non-food insecure patients (relative risk = 1.90 [1.21-2.99], p<.01). Food insecure patients were younger than non-food insecure patients (50.4 vs 57.5 p<.02), and had significantly higher hemoglobin A1c (HgbA1c) levels (11.2% vs 9.9% p = 0.04). Of the 49 patients prescribed insulin, 17 (34.6%) stated they had used less insulin during the prior week than had been prescribed, and 21 (42.9%) stated they had used less insulin during the prior year than had been prescribed. Food insecure patients were more likely to have used less insulin than prescribed in the prior year (odds ratio = 3.60 [1.09-11.9], p = 0.04). Conclusion: Our exploratory findings suggest almost half of clinically stable adults presenting to our inner-city ED with hyperglycemia experience food insecurity. More than one-third of those prescribed insulin used less than their prescribed amount in the prior year. [ABSTRACT FROM AUTHOR]

Cigarette smoking is the leading cause of preventable disease and death in the United States (1). The prevalence of adult cigarette smoking has declined in recent years to 14.0% in 2017 (2). However, an array of new tobacco products, including e-cigarettes, has entered the U.S. market (3). To assess recent national estimates of tobacco product use among U.S. adults aged ≥18 years, CDC, the Food and Drug Administration (FDA), and the National Cancer Institute analyzed data from the 2018 National Health Interview Survey (NHIS). In 2018, an estimated 49.1 million U.S. adults (19.7%) reported currently using any tobacco product, including cigarettes (13.7%), cigars (3.9%), e-cigarettes (3.2%), smokeless tobacco (2.4%), and pipes* (1.0%). Most tobacco product users (83.8%) reported using combustible products (cigarettes, cigars, or pipes), and 18.8% reported using two or more tobacco products. The prevalence of any current tobacco product use was higher in males; adults aged ≤65 years; non-Hispanic American Indian/Alaska Natives; those with a General Educational Development certificate (GED); those with an annual household income <$35,000; lesbian, gay, or bisexual adults; uninsured adults; those with a disability or limitation; and those with serious psychological distress. The prevalence of e-cigarette and smokeless tobacco use increased during 2017-2018. During 2009-2018, there were significant increases in all three cigarette cessation indicators (quit attempts, recent cessation, and quit ratio). Implementing comprehensive population-based interventions in coordination with regulation of the manufacturing, marketing, and distribution of all tobacco products can reduce tobacco-related disease and death in the United States (1,4). [ABSTRACT FROM AUTHOR]

Background: Evidence is accumulating that youth who try Electronic Nicotine Delivery Systems (ENDS, e-cigarettes) may go on to try cigarettes. This analysis examines the bidirectional patterns of ENDS and cigarette use among US youth over one year and uses propensity score matching (PSM) to examine frequency of ENDS use on changes in cigarette smoking.Methods: Our analysis included 11 996 participants who had two waves of available data (Wave 1 [W1] 2013-2014; Wave 2 [W2] 2014-2015) drawn from the longitudinal Population Assessment of Tobacco and Health Study. Cross-sectional weighted prevalence estimates are reported for cigarettes and ENDS. We used PSM to estimate the likelihood of ENDS use at W1 and to draw matched analytic samples, then used regression (logistic or linear) models to examine the effect of W1 ENDS use on W2 cigarette smoking. All statistical tests were two-sided.Results: In weighted analyses, 69.3% of W1 past-30-day cigarette smokers exhibited past-30-day smoking at W2; 42.2% of W1 past-30-day ENDS users were using ENDS at W2. W1 ever use of either product was similarly associated with W2 new use of the other product. Unweighted PSM models indicated W1 cigarette-naïve ENDS use was associated with W2 ever-cigarette smoking (n = 676; adjusted odds ratio = 3.21, 95% confidence interval [CI] = 1.95 to 5.45, P < .001); W1 ever-ENDS use did not affect change in cigarette frequency at W2 (n = 1020, beta = 0.31, 95% CI = -0.76 to 1.39, P = .57); 1-5 days ENDS use compared with ever, no past-30-day ENDS use was associated with a statistically significant decrease of W2 smoking days (n = 256, beta = -2.64, 95% CI = -4.96 to -0.32; P = .03); and W1 6+ day ENDS users did not show a decrease in frequency of cigarette smoking.Conclusions: Ever-ENDS use predicts future cigarette smoking, and frequency of ENDS use has a differential impact on subsequent cigarette smoking uptake or reduction. These results suggest that both cigarettes and ENDS should be targeted in early tobacco prevention efforts with youth. [ABSTRACT FROM AUTHOR]

As pollen and nectar foragers, bees have long been considered strictly herbivorous. Their pollen provisions, however, are host to abundant microbial communities, which feed on the pollen before and/or while it is consumed by bee larvae. In the process, microbes convert pollen into a complex of plant and microbial components. Since microbes are analogous to metazoan consumers within trophic hierarchies, the pollen-eating microbes are, functionally, herbivores. When bee larvae consume a microbe-rich pollen complex, they ingest proteins from plant and microbial sources and thus should register as omnivores on the trophic "ladder." We tested this hypothesis by examining the isotopic compositions of amino acids extracted from native bees collected in North America over multiple years. We measured bee trophic position across the six major bee families. Our findings indicate that bee trophic identity was consistently and significantly higher than that of strict herbivores, providing the first evidence that omnivory is ubiquitous among bee fauna. Such omnivory suggests that pollen-borne microbes represent an important protein source for larval bees, which introduces new questions as to the link between floral fungicide residues and bee development. [ABSTRACT FROM AUTHOR]

Introduction: E-cigarette use is increasing, and the long-term impact on public health is unclear. We described the acute adverse health effects from e-cigarette exposures reported to U.S. poison centers. Methods: We compared monthly counts and demographic, exposure, and health effects data of calls about e-cigarettes and conventional cigarettes made to poison centers from September 2010 through December 2014. Results: Monthly e-cigarette calls increased from 1 in September 2010, peaked at 401 in April 2014, and declined to 295 in December 2014. Monthly conventional cigarette calls during the same period ranged from 302 to 514. E-cigarette calls were more likely than conventional cigarette calls to report adverse health effects, including vomiting, eye irritation, and nausea. Five e-cigarette calls reported major health effects, such as respiratory failure, and there were two deaths associated with e-cigarette calls. Conclusion: E-cigarette calls to U.S. poison centers increased over the study period, and were more likely than conventional cigarettes to report adverse health effects. It is important for health care providers and the public to be aware of potential acute health effects from e-cigarettes. Developing strategies to monitor and prevent poisonings from these novel devices is critical. [ABSTRACT FROM AUTHOR]

Objectives: Adverse events (AEs) are unintended physical injuries resulting from or contributed to by medical or surgical care. We determined the frequency and type of AEs before, during, and after hospital admission.Methods: We conducted a cohort study of 296 adult hospital patients. We used the standardized Institute for Healthcare Improvement Global Trigger Tool for Measuring Adverse Events to review the medical records of the hospital patients for occurrence, timing relative to hospital admission, severity, and preventability of AEs. We also identified the primary physiologic system affected by the AE.Results: Among 296 patients, we identified 338 AEs. AEs occurred with similar frequency before (n = 148; 43.8%) and during hospital admission (n = 162; 47.9%). Fewer AEs occurred after discharge (n = 28; 8.3%). Half of all AEs (n = 169; 50.0%) were severe, whereas 47.9% (n = 162) were preventable.Conclusions: AEs occur with similar frequency before and during hospitalization and may contribute more to hospital admissions than previously recognized. These findings suggest that efforts to improve patient safety should include outpatient settings in addition to the more commonly targeted acute care settings. [ABSTRACT FROM AUTHOR]

While significant declines in cigarette smoking have occurred among U.S. adults during the past 5 decades, the use of emerging tobacco products* has increased in recent years (1-3). To estimate tobacco use among U.S. adults aged ≥18 years, CDC and the Food and Drug Administration (FDA) analyzed data from the 2013-2014 National Adult Tobacco Survey (NATS). During 2013-2014, 21.3% of U.S. adults used a tobacco product every day or some days, and 25.5% of U.S. adults used a tobacco product every day, some days, or rarely. Despite progress in reducing cigarette smoking, during 2013-2014, cigarettes remained the most commonly used tobacco product among adults. Young adults aged 18-24 years reported the highest prevalence of use of emerging tobacco products, including water pipes/hookahs and electronic cigarettes (e-cigarettes). Furthermore, racial/ethnic and sociodemographic differences in the use of any tobacco product were observed, with higher use reported among males; non-Hispanic whites, non-Hispanic blacks, and non-Hispanics of other races(†); persons aged <45 years; persons living in the Midwest or South; persons with a General Educational Development (GED) certificate; persons who were single/never married/not living with a partner or divorced/separated/widowed; persons with annual household income <$20,000; and persons who were lesbian, gay, or bisexual (LGB). Population-level interventions that focus on all forms of tobacco product use, including tobacco price increases, high-impact anti-tobacco mass media campaigns, comprehensive smoke-free laws, and enhanced access to help quitting tobacco use, in conjunction with FDA regulation of tobacco products, are critical to reducing tobacco-related diseases and deaths in the United States.(§). [ABSTRACT FROM AUTHOR]

In most ecosystems, microbes are the dominant consumers, commandeering much of the heterotrophic biomass circulating through food webs. Characterizing functional diversity within the microbiome, therefore, is critical to understanding ecosystem functioning, particularly in an era of global biodiversity loss. Using isotopic fingerprinting, we investigated the trophic positions of a broad diversity of heterotrophic organisms. Specifically, we examined the naturally occurring stable isotopes of nitrogen (15N:14N) within amino acids extracted from proteobacteria, actinomycetes, ascomycetes, and basidiomycetes, as well as from vertebrate and invertebrate macrofauna (crustaceans, fish, insects, and mammals). Here, we report that patterns of intertrophic 15N-discrimination were remarkably similar among bacteria, fungi, and animals, which permitted unambiguous measurement of consumer trophic position, independent of phylogeny or ecosystem type. The observed similarities among bacterial, fungal, and animal consumers suggest that within a trophic hierarchy, microbiota are equivalent to, and can be interdigitated with, macrobiota. To further test the universality of this finding, we examined Neotropical fungus gardens, communities in which bacteria, fungi, and animals are entwined in an ancient, quadripartite symbiosis. We reveal that this symbiosis is a discrete fourlevel food chain, wherein bacteria function as the apex carnivores, animals and fungi are meso-consumers, and the sole herbivores are fungi. Together, our findings demonstrate that bacteria, fungi, and animals can be integrated within a food chain, effectively uniting the macro- and microbiome in food web ecology and facilitating greater inclusion of the microbiome in studies of functional diversity. [ABSTRACT FROM AUTHOR]

The article reports on the estimated tobacco use among adults in the U.S. from 2012 to 2013 based on data from the 2012-2013 National Adult Tobacco Survey (NATS). It discusses an estimated 21.3% of U.S. adults who used any tobacco product every day or some days during the period, the higher percentage of tobacco use every day or some days among men than women and a proposal by the U.S. Food and Drug Administration (FDA) to extend its authority to additional tobacco products in April 2014.