scholarly journals Predictors of Biologic Use and Satisfaction Among Patients With Psoriasis: An Analysis and Geographic Visualization of the 2016 and 2017 National Psoriasis Foundation Annual Surveys

2020 ◽  
Vol 5 (3) ◽  
pp. 100-108
Author(s):  
Clinton W. Enos ◽  
Hadiza Galadima ◽  
Arjun D. Saini ◽  
Stacie Bell ◽  
Michael Siegel ◽  
...  
Keyword(s):  
United States ◽  
Biologic Therapy ◽  
Residual Disease ◽  
Hot Spot ◽  
Severe Disease ◽  
Southeastern United States ◽  
The United States ◽  
Annual Survey ◽  
National Psoriasis Foundation ◽  
Survey Responses

Background: There are an increasing number of biologic therapies approved for the treatment of psoriasis. Previous reports have identified undertreatment as a concern in the United States. Undertreatment has been associated with decreased patient satisfaction and increased morbidity. Objectives: Assess biologic use and satisfaction among respondents to the 2016 and 2017 National Psoriasis Foundation (NPF) Annual Surveys. Methods: Retrospective data analysis of the 2016 and 2017 NPF Annual Survey responses from individuals with psoriasis. ArcGIS Pro software was utilized to generate maps and perform an optimized hot spot analysis of moderate-to-severe psoriasis and biologic use. Results: There were 427 patients with psoriasis involving the skin alone. Biologics were used in <23% of respondents, while nearly 69% reported body surface area (BSA) >3%. Respondents with BSA <3% and 3% to 4% were less likely to be on biologic therapy (odds ratio [OR]: 0.29, 0.11-0.78 and OR: 0.22, 0.09-0.56, respectively). Nonbiologic users were more likely to be very unsatisfied with their treatment compared to those receiving biologic therapy (OR: 5.23, 2.80-9.75). With geographic information systems (GIS), counties with increased moderate-to-severe disease were identified in the southeastern United States. Conclusion: Despite the increasing number of Food and Drug Administration–approved biologic medications, the proportion of respondents on biologic therapy remained small. Treatment with biologics correlated with less residual disease and increased satisfaction. Geographic variation in state legislation as well as state and federal health insurance did not impact biologic use. However, using GIS, we identify a greater burden of moderate-to-severe disease among respondents in the Southeastern United States and a lack of commensurate use of biologics in those areas.

Hunting the eagle killer: A cyanobacterial neurotoxin causes vacuolar myelinopathy

Science ◽  
2021 ◽  
Vol 371 (6536) ◽  
pp. eaax9050
Author(s):  
Steffen Breinlinger ◽  
Tabitha J. Phillips ◽  
Brigette N. Haram ◽  
Jan Mareš ◽  
José A. Martínez Yerena ◽  
...  
Keyword(s):  
United States ◽  
Aquatic Vegetation ◽  
Southeastern United States ◽  
Hydrilla Verticillata ◽  
Toxin Production ◽  
The United States ◽  
Biosynthetic Gene Cluster ◽  
Biosynthetic Gene ◽  
Bald Eagles ◽  
Cyanobacterial Species

Vacuolar myelinopathy is a fatal neurological disease that was initially discovered during a mysterious mass mortality of bald eagles in Arkansas in the United States. The cause of this wildlife disease has eluded scientists for decades while its occurrence has continued to spread throughout freshwater reservoirs in the southeastern United States. Recent studies have demonstrated that vacuolar myelinopathy is induced by consumption of the epiphytic cyanobacterial species Aetokthonos hydrillicola growing on aquatic vegetation, primarily the invasive Hydrilla verticillata. Here, we describe the identification, biosynthetic gene cluster, and biological activity of aetokthonotoxin, a pentabrominated biindole alkaloid that is produced by the cyanobacterium A. hydrillicola. We identify this cyanobacterial neurotoxin as the causal agent of vacuolar myelinopathy and discuss environmental factors—especially bromide availability—that promote toxin production.

scholarly journals Fungicide Rotation Programs for Managing Phytophthora Fruit Rot of Watermelon in Southeastern United States

2017 ◽  
Vol 18 (1) ◽  
pp. 28-34 ◽  
Author(s):  
Chandrasekar (Shaker) S. Kousik ◽  
Pingsheng Ji ◽  
Daniel S. Egel ◽  
Lina M. Quesada-Ocampo
Keyword(s):  
United States ◽  
South Carolina ◽  
Phytophthora Capsici ◽  
Southeastern United States ◽  
Heavy Rain ◽  
Integrated Approach ◽  
The United States ◽  
Fruit Rot ◽  
Management Options ◽  
Before And After

About 50% of the watermelons in the United States are produced in the southeastern states, where optimal conditions for development of Phytophthora fruit rot prevail. Phytophthora fruit rot significantly limits watermelon production by causing serious yield losses before and after fruit harvest. Efficacy of fungicide rotation programs and Melcast-scheduled sprays for managing Phytophthora fruit rot was determined by conducting experiments in Phytophthora capsici-infested fields at three locations in southeastern United States (North Carolina, South Carolina, and Georgia). The mini seedless cultivar Wonder and seeded cultivar Mickey Lee (pollenizer) were used. Five weekly applications of fungicides were made at all locations. Significant fruit rot (53 to 91%, mean 68%) was observed in the nontreated control plots in all three years (2013 to 2015) and across locations. All fungicide rotation programs significantly reduced Phytophthora fruit rot compared with nontreated controls. Overall, the rotation of Zampro alternated with Orondis was highly effective across three locations and two years. Rotations of Actigard followed by Ranman+Ridomil Gold, Presidio, V-10208, and Orondis, or rotation of Revus alternated with Presidio were similarly effective. Use of Melcast, a melon disease-forecasting tool, may occasionally enable savings of one spray application without significantly impacting control. Although many fungicides are available for use in rotations, under very heavy rain and pathogen pressure, the fungicides alone may not offer adequate protection; therefore, an integrated approach should be used with other management options including well-drained fields.

scholarly journals Cold Hardiness and Vernal Budbreak of Rhamnus caroliniana and the Invasive Rhamnus cathartica

2006 ◽  
Vol 131 (3) ◽  
pp. 345-351 ◽  
Author(s):  
J. Ryan Stewart ◽  
William R. Graves ◽  
Reid D. Landes
Keyword(s):  
United States ◽  
Water Stress ◽  
Cold Hardiness ◽  
Southeastern United States ◽  
The United States ◽  
Rhamnus Cathartica ◽  
Small Tree ◽  
Natural Distribution ◽  
Ecological Problems ◽  
Managed Landscapes

Carolina buckthorn [Rhamnus caroliniana Walt. or Frangula caroliniana (Walt.) Gray] is an attractive and water-stress-resistant shrub or small tree distributed extensively in the southeastern United States that merits use in managed landscapes. Due to substantial climatic differences within its distribution (30-year normal midwinter minima range from 13 to -8 °C), selection among provenances based on differences in cold hardiness is warranted. Before selections are marketed, the potential of carolina buckthorn to be invasive also merits investigation. Ecological problems resulting from the introduction of Rhamnus L. species in the United States, most notably the dominance of R. cathartica L. (common buckthorn) over neighboring taxa, are due in part to early budbreak. Consequently, we investigated depth of cold hardiness and vernal budbreak of carolina buckthorn and common buckthorn. Stem samples of carolina buckthorn and common buckthorn collected in midwinter survived temperatures as low as -21 and -24 °C, respectively. Although the cold hardiness of carolina buckthorns from Missouri was greater than that of carolina buckthorns from Ohio and Texas on 2 Apr. 2003, there were no differences in cold hardiness of stems from Missouri and Texas on all three assessment dates in the second experiment. All plants survived at both field locations except for the carolina buckthorns from southern Texas planted in Iowa, which showed 0% and 17% survival in 2003 and 2004, respectively. Budbreak of both species with and without mulch in Ames, Iowa, was recorded from 9 Apr. to 10 May 2002. Mean budbreak of common buckthorn was 5.7 days earlier than budbreak of carolina buckthorn, and buds of mulched carolina buckthorns broke 4.2 days earlier than did buds of unmulched carolina buckthorns. We conclude that the cold hardiness of carolina buckthorn is sufficient to permit the species to be planted outside of its natural distribution. Populations of carolina buckthorn in Ohio and Missouri should be the focus of efforts to select genotypes for use in regions with harsh winters. Phenology of its budbreak suggests carolina buckthorn will not be as invasive as common buckthorn, but evaluation of additional determinants of invasiveness is warranted.

Viral Hepatitis A

2021 ◽  
Author(s):  
Kenrad E Nelson ◽  
Brittany L Kmush
Keyword(s):  
United States ◽  
Acute Hepatitis ◽  
Injection Drug Users ◽  
Drug Users ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Severe Disease ◽  
The United States ◽  
Childhood Immunization ◽  
Effective Prevention

Epidemics of infectious jaundice have been reported throughout recorded history. However, the proof that many of these outbreaks and individual cases of acute hepatitis were caused by a viral infection, the hepatitis A virus (HAV), did not appear until the 1960s. After the transmission of infection to marmosets and humans, the epidemiologic and virologic characteristics that differed between hepatitis A and hepatitis B virus infections were defined more clearly. After the development and licensure of hepatitis A vaccines in the 1990s, it became possible to implement an effective prevention program involving routine immunization of young children in the United States and several other Western countries. However, despite the dramatic efficacy of the childhood immunization program in reducing the incidence of acute hepatitis from HAV in the population, older children and adults remained susceptible. Significant morbidity continues to occur in the United States among international travelers, injection drug users, persons with underlying liver disease, and other high-risk populations. Since HAV is a global pathogen, the prevention of increasing morbidity from hepatitis A attributable to the incidence of clinically more severe disease increases in countries transitioning from high to intermediate or low endemic status is a major public health challenge. In this review, we discuss the epidemiology, virology, clinical characteristics, and prevention of hepatitis A infections. This review contains 8 figures, 3 tables and 89 references Key words: epidemiology, global impact, hepatitis A vaccine, hepatitis A virus, prevention, reservoirs, risk factors, treatment

Variation in pediatric stereoelectroencephalography practice among pediatric neurosurgeons in the United States: survey results

2021 ◽  
pp. 1-9
Author(s):  
Benjamin C. Kennedy ◽  
Joshua Katz ◽  
Jacob Lepard ◽  
Jeffrey P. Blount
Keyword(s):  
United States ◽  
The United States ◽  
Median Number ◽  
Pediatric Epilepsy ◽  
Case Volume ◽  
Median Response ◽  
Younger Patients ◽  
Electronic Survey ◽  
Survey Results ◽  
Survey Responses

OBJECTIVE Stereoelectroencephalography (SEEG) has become widespread in the United States during the past decade. Many pediatric neurosurgeons practicing SEEG may not have had experience with this technique during their formal training, and the literature is mostly limited to single-center series. As a result, implementation of this relatively new technique may vary at different institutions. The authors hypothesized that aspects of SEEG experience, techniques, and outcomes would vary widely among programs across the country. METHODS An electronic survey with 35 questions addressing the categories of training and experience, technique, electrode locations, and outcomes was sent to 128 pediatric epilepsy surgeons who were potential SEEG users. RESULTS Sixty-one pediatric fellowship-trained epilepsy surgeons in the United States responded to the survey. Eighty-nine percent were actively using SEEG in their practice. Seventy-two percent of SEEG programs were in existence for less than 5 years, and 68% were using SEEG for > 70% of their invasive monitoring. Surgeons at higher-volume centers operated on younger patients (p < 0.001). Most surgeons (70%) spent 1–3 hours per case planning electrode trajectories. Two-thirds of respondents reported a median implant duration of 5–7 days, but 16% reported never having an implant duration > 5 days, and 16% reported having had implants stay in place for > 4 weeks. The median response for the median number of electrodes initially implanted was 12 electrodes, although 19% of respondents reported median implants of 5–8 electrodes and 17% reported median implants of 15–18 electrodes. Having a higher volume of SEEG cases per year was associated with a higher median number of electrodes implanted (p < 0.001). Most surgeons found SEEG helpful in defining an epileptic network and reported that most of their SEEG patients undergo focal surgical treatment. CONCLUSIONS SEEG has been embraced by the pediatric epilepsy surgery community. Higher case volume is correlated with a tendency to place more electrodes and operate on younger patients. For most parameters addressed in the survey, responses from surgeons clustered around a norm, though additional findings of substantial variations highlight differences in implementation and philosophy among pediatric epilepsy programs.

Brief Report

2021 ◽  
pp. 181-196
Author(s):  
Sean G Massey ◽  
Richard E. Mattson ◽  
Mei-Hsiu Chen ◽  
Melissa Hardesty ◽  
Ann Merriwether ◽  
...  
Keyword(s):  
United States ◽  
Sexual Orientation ◽  
Emerging Adults ◽  
Emerging Adult ◽  
The United States ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Trend Study ◽  
Attraction Behavior ◽  
Survey Responses

This trend study analyzed 9 years (2011–2019) of cross-sectional survey responses to Klein’s Sexual Orientation Grid to explore changes in sexual orientation among emerging adult college students. Categorical regression models based on ordinal responses revealed that participants were moving away from exclusive heterosexuality on attraction, behavior, and identity subscales at a rate of approximately 6% per year. This trend augments for women after 2014, coinciding with increased advocacy efforts related to U.S. marriage equality, but attenuates for men. Participants’ race also related to variations in sexual orientation: Black participants were less likely than White participants to identify as exclusively heterosexual, whereas the pattern reversed for Asian participants relative to White participants. These findings suggest that changes in sexual orientation are occurring among emerging adults in the United States, potentially in response to changing social and political contexts, but these changes are more pronounced in women and Black emerging adults.

Uncle Sam versus Uncle Usama

2018 ◽  
pp. 135-173
Author(s):  
Charles Kurzman
Keyword(s):  
United States ◽  
Foreign Policy ◽  
American Foreign Policy ◽  
The United States ◽  
Nobel Prize Winner ◽  
Barack Obama ◽  
Past Century ◽  
Revolutionary Violence ◽  
Survey Responses ◽  
Counterterrorism Policy

Shifts in American foreign policy have had little effect on Muslim attitudes toward the United States—even the shift from the administration of Barack Obama to that of Donald Trump barely changed Muslims’ survey responses or the prevalence of revolutionary violence. So why should the United States bother to take Muslim sensibilities into account? Following the lead of Nobel Prize winner Shirin Ebadi and remarkable American humanitarians of the past century, this chapter proposes that the United States reorganize its counterterrorism policy around the interests of its liberal Muslim allies, rather than expose them to the dangers of militarism and authoritarianism.

scholarly journals Cry Wolf Effect? Evaluating the Impact of False Alarms on Public Responses to Tornado Alerts in the Southeastern United States

2019 ◽  
Vol 11 (3) ◽  
pp. 549-563 ◽  
Author(s):  
JungKyu Rhys Lim ◽  
Brooke Fisher Liu ◽  
Michael Egnoto
Keyword(s):  
United States ◽  
False Alarm ◽  
Protective Action ◽  
Southeastern United States ◽  
The United States ◽  
False Alarms ◽  
Protective Behavior ◽  
Tornado Warnings ◽  
Research Findings ◽  
The Impact

Abstract On average, 75% of tornado warnings in the United States are false alarms. Although forecasters have been concerned that false alarms may generate a complacent public, only a few research studies have examined how the public responds to tornado false alarms. Through four surveys (N = 4162), this study examines how residents in the southeastern United States understand, process, and respond to tornado false alarms. The study then compares social science research findings on perceptions of false alarms to actual county false alarm ratios and the number of tornado warnings issued by counties. Contrary to prior research, findings indicate that concerns about false alarm ratios generating a complacent public may be overblown. Results show that southeastern U.S. residents estimate tornado warnings to be more accurate than they are. Participants’ perceived false alarm ratios are not correlated with actual county false alarm ratios. Counterintuitively, the higher individuals perceive false alarm ratios and tornado alert accuracy to be, the more likely they are to take protective behavior such as sheltering in place in response to tornado warnings. Actual country false alarm ratios and the number of tornado warnings issued did not predict taking protective action.

scholarly journals Long-Term Timber Contracts in the Southeastern United States: Updating the Primer Valuation Framework

2020 ◽  
Vol 66 (6) ◽  
pp. 653-665
Author(s):  
Hector I Restrepo ◽  
Bin Mei ◽  
Bronson P Bullock
Keyword(s):  
United States ◽  
Interest Rates ◽  
Southeastern United States ◽  
Price Volatility ◽  
Forest Products ◽  
The United States ◽  
Raw Material ◽  
Conditional Volatility ◽  
Material Supply

Abstract Timberland ownership has drastically changed in the United States since the 1980s, driven by the divestitures of vertically integrated forest products companies. Having sold their timberland, forest products companies have exposed themselves more to the risk of raw material supply. To hedge against this risk, forest products companies usually use long-term timber contracts (LTTC). The objective of this article is to update the valuation framework for LTTCs proposed by Shaffer (1984) by including alternative option price models and refining the estimates of some key economic variables. In particular, conditional volatility from the generalized autoregressive conditional heteroscedasticity model and quasi-conditional volatility from rolling estimation windows, in addition to simple standard deviation, are used for the volatility estimates in the option pricing models. Contrary to the previous result by Shaffer (1984), our analysis suggests that LTTCs that were once profitable for forest products companies in the 1980s are no longer so under current market conditions. This is primarily because both timber price volatility and the risk-free interest rates have declined significantly. Thus, to be better off, forest products companies need to either lower the administration and management costs of those LTTCs or rely more on the open market for timber procurement. Study Implications: Forest products companies have traditionally relied on long-term timber contracts (LTTC) negotiated with forest landowners to mitigate the risk of raw material supply. The value of these LTTCs highly depends on the economic context. This research provides some insights into the valuation of LTTCs in the southeastern United States. Forest products companies can use this updated framework to aid their decisionmaking in timber procurement.

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