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A matrix is proposed to characterize mental health diversion programs and standardize the reporting of program context, outputs, outcomes, and community settings. Data collection for program reporting is challenging because individual programs report on what is relevant to local conditions and may omit or overlook important contextual or structural factors that are key to programmatic success or failure. This limits generalizability and comparability. Using a standard matrix reporting framework clearly lists the constructs of the program, context, and community systems. Two diversion programs are reported demonstrating the use of the matrix. Although different jurisdictions have a wide spectrum of agencies and resources available to support diversion, and may approach the concept differently, standardizing and streamlining reporting will assist with evaluation of diversion and the creation of sustainable programs. [ABSTRACT FROM AUTHOR]

There is a distinct lack of a normative theory for diversion of justice-involved individuals with mental illness at the intersection of the criminal justice and health care systems. The nexus where the criminal justice and health care systems are supposed to connect during diversion is not conceptually framed in a measurable way. The paper proposes a potential systems theory of diversion that explicates the overlapping boundaries within and between the criminal justice and health care systems. From a systems perspective, diversion is operationalized differently depending on the entry of an individual with justice involvement and mental illness into one of the systems. The criminal justice and health care systems have multiple levels (micro-, meso-, and macro-), but individuals enter both systems at the respective systems intersection of the micro- and meso-levels. The theoretical disconnect may fail to consider the impact of criminal justice diversion on the health care system. We propose a unified systems theory of diversion to improve evaluation, comparability, sustainability, resource allocation, and outcomes of diversion programs. [ABSTRACT FROM AUTHOR]

Introduction: Homeless individuals lack resources for primary healthcare and as a result use the emergency department (ED) as a social safety net. Our primary objective in this study was to identify the differences between features of visits to United States (US) EDs made by patients without a home and patients who live in a private residence presenting with mental health symptoms or no mental health symptoms at triage. Methods: Data for this study come from the 2009-2017 National Health and Ambulatory Medical Care Survey, a nationally representative cross-sectional survey of ED visits in the US. We examined differences in waiting time, length of visit, and triage score among homeless patients, and privately housed and nursing home residents. We used logistic regression to determine the odds of receiving a mental health diagnosis. Residence, age, gender, race, urgency, and whether the person was seen in the ED in the previous 72 hours were controlled. Results: Homeless individuals made up less than 1% of all ED visits during this period. Of these visits, 47.2% resulted in a mental health diagnosis compared to those who live in a private residence. Adjusting for age, race, gender, triage score, and whether the person had been seen in the prior 72 hours, homeless individuals were still six times more likely to receive a mental health diagnosis despite reporting no mental health symptoms compared to individuals who lived in a private residence. Homeless individuals reporting mental health symptoms were two times more likely to receive a mental health diagnosis compared to privately housed and nursing home residents. Conclusions: Homeless individuals are more likely to receive a mental health diagnosis in the ED whether or not they present with mental health symptoms at triage. This study suggests that homelessness as a status impacts how these individuals receive care in the ED. Community coordination is needed to expand treatment options for individuals experiencing emergent mental health symptoms. [ABSTRACT FROM AUTHOR]

Objectives: This study explores sex differences in ischemic stroke hospitalization incidence, 30-day mortality, and 30-day readmission in a southwestern US medical center.Methods: Ischemic stroke admissions in a regional medical center in the southwestern United States were obtained for a 6.5-year time frame (N = 1968). Logistic regression models examine the adjusted effects of sex on 30-day mortality and 30-day readmission outcomes among individuals hospitalized for ischemic stroke.Results: Findings confirm that although women experience higher mortality than men (9.1% vs 6.7%), the sex disparity in mortality is explained by the age distribution of strokes. Women experience far more strokes and deaths because of stroke at older ages. No differences in principal procedure or 30-day readmission emerged.Conclusions: Men experienced higher stroke hospitalization incidence, although women exhibited higher 30-day mortality. Age composition explained sex differences in mortality, but higher male stroke hospitalization incidence represents a larger public health issue that suggests the need for behavioral change at the population level. No meaningful sex differences emerged in treatment, mortality, or readmission. [ABSTRACT FROM AUTHOR]

Substance use disorder (SUD) stigma persists in society despite a movement toward people-first language in the mental health field. Stigma creates barriers to treatment and marginalizes already at-risk populations. Opioid use disorder (OUD) is of particular relevance to this discussion because recent increases in OUD can be traced to iatrogenic origins, and as such, power differentials between prescriber and patient may complicate stigma and/or create additional barriers for those who develop opioid dependence. We examine the shift to use destigmatizing language surrounding OUD, explores the unique power dynamics associated with the rise of OUD prevalence, and presents a manifest content analysis of phrases related to OUD to observe the emergence of opioid use as a public health issue. Whereas SUD has long had visibility in public health discourse, OUD has emerged as a major theme in this discourse as its prevalence and mortality rate reached epidemic levels. We advocate for public health practice and research discourse to more uniformly adopt destigmatizing language alongside clinical SUD practitioners toward the goal of reducing stigma and barriers to treatment seeking for OUD. [ABSTRACT FROM AUTHOR]

Objective: Hypertension can cause significant morbidity and reduced life expectancy. Most patients with hypertension have primary hypertension; however, 10% to 15% have secondary hypertension. Endocrine disorders as a secondary cause occur in approximately 10% of patients with secondary hypertension, and thyroid disorders account for approximately 1% of all patients with hypertension. The identification of patients with hyperthyroidism has important benefits for these particular patients. The objective of this study was to examine the occurrence of high blood pressure in patients with hyperthyroidism.Methods: We reviewed the clinical information available from 414 new patients referred to an endocrinology clinic in west Texas for evaluation of hyperthyroidism. The final cohort included 96 patients who had both thyroid laboratory tests and blood pressure measurements at the time of their clinic visit. We also examined this relationship in a nationally representative sample of US adults (National Health and Nutrition Examination Survey 2007-2012), which included thyroid test results and at least one blood pressure measurement (N = 8837).Results: Sixty-five of these clinic patients had elevated blood pressure based on criteria suggested by the American College of Cardiology/American Heart Association. These patients had similar thyroid hormone levels as patients who did not have hypertension but tended to be older. Ordinary least squares regression analysis of the National Health and Nutrition Examination Survey 2007-2012 data demonstrated a significant positive association between free T3 levels and systolic blood pressure, adjusting for age, sex, and the use of levothyroxine.Conclusions: These findings from a specialty clinic and a national sample suggest that clinicians should consider the possibility of hyperthyroidism in patients with hypertension, even in older patients. [ABSTRACT FROM AUTHOR]

Objective: To describe patterns of conventional health care (CH) and complementary and alternative medicine (CAM) use among U.S. adults reporting recent joint symptoms in a nationally representative sample. Design: This study uses the adult alternative medicine supplement from the 2012 National Health Interview Survey (NHIS). Location: United States. Subjects: Nationally representative cross-sectional sample of non-institutionalized U.S. residents. Of 34,525 respondents who answered the alternative medicine supplement, approximately 30% (n = 10,964) reported recent pain symptoms (pain, aching, stiffness). Outcome measures: Among adults reporting joint symptoms, we examine reported use of CH, CAM, both CH and CAM, or neither specifically for joint symptoms or joint condition. Results: Among adults reporting joint symptoms in the past 30 days, 64% reported using only CH for their joint pain, whereas ∼10% reported using CAM. Among those using CAM for their joint symptoms, 83% also sought help from a CH practitioner. CAM-only users comprised only 1.6% of the sample of joint pain sufferers. Those who reported using both CH and CAM for joint pain were more likely to report a diagnosis of a joint condition compared with CAM-only users, but also reported higher comorbidities and worse self-reported health. Conclusion: Most U.S. adults reporting recent joint pain seek care only from a CH practitioner, although among the 10% who report CAM use for joint conditions, a strong majority also report seeking care from a CH practitioner. CH and CAM providers should consistently inquire about other forms of treatment their patients are using for specific symptoms to provide effective integrative health care management. [ABSTRACT FROM AUTHOR]

Background: Global 12-month psychosis prevalence is estimated at roughly 0.4%, although prevalence of antipsychotic use in the U.S. is estimated at roughly 1.7%. Antipsychotics are frequently prescribed for off label uses, but have also been shown to carry risk factors for certain comorbid conditions and with other prescription medications. The study aims to describe the socio-demographic and health characteristics of U.S. adults taking prescription antipsychotic medications, and to better understand the association of antipsychotic medications and comorbid chronic diseases. Methods: The study pools 2013–2018 data from the National Health and Nutrition Examination Survey (NHANES), a nationally representative cross-sectional survey of non-institutionalized U.S. residents (n = 17,691). Survey staff record prescription medications taken within the past 30 days for each respondent, from which typical and atypical antipsychotic medications were identified. Results: Prevalence of antipsychotic use among U.S. adults was 1.6% (n = 320). Over 90% of individuals taking antipsychotics reported having health insurance and a usual place for care, significantly more than their counterparts not taking antipsychotics. Further, those taking antipsychotics reported higher prevalence of comorbid chronic diseases and took an average of 2.3 prescription medications more than individuals not taking antipsychotics. Individuals taking antipsychotics were more likely to sleep 9 or more hours per night, be a current smoker, and have a body mass index greater than 30 kg/m2. Conclusions: U.S. adults who take antipsychotic medications report more consistent health care access and higher prevalence of comorbid chronic diseases compared to those not taking antipsychotics. The higher comorbidity prevalence and number of total prescriptions highlight the need for careful assessment and monitoring of existing comorbidities and potential drug-drug interactions among adults taking antipsychotics in the U.S. [ABSTRACT FROM AUTHOR]

Electronic cigarettes (EC) remain a controversial topic with uncertainty about harm reduction in current smokers, their efficacy in smoking cessation, their potential for addiction, the need for regulation, and the type of information needed to educate the public about the benefits and hazards of EC. Multiple medical institutions and organizations have conducted surveys to investigate the demographics and perceptions of EC consumers in adult and youth populations. However, it is unknown whether these surveys use consistent, reliable, or accurate measures for EC use. We analyzed 13 survey articles identified during a review of the use of EC during smoking cessation programs to determine the characteristic features of the surveys and to determine how frequently they satisfied the measurement of important core items suggested by recent articles. Our analysis focused on 13 studies. These studies represented the work of 13 separate research groups and were published in 10 different biomedical journals with a median impact factor score of 4.1. The median number of participants in the studies was 2,624 (Q1-Q3: 662–6,356); the number of participants ranged from 179 to 19,414. The median number of e-cigarette users in the surveys was 840 (Q1-Q3: 256–3,849). All studies provided clear study goals in their introduction. Five surveys used on-line methods to collect information; four studies provided limited information about the reliability of their data. All studies reported study outcomes and considered limitations. Five studies had limited external validity. None of the surveys collected a complete set of core information recommended by recent authorities on survey methodology for EC. The surveys reviewed in this project had significant variability in study design, survey population, and study goals. Consequently, comparisons across studies become difficult and limit the external validity of survey studies on EC. [ABSTRACT FROM AUTHOR]

Background/Objective. Sleep apnea is associated with elevated inflammatory markers. A subgroup of patients never report sleep disturbances to their physician. The inflammatory status of this subgroup is not known. The present study aims to evaluate two inflammatory markers, C-reactive protein (CRP) and red cell distribution width (RDW), in those with unreported sleep disturbances and compares these findings to those with and without reported sleep disorders. We also investigate the utility of RDW as an inflammatory marker in sleep disorders. Methods. Sample includes 9,901 noninstitutionalized, civilian, nonpregnant adults from the 2005-2008 National Health and Nutrition Examination Survey, a nationally representative, cross-sectional U.S. study. Sleep questionnaire and laboratory data were used to compare inflammatory markers (CRP and RDW) in five subgroups of individuals: reporting physician-diagnosed sleep apnea, reporting another physician-diagnosed sleep disorder, reported sleep disturbance to physician with no resulting diagnosis, unreported sleep disturbance (poor sleep quality not reported to physician), and no diagnosed sleep disorder or sleep disturbance. Results. Individuals with unreported sleep disturbance had significantly higher odds of elevated RDW (>13.6%) when compared to those without a sleep disturbance in adjusted models (OR=1.33). Those with unreported sleep disturbance had significantly higher odds of elevated CRP levels (>1 mg/L) than those without sleep disturbances (OR 1.34), although the association was not significant when adjusted for obesity and other controls. Conclusion. Self-identified unreported sleep disturbances are associated with significantly higher odds of elevated RDW than those without sleep disturbances. RDW may serve as a valuable indicator in identifying individuals at higher risk for sleep apnea and other sleep disorders. [ABSTRACT FROM AUTHOR]

Background Given the safety concerns regarding pharmacological agents, and the considerable impact of headache and migraine on the sufferer's quality of life, many people seek other treatment options beyond conventional medication and care to address their symptoms; this includes complementary and alternative medicine (CAM). Some CAM interventions have shown promising results in clinical trials of headache and migraine management. Nonetheless, there has been little research exploring the reasons for using CAM, and the types of CAM used, among this population. Objective The study aimed to answer the following questions: (1) Which CAM modalities are used most frequently among migraine/headache sufferers? and (2) What are the self-reported reasons for CAM use among migraine/headache sufferers? Methods This secondary analysis of data from the 2012 U.S. NHIS (a national cross-sectional survey) examined the use of CAM among migraine/headache sufferers, including the main reasons related to CAM use. Data were weighted and analyzed using STATA 14.0. Results The sample of 34,525 adults included 6558 (18.7%) headache/migraine sufferers. Of the headache/migraine sufferers, a substantial proportion (37.6%, n = 2427) used CAM for various conditions; however, CAM use specifically for headache/migraine was much less prevalent (3.3%, n = 216). Of those who used CAM for headache/migraine, about half used CAM in conjunction with prescription (47.8%, n = 100) or over-the-counter medication (55.1%, n = 113). As severity of headache/migraine increased so did the likelihood of using CAM (severe migraine odds ratio [OR] = 2.32; 95% confidence interval [CI]: 1.41, 3.82; both recurring headache/severe migraine OR = 3.36; 95% CI: 2.08, 5.43; when compared to those with recurring headache only). The most frequently used CAM modality among all headache/migraine sufferers (N = 6558) was manipulative therapy (22.0%, n = 1317), herbal supplementation (21.7%, n = 1389) and mind-body therapy (17.9%, n = 1100). The top 3 reasons for using CAM for headache were general wellness (28.7%, n = 60/209), improving overall health (26.8%, n = 56/209), and reducing stress (16.7%, n = 35/209). Conclusions Although CAM is used by many sufferers of headache/migraine, the use of CAM specifically for the treatment of headache/migraine is relatively low in the United States. The study also assesses the key differences of CAM use among headache/migraine sufferers in NHIS 2012 compared with those in NHIS 2007, and identifies shortfalls in the evidence-base of several CAM modalities used by U.S. adults for headache/migraine. This information may assist health providers and consumers in making informed decisions about the safest and most appropriate approach to managing headache/migraine. [ABSTRACT FROM AUTHOR]

This conclusion provides a brief synopsis of the research articles presented in this special edition of The Journal of Contemporary Justice. The research findings clearly demonstrate that when the objective of diversion is sought by diversion-based programs where the criminal justice and health care systems intersect, processes and services frequently break down. As this collection of articles highlights, our collective understanding of diversion is siloed by academic discipline; thus, the broader picture of diversion remains muddled. It remains muddled because the reporting of diversion is scattered across disciplinary journals where a more robust understanding of diversion becomes unwieldy if not impossible for researchers and practitioners alike without sifting through multiple books, journals, manuscripts, and websites. Therefore, diversion will continue to elude efficacy without the coordination and cooperation of numerous disciplines spanning both the criminal justice and health care systems diversion. As this collection of articles strongly suggests, there is a need to create a transdisciplinary understanding of diversion as well as publication outlets so best practices can be developed and shared in one place. [ABSTRACT FROM AUTHOR]

Highlights: [•] Smoking and background SES account for disparities in birth outcomes among U.S. white teen mothers. [•] African American teen mothers exhibit no increased risk of LBW relative to their older counterparts. [•] Foreign and U.S.-born Hispanic mothers in the U.S. exhibit age patterns in LBW prevalence more resembling that of white mothers. [Copyright &y& Elsevier]

Abstract: Previous studies find U.S. immigrants have weaker socioeconomic gradients in health relative to non-Hispanic Whites and their U.S.-born co-ethnics. Several explanations have been advanced but few have been tested empirically. We use data from the Mexican Family Life Survey and the U.S. National Health Interview Survey, including longitudinal data in the former measuring socioeconomic status (SES) and health previous to emigration, to test if (1) immigrants “import” their gradients from the sending country, or if (2) they may be changing as a result of SES-graded acculturation among Mexican migrant men in two health indicators: obesity and current smoking. We find evidence consistent with the first hypothesis: the gradients of migrants measured prior to coming to the U.S. are not statistically different from those of nonmigrants, as the gradients of each are relatively weak. Although the gradients for obesity and smoking appear to weaken with time spent in the U.S., the differences are not significant, suggesting little support for the selective acculturation hypothesis. [Copyright &y& Elsevier]

The article offers information on the surgical and medical treatment of canine pyometra including intial therapy. It stated that surgical management of pyometra should be based on the clinical stability of the bitch and dogs showing sign of illness or shock should be given direct treatment of the uterine disease. It discusses about ovariohysterectomy, Prostaglandin F2ot and Dopamine agonists as treatment option for pyometra.

The article focuses on the pathophysiology, signalment, clinical signs, and diagnosis of canine pyometra. It discusses various bacteria that are cultured with pyometra including Pasteurella, Pseudomonas, and Proteus species. It informs about the breeds that predisposed to pyometra including rough-coated collies, rottweilers, and miniature schnauzers.

This introduction offers a primer for this special edition of the Journal of Contemporary Criminal Justice. The purpose is to provide an interdisciplinary platform for scholars and practitioners to communicate perspectives of criminal justice, criminology, and law; public policy and administration, economics and political science; social work and sociology; behavioral health, counseling and psychology; public health, emergency medicine, and psychiatry around diversion. While disciplines share objectives of diversion as (1) rehabilitation, (2) efficient case processing, and (3) reducing resources, the defining and reporting of diversion differs. Justice-involved individuals with mental health issues making successful re-entry into the civil society, however, becomes convoluted. Diversion in practice has taken many shapes. Diversion in theory has taken many meanings. This special edition offers a variety of empirical and theoretical articles that attempt to provide clarity to an often implemented and understudied area of criminal justice and health care. Interviews with street-level officials, quantitative analyses of programs, and philosophical challenges to innate assumptions about individuals and systems are seen from a wide variety of scholars. The authors showcase their varied backgrounds with graduate students, university faculty, and practitioners, offering the fields of criminal justice and health care insight into diversion at all levels. [ABSTRACT FROM AUTHOR]

Introduction: The majority of trauma-related deaths occur within the first 24 h of injury, and time elapsed until intervention for an injury is one of the greatest causes of preventable death in mature trauma centers. This study seeks to determine if there is a correlation between time spent in the trauma bay and mortality outcomes. Methods: A retrospective analysis of Level 1 trauma patients from 1 January 2010 to 1 January 2016 in a single center. Results: Charts from 1678 Level 1 trauma patients with 1290 (76.9%) blunt and 388 (23.1%) penetrating injuries were analyzed. Of these, 345 patients died and 237 (68.7%) died within the first 24 h. Multivariate analysis yields an inverse correlation between increased times spent in the trauma bay and mortality, with controls for injury severity, age, and race/ethnicity and with deaths in the trauma bay excluded (p < 0.001). Each additional minute spent in the trauma bay increases odds of surviving by 1%. However, increase in ISS and decrease in TRISS were directly correlated with reduced time in the trauma bay for both blunt and penetrating traumas. Results did not differ based on mechanism of injury or destination after the trauma bay. Conclusion: Reduced time spent in trauma bay was not correlated with improved mortality outcomes in Level 1 trauma patients. Findings do not necessarily suggest that increased trauma bay time would reduce mortality, but rather current evaluation procedures may prioritize trauma patients appropriately. Instinctive adjustment by emergency care providers to move more severely injured patients out of the trauma bay quicker and other additional variables could account for the measured phenomena. This is the first study to examine trauma bay times and mortality outcomes. [ABSTRACT FROM AUTHOR]

The transmission of social disadvantage from teenage mothers to their children is well established, but when and why do these disparities emerge in the early life course? Using nationally representative data from the Early Childhood Longitudinal Study-Birth Cohort, this study investigated the relationship between teen childbearing and children's cognition, behavior, and health from infancy through preschool. Developmental disparities between teenage mothers' children and others were largely nonexistent at nine months but accumulated with age. Having a teenage mother predicted compromised development across several domains by age four and a half. Our conceptual model expected preexisting disadvantage, ongoing resource disadvantage, and compromised parenting quality to explain the association between teen childbearing and child outcomes. Preexisting social disadvantage accounted for much of this relationship. Financial, social, and material resources in the child's household partially or fully explained each of the remaining significant relationships between teenage childbearing and child outcomes. Parenting quality explained a smaller proportion of these relationships than did resources, and these factors' influences were largely independent. Because children of teenage mothers with a modest set of resources were not predicted to have compromised development, resources provided in early childhood may have the potential to reduce developmental disparities for teenage mothers' children. [ABSTRACT FROM AUTHOR]

Abstract: Beyond mothers’ union status transitions, other adults’ transitions into and out of the household contribute to family instability, particularly in early childhood. Using the Early Childhood Longitudinal Study-Birth Cohort (N ≅8550), this study examines associations between extended household transitions and age 2 cognitive development. A substantial minority of toddlers experiences these transitions, and their consequences vary by household member type, entry versus exit, and race/ethnicity. Extended household transitions predict lower cognitive scores for white children, but the selection of low-socioeconomic status families into extended households explains these disparities. Grandparent transitions predict significantly higher cognitive scores for African American and Latino children than whites, and some “other adult” transitions predict higher scores for Latinos than African Americans and whites. Extended household transitions’ consequences are independent of co-occurring residential moves and partner transitions. Findings suggest that studying extended household transitions is useful for understanding children’s early development, and their consequences vary by race/ethnicity. [Copyright &y& Elsevier]

Introduction: Benefits, risks, and the increasing popularity of yoga use warrant assessing yoga practice prevalence and users' profiles. This study describes trends in yoga practice exclusively among American adults from 2002 to 2017, compares the profile of yoga users, and identifies factors related to yoga use over time. Materials and Methods: This study is a secondary analysis done in 2019 and 2020 using the National Health Interview Survey (NHIS) 2002, 2007, 2012, and 2017 data. Population weights were used to obtain statistically accurate estimates of yoga use prevalence for the U.S. population. Descriptive statistics were used to profile the sociodemographic and health-related characteristics of yoga users. Multivariable logistic regression was used to identify factors associated with yoga use in each cohort defined by the NHIS year. Results: Yoga practice prevalence nearly tripled from 5.1% in 2002 to 13.7% in 2017 (weighted estimate 10,386,456 and 32,761,194 American adults, respectively). Typical yoga users were young non-Hispanic single white female adults with bachelor or higher education and health insurance, and resided in the west region of the United States. Yoga use pattern change over time was significantly related to only younger age (p < 0.001) but not to other sociodemographic or health-related factors. Conclusions: Yoga has gained increasing popularity in the past two decades among American adults, with younger adults being the driving force. Yoga appears to be adopted for general well-being or prevention more than for specific disease treatment. Future research should evaluate how yoga can be effectively and safely integrated into preventive medicine strategies. [ABSTRACT FROM AUTHOR]

Background: Medical students face a wide variety of stressors throughout their medical education, including academic, financial, health, and relationship concerns. Past research has found increased odds of depression and stress about educational debt. Married medical students have been found to have lower stress levels than their single counterparts, although more research is needed to understand the scope of financial stressors in this population. Objective: This study explores financial safety net as a predictor of medical student subjective happiness. Methods: This study sampled 256 medical students at Texas Tech University Health Sciences Center in February 2017 to explore the association between perceived financial safety net and subjective happiness. OLS and logistic regression analysis were used to explore the relationship between subjective happiness and financial safety net while adjusting for other factors. Results: In adjusted logistic and OLS regression models, students who reported that they "very likely" could turn to parents or family for help with an unforeseen expense also showed greater subjective happiness compared to those who perceived they were less than very likely to receive financial support. Conclusions: Perceived financial safety net demonstrated a persistent association with medical student subjective happiness, suggesting that economic insecurity may detrimentally impact medical students. [ABSTRACT FROM AUTHOR]

Abstract This study explores the sources and mechanisms of dissolved phosphorus (P) mobilization under base flow conditions in a headwater stream. We characterized the relevant chemical species and processes within the watershed to investigate connections between stream sediment, surface water, and groundwater with respect to P dynamics. Waters were monitored monthly during the 2017 snow-free period for temperature, pH, dissolved oxygen, conductivity, soluble reactive P (SRP), total P, strong acid anions, strong base cations, dissolved organic carbon (DOC), Al, Fe, and Mn. Phosphorus speciation within sediment samples was determined by sequential chemical extractions. The emerging groundwater was under-saturated by up to 40% with respect to O 2 , with pH = 7.24, T = 7.0 °C, and SRP = 3.0 μg L−1. Groundwater P CO2 was up to ~35× the ambient P CO2 (410 ppm). Degassing of CO 2 from the emerging groundwater resulted in a significant increase in pH downstream, and an increase in the SRP concentration from 3.0 to a maximum of 40.6 μg L−1. Laboratory experiments, using homogenized stream sediment, identified a reduction in the P adsorption capacity, and an increase in desorption of native P with increasing pH from ~7.25 (emerging groundwater) to ~8.50 (air-equilibrated surface water). These data allow us to identify the pH-dependent desorption from P-laden sediment as the most significant source of dissolved P in the headwater stream under base flow conditions. Graphical abstract Unlabelled Image Highlights • Increases in stream pH are driven by CO 2 degassing of emergent groundwater. • SRP in emerging groundwater (<2 μg L−1) increases to 30–50 μg L−1 in the stream. • Calcite precipitation does not measurably impact dissolved P concentration. • Sediment P adsorption capacity decreases with increasing pH. • pH-dependent desorption mobilizes P from stream sediment. [ABSTRACT FROM AUTHOR]

Abstract Introduction Mean platelet volume (MPV) is a measure of platelet size and activity. We conducted a population study with National Health and Nutrition Examination Survey (NHANES) data to understand the relationship of MPV with health and diseases. Materials and methods The NHANES is a cross-sectional survey of non-institutionalized adult population, administered every 2 years by the Centers for Disease Control and Prevention. Participants answer a questionnaire, receive a physical examination, and undergo laboratory tests. Values of MPV were collected over 6 years (2011–2016). Logistic regression was used to predict likelihood of being in categories with MPV < 10th percentile or >90th percentile. Statistical analysis was performed using Stata/SE 15.1. Results In our study with 17,969 individuals, the mean MPV was 8.40 [SD = 0.92] femtoliter. Individuals with male sex, age 45–64 years, and recent hospital-stay were more likely to have MPV < 10th percentile. Obese, Blacks and Mexican Americans had higher odds of having MPV > 90th percentile. Individuals with emphysema had significantly higher adjusted Odds [OR 1.92, 95% CI: 1.11–3.31, p = 0.021] of MPV < 10th percentile. Individuals with cancer were less likely to have MPV > 90th percentile [OR 0.74, 95% CI: 0.55–0.99, p = 0.042]. A diagnosis of coronary artery disease, asthma, and chronic obstructive pulmonary disease did not have significant associations with MPV. Conclusions Obese individuals are more likely to have higher MPV. Individuals with emphysema had higher odds of having MPV < 10th percentile and those with cancer were less likely to have MPV > 90th percentile. Highlights • Mean platelet volume (MPV) is a measure of platelet size and activity. • Obese individuals are more likely to have a higher MPV. • A diagnosis of emphysema has higher odds of having MPV < 10th percentile. • An individual with a cancer is less likely to have MPV > 90th percentile. [ABSTRACT FROM AUTHOR]

Foreign- and U.S.-born Hispanic health deteriorates with increasing exposure and acculturation to mainstream U.S. society. Because these associations are robust to (static) socioeconomic controls, negative acculturation has become their primary explanation. This overemphasis, however, has neglected important alternative structural explanations. Examining Hispanic mortality using the 1998-2006 U.S. National Health Interview Survey-Linked Mortality File according to nativity, immigrant adaptation measures, and health behaviors, this study presents indirect but compelling evidence that suggests negative acculturation is not the only or main explanation for this deterioration. [ABSTRACT FROM AUTHOR]