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Objective: The current study longitudinally examines college student Twitter patterns throughout initial phases of the COVID-19 pandemic. This study aims to better understand psychological impact and online personal communication during the pandemic. Participants: A dataset consisting of ~720,000 tweets posted by students from universities throughout the United States during the 2020 spring semester was analyzed according to structural and sentimental analysis. Methods: Using a data-driven approach, three time periods emerged which reflected the transition to online learning. Results: Significant changes in structure and sentiment of tweets were observed across phases. Conclusions: Changes in Twitter patterns revealed important features of this unprecedented transition to online learning for college students.

Studies on framing demonstrate that the way ideas are presented influences emotions and decision-making. Many bullying interventions involve competing frames, with some discussing bullying in terms of negative effects and others in terms of resiliency. Gender is closely related to frames about bullying, as culturally communicated expectations contribute to differences in individuals' internalized frames. The current cross-sectional study explores how resiliency and negative effects frames in the context of bullying impact emotion and social decision-making across males and females. Participants (N = 92) ages 19-30 (M = 27.97, SD = 2.17) answered questionnaires around self-construal, internalized beliefs about bullying, and current bullying experiences before being randomized to write about a time they either demonstrated resiliency to or negative effects from bullying, balanced by males and females. The participants completed questionnaires regarding predictions of future bullying, current emotions, and social decision-making. The four groups were entered in a MANOVA and compared across dependent measures to better understand how both frames and gender affected future predictions of bullying, current emotions, and social decision-making. The overall model was significant (Wilks Lamda = 0.51, F = 1.94, p = 0.004, [partial-eta squared] = 0.20). Next, a MANOVA compared males versus females on self-construal, beliefs about bullying, and current levels of bullying to better understand pre-existing gender-based differences. The overall model was significant (Wilks Lamda, F = 3.41, p = 0.00). These variables that differed across gender were entered as covariates into a MANCOVA model which compared the four groups across dependent measures, with the aim to elucidate factors influencing the gender by frame effect. The overall model was significant (Wilks Lamda = 0.57, F(30,228) = 1.81, p = 0.009, [partial-eta squared] = 0.20). The results demonstrate that frames around bullying influence emotions and social decision-making, and that this impact differs across gender.

The COVID-19 pandemic impacted testing and incidence of sexually transmitted infections (STIs), with some studies showing uneven effects across sociodemographic groups. We aim to determine whether rates of gonorrhea and chlamydia testing and infections were affected by the pandemic, overall and by subgroups, defined by sociodemographic factors and comorbidities. We conducted a retrospective cohort study from January 1, 2016, through December 31, 2022, among adolescents and young adults ages 15–29 years within Kaiser Permanente Northern California (KPNC). We determined the rate of testing for gonorrhea/chlamydia, and the incident rates of infections before and during the COVID-19 pandemic by sociodemographic factors. We compared incidence rates of gonorrhea/chlamydia testing and infection before and during the pandemic using Poisson regression. Gonorrhea/chlamydia testing during the pandemic was 19% lower than prepandemic baseline. Testing among Black patients was 1.8-fold higher than White patients. Black patients had 5.5 and 3.6-fold higher rate of gonorrhea and chlamydia infections, respectively, compared with White patients. Patients living in more deprived neighborhoods also had higher rates of infection compared to those in the least deprived neighborhoods. In multivariable analyses stratified by the period before and during the COVID-19 pandemic, there were no significant differences in the incidence rate ratios of testing or infections for any specific sociodemographic factor. STI testing in adolescents and young adults dropped dramatically after the start of the pandemic and has not recovered to its prior levels. Preexisting disparities in STI testing and infections were not exacerbated by the pandemic. [ABSTRACT FROM AUTHOR]

OBJECTIVE:The Affordable Care Act (ACA) introduced reforms to mitigate adverse selection into and within the individual insurance market. We examined the traits and predicted medical spending of enrollees in California post-ACA. DATA SOURCES:Survey of 2,103 enrollees in individual market plans, on- and off-exchange, in 2014. STUDY DESIGN:We compared actual versus potential participants using data from the 2014 California Health Interview Survey on respondents who were individually insured or uninsured. We predicted annual medical spending for each group using age, sex, self-rated health, body mass index, smoking status, and income. PRINCIPAL FINDINGS:Average predicted spending was similar for actual ($3,377, 95 percent CI [$3,280-$3,474]) and potential participants ($3,257 [$3,060-$3,454]); however, some vulnerable subgroups were underrepresented. On- versus off-exchange enrollees differed in sociodemographic and health traits with modest differences in spending ($3,448 [$3,330-$3,565] vs. $3,175 [$3,012-$3,338]). CONCLUSIONS:We did not find evidence of selection into the overall insurance pool in 2014; however, differences by exchange status reflect the importance of including off-exchange enrollees in analyses and the pool for risk adjustment. California's post-ACA individual market has been a relative success, highlighting the importance of state policies and outreach efforts to encourage participation in the market.

The buccal space and its fat pad (BFP) is a valuable, overlooked target in facial rejuvenation procedures. We identified a specific group of patients who have normal or prominent malar projection in the presence of atrophy of the buccal fat pad, with or without prominent gonial angles.

Background: Recent efforts to study quality improvement (QI) efforts to improve the effectiveness and efficiency of healthcare have raised important questions about ethical boundaries for waiving informed consent. Confusion exists because similar projects can be undertaken for research or QI purposes, a distinction currently used to define Institutional Review Board oversight. However, patients are not aware of such distinctions. We sought to evaluate patients' views of waiving consent for non-invasive projects to improve healthcare quality and delivery. Methods: We developed a 32-item measure of patient thresholds for waiving consent for different types of QI interventions, including those involving changes to: 1) the hospital environment; 2) hospital policies or procedures; 3) objects used by patients; 4) medications or devices; and 5) use of patient information. In a sample of 200 hospitalized patients, we tested and confirmed the reliability and validity of subscales representing each of the 5 intervention types. Results: For each of the five consent threshold scales, all items in each scale had substantial item-to-total correlations with the other items in that scale taken together. All five internal consistency reliability coefficients exceeded.70 for the total sample. Means for all 5 scales indicated general patient support for waiving consent across all categories of interventions studied. However, patients were significantly less comfortable foregoing consent for interventions involving medications or devices, or sharing of patient information. Conclusion: We developed and tested a survey instrument to contribute to the understanding of patient preferences for consent in QI assessment activities. Measures were found to be reliable and valid. Findings indicated general patient support for waiving consent across all minimal risk categories studied. However, more work is needed to reassure and protect patients during minimal risk studies involving medications or devices, or the sharing of patient information.

Adjusting for a balancing score is sufficient for bias reduction when estimating causal effects including the average treatment effect and effect among the treated. Estimators that adjust for the propensity score in a nonparametric way, such as matching on an estimate of the propensity score, can be consistent when the estimated propensity score is not consistent for the true propensity score but converges to some other balancing score. We call this property the balancing score property, and discuss a class of estimators that have this property. We introduce a targeted minimum loss-based estimator (TMLE) for a treatment-specific mean with the balancing score property that is additionally locally efficient and doubly robust. We investigate the new estimator's performance relative to other estimators, including another TMLE, a propensity score matching estimator, an inverse probability of treatment weighted estimator, and a regression-based estimator in simulation studies.

ObjectivesTo compare the performance of a targeted maximum likelihood estimator (TMLE) and a collaborative TMLE (CTMLE) to other estimators in a drug safety analysis, including a regression-based estimator, propensity score (PS)-based estimators, and an alternate doubly robust (DR) estimator in a real example and simulations.Study design and settingThe real data set is a subset of observational data from Kaiser Permanente Northern California formatted for use in active drug safety surveillance. Both the real and simulated data sets include potential confounders, a treatment variable indicating use of one of two antidiabetic treatments and an outcome variable indicating occurrence of an acute myocardial infarction (AMI).ResultsIn the real data example, there is no difference in AMI rates between treatments. In simulations, the double robustness property is demonstrated: DR estimators are consistent if either the initial outcome regression or PS estimator is consistent, whereas other estimators are inconsistent if the initial estimator is not consistent. In simulations with near-positivity violations, CTMLE performs well relative to other estimators by adaptively estimating the PS.ConclusionEach of the DR estimators was consistent, and TMLE and CTMLE had the smallest mean squared error in simulations.

Chronic beryllium disease (CBD) is an exposure-related granulomatous disease mimicking sarcoidosis. Beryllium exposure-associated disease occurs mainly via inhalation, but skin may also be a source of sensitization. A 65-year-old male with a history of war-related shrapnel wounds was initially diagnosed with pulmonary sarcoidosis. Twenty years later, the possibility of a metal-related etiology for the lung disease was raised. A beryllium lymphocyte proliferation test, elemental analysis of removed shrapnel, and genetic studies were consistent with a diagnosis of CBD. This case demonstrates that retained beryllium-containing foreign bodies can be linked to a pathophysiologic response in the lung consistent with CBD.

BACKGROUND: Impulse oscillometry (IOS) is a noninvasive technique that measures lung physiology independently of patient effort. In the present study, we aimed to investigate the utility of IOS parameters in comparison with pulmonary function testing (PFT) among hospitalized subjects, with emphasis on obstructive and small airway diseases. METHODS: Sixty-one subjects hospitalized either with unexplained dyspnea or for pre-surgery evaluation were included in the study. All subjects underwent PFTs and IOS test. The correlation between IOS results and PFTs was examined in different subgroups. The ability of IOS parameters to predict abnormal PFTs was evaluated using the area under the receiver operating characteristic (ROC) curve, and optimal cutoff values were calculated. RESULTS: IOS results were found to correlate with PFT values. Subgroup analysis revealed that these correlations were higher in younger (age < 70) and non-obese (body mass index < 25kg/m²) subjects. The resonant frequency was an independent predictor and had the best predictive ability for abnormal FEV1/FVC (area under the ROC curve 0.732 [95% CI 0.57-0.90], optimal cutoff 17 Hz, 87% sensitivity, 62% specificity) and abnormal forced expiratory flow during the middle half of the FVC maneuver (area under the ROC curve 0.667 [95% CI 0.53-0.81], optimal cutoff 15 Hz, 77% sensitivity, 54% specificity). Area of reactance and the difference in respiratory resistance at 5 Hz and 20 Hz also showed a good predictive ability for abnormal FEV1/FVC (area under the ROC curve 0.716 and 0.730, respectively). CONCLUSIONS: We found that the IOS performed well in diagnosing small airway and obstructive diseases among hospitalized subjects. IOS might serve as an alternative to standard PFTs in non-cooperative or dyspneic hospitalized patients. [ABSTRACT FROM AUTHOR]

This article describes an internship program designed specifically to meet graduate students' training needs within the context of their work in a prevention program for children in foster care. An internship based on a strong model of intern recruitment and supervision, structured inclusion of interns in a supportive agency culture, a manualized orientation, and an ongoing didactic program was hypothesized to result in a positive experience for interns. Results of anonymous surveys administered to 102 interns over a 9-year period assessing their internship experience are presented and discussed. Recommendations are made for development of internship training sites.

Prior research has demonstrated that victims of peer victimization show reduced psychological adjustment, social adjustment, and physical well-being compared with nonvictims. However, little research has addressed whether this maladjustment continues over the long term. This study examined adjustment in 72 high school students who had participated in a peer-nomination procedure assessing peer victimization when in elementary school (5 to 8 years earlier). Thirty-five high school students who had been peer nominated as overtly and/or relationally peer victimized were compared with 37 peers who were not nominated as victimized in elementary school. High school students completed self-report measures of psychological adjustment, social adjustment, physical well-being, and current overt and relational victimization. In addition, a retrospective self-report measure of peer victimization in elementary school was administered. Results revealed that, although current self-reported peer victimization was negatively related to adjustment, elementary-school peer-nomination measures of victimization were unrelated to high-school adjustment. Further, current self-reports of remembered victimization in elementary school were associated with lowered adjustment. These results indicate that current and past perceived peer victimization is negatively related to adjustment, but past experience of peer-identified victimization has a more complex relation to current adjustment.

Endoscopist adenoma detection rates (ADRs) vary widely and are associated with patients' risk of postcolonoscopy colorectal cancers (PCCRCs). However, few scalable physician-directed interventions demonstrably both improve ADR and reduce PCCRC risk. Among patients undergoing colonoscopy, we evaluated the influence of a scalable online training on individual-level ADRs and PCCRC risk. The intervention was a 30-minute, interactive, online training, developed using behavior change theory, to address factors that potentially impede detection of adenomas. Analyses included interrupted time series analyses for pretraining versus posttraining individual-physician ADR changes (adjusted for temporal trends) and Cox regression for associations between ADR changes and patients' PCCRC risk. Across 21 endoscopy centers and all 86 eligible endoscopists, ADRs increased immediately by an absolute 3.13% (95% confidence interval [CI], 1.31-4.94) in the 3-month quarter after training compared with.58% per quarter (95% CI,.40-.77) and 0.33% per quarter (95% CI,.16-.49) in the 3-year pretraining and posttraining periods, respectively. Posttraining ADR increases were higher among endoscopists with pretraining ADRs below the median. Among 146,786 posttraining colonoscopies (all indications), each 1% absolute increase in screening ADR posttraining was associated with a 4% decrease in their patients' PCCRC risk (hazard ratio,.96; 95% CI,.93-.99). An ADR increase of ≥10% versus <1% was associated with a 55% reduced risk of PCCRC (hazard ratio,.45; 95% CI,.24-.82). A scalable, online behavior change training intervention focused on modifiable factors was associated with significant and sustained improvements in ADR, particularly among endoscopists with lower ADRs. These ADR changes were associated with substantial reductions in their patients' risk of PCCRC. [ABSTRACT FROM AUTHOR]

This study examined the communication of non-aggressive, rejected (NAR) children and popular children during peer interaction. The participants were 80 fifth and sixth graders recruited from a larger sociometric sample (40 boys and 40 girls; 20 NAR children and 60 non-aggressive, popular children). Participants were assigned to 40 same-gender dyads: 20 NAR-Popular dyads and 20 Popular-Popular dyads, and each dyad was asked to collaborate on a social reasoning task. Results showed that when placed in a collaborative context with a popular peer, NAR children displayed a distinct pattern of social goals and self-efficacy, self-focused and disruptive patterns of communication, and emotional responses to the collaborative interaction. Differences between boys and girls were found for communication patterns, and a social status and gender interaction was found for emotional experience. (Contains 1 table.)

Peer nominations and demographic information were collected from a diverse sample of 1493 elementary school participants to examine behavior (overt and relational aggression, impulsivity, and prosociality), context (peer status), and demographic characteristics (race and gender) as predictors of teacher and administrator decisions about discipline. Exploratory results using classification tree analyses indicated students nominated as average or highly overtly aggressive were more likely to be disciplined than others. Among these students, race was the most significant predictor, with African American students more likely to be disciplined than Caucasians, Hispanics, or Others. Among the students nominated as low in overt aggression, a lack of prosocial behavior was the most significant predictor. Confirmatory analysis using hierarchical logistic regression supported the exploratory results. Similarities with other biased referral patterns, proactive classroom management strategies, and culturally sensitive recommendations are discussed. (Contains 5 figures and 5 tables.)

Over 1100 students over four semesters were given the option of taking an introductory undergraduate statistics class either by in-person attendance in lectures or by taking exactly the same class (same instructor, recorded lectures, homework, blind grading, website, etc.) without the in-person lectures. Roughly, equal numbers of students chose each option. The online students did slightly better on computer-graded exams. The causal effect of choosing only online lectures was estimated by adjusting for measured confounders using four standard methods. The four nearly identical point estimates remained positive but were small and not statistically significant at the 95% confidence level. Sensitivity analysis indicated that unmeasured confounding was unlikely to be large but might plausibly reduce the point estimate to zero. No statistically significant differences were found in preliminary comparisons of effects on females/males, U.S./non-U.S. citizens, freshmen/non-freshman, and lower-scoring/higher-scoring math ACT groups. [ABSTRACT FROM AUTHOR]

The Colfax High School (Colfax, California) Design Tech program incorporates both academic instruction and practical use of advanced technology to prepare students for the wide range of occupations that involve working with metal, wood, computers, and electronics. In this article, the author describes how Colfax students applied academic learning, developed flexible thinking, and acquired marketable skills in the school's Design Tech program while using advanced manufacturing technology to build solar-powered drag racers. The students learn to use a computer numerical control (CNC) router that is used to build the wooden body as well as a CNC plasma cutter that is used to build the metal chassis of the drag racer.