Immigration and the Public Policy Survey

Evidence suggests that public opinion has a significant and measurable impact on legislative, executive, and citizen interaction. The state of Idaho is no exception. In this white paper, we examine a sample of the opinions of Idahoans, as expressed in the Public Policy Survey, on the subject of immigration. In the 18th and 19th Annual Idaho Public Policy Surveys, the survey sample was asked to respond to a number of questions concerning immigration in Idaho. Questions on the survey ranged from economic impacts to the quality of education to indigent medical care. Of the many benefits that the data offers, some of the not inconsequential benefits are an additional outlet through which citizens may express their opinions, and additional information provided for decision makers. Generally, the information gathered from the survey is used discretely, year by year, to inform policy makers. In this white paper, we have taken a look at the immigration questions in the last two iterations of the survey and summarized the results. The following is a list of findings: • Idaho residents feel strongly that undocumented immigrants reduce the quality of education for Idaho children. • Idahoans have indicated that they feel that counties should deny indigent medical care to undocumented immigrants. • An English-only policy for the state of Idaho is a very popular concept for Idahoans. • Stricter immigration policy is not likely to negatively affect the economy. We offer some concluding thoughts at the end of the survey data presentation. Our sense is that the presentation of the perceptions of the public related to immigration is only part of the story. What is clearly missing is any secondary empirical analysis of, for instance, the measurable effects of illegal immigrants on school performance. What we seem to glean from this analysis is that there is much yet to be learned about immigration and its effects on Idaho and Idahoans

Nineteen Years of Public Opinion: The Boise State University Annual Public Policy Survey

Evidence suggests that public opinion has a significant and measurable impact on legislative, executive, and citizen interaction. The state of Idaho is no exception. In this white paper, we examine a sample of the opinions of Idahoans, as expressed in the Public Policy Survey, over the past nineteen years

The biomechanics of amnion rupture: an X-ray diffraction study

Pre-term birth is the leading cause of perinatal and neonatal mortality, 40% of which are attributed to the pre-term premature rupture of amnion. Rupture of amnion is thought to be associated with a corresponding decrease in the extracellular collagen content and/or increase in collagenase activity. However, there is very little information concerning the detailed organisation of fibrillar collagen in amnion and how this might influence rupture. Here we identify a loss of lattice like arrangement in collagen organisation from areas near to the rupture site, and present a 9% increase in fibril spacing and a 50% decrease in fibrillar organisation using quantitative measurements gained by transmission electron microscopy and the novel application of synchrotron X-ray diffraction. These data provide an accurate insight into the biomechanical process of amnion rupture and highlight X-ray diffraction as a new and powerful tool in our understanding of this process

The SAMI Galaxy Survey: : extraplanar gas, galactic winds, and their association with star formation history

This article has been accepted for publication in Monthly Notices of the Royal Astronomical Society. ©: 2016 The Authors. Published by Oxford University Press on behalf of the Royal Astronomical Society, the version of record is available on line at doi: 10.1093/mnras/stw017We investigate a sample of 40 local, main-sequence, edge-on disc galaxies using integral field spectroscopy with the Sydney-AAO Multi-object Integral field spectrograph (SAMI) Galaxy Survey to understand the link between properties of the extraplanar gas and their host galaxies. The kinematics properties of the extraplanar gas, including velocity asymmetries and increased dispersion, are used to differentiate galaxies hosting large-scale galactic winds from those dominated by the extended diffuse ionized gas. We find rather that a spectrum of diffuse gas-dominated to wind dominated galaxies exist. The wind-dominated galaxies span a wide range of star formation rates ($-1 \lesssim \log({\rm SFR/M_{\odot} yr^{-1}}) \lesssim 0.5$) across the whole stellar mass range of the sample ($8.5 \lesssim \log({\rm M_{*}/M_{\odot}}) \lesssim 11$). The wind galaxies also span a wide range in SFR surface densities ($10^{-3} \textrm{--} 10^{-1.5}\rm~M_{\odot} ~yr^{-1}~kpc^{-2}$) that is much lower than the canonical threshold of $\rm0.1~M_{\odot} ~yr^{-1}~kpc^{-2}$. The wind galaxies on average have higher SFR surface densities and higher $\rm H\delta_A$ values than those without strong wind signatures. The enhanced $\rm H\delta_A$ indicates that bursts of star formation in the recent past are necessary for driving large-scale galactic winds. We demonstrate with Sloan Digital Sky Survey data that galaxies with high SFR surface density have experienced bursts of star formation in the recent past. Our results imply that the galactic winds revealed in our study are indeed driven by bursts of star formation, and thus probing star formation in the time domain is crucial for finding and understanding galactic winds.Peer reviewe

Erratum to: Methods for evaluating medical tests and biomarkers

[This corrects the article DOI: 10.1186/s41512-016-0001-y.]

The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study

Background: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy. Methods: Consecutive women undergoing mastectomy ± IBR for breast cancer July–December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored. Results: A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays. Conclusions: IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

Evidence synthesis to inform model-based cost-effectiveness evaluations of diagnostic tests: a methodological systematic review of health technology assessments

Background: Evaluations of diagnostic tests are challenging because of the indirect nature of their impact on patient outcomes. Model-based health economic evaluations of tests allow different types of evidence from various sources to be incorporated and enable cost-effectiveness estimates to be made beyond the duration of available study data. To parameterize a health-economic model fully, all the ways a test impacts on patient health must be quantified, including but not limited to diagnostic test accuracy. Methods: We assessed all UK NIHR HTA reports published May 2009-July 2015. Reports were included if they evaluated a diagnostic test, included a model-based health economic evaluation and included a systematic review and meta-analysis of test accuracy. From each eligible report we extracted information on the following topics: 1) what evidence aside from test accuracy was searched for and synthesised, 2) which methods were used to synthesise test accuracy evidence and how did the results inform the economic model, 3) how/whether threshold effects were explored, 4) how the potential dependency between multiple tests in a pathway was accounted for, and 5) for evaluations of tests targeted at the primary care setting, how evidence from differing healthcare settings was incorporated. Results: The bivariate or HSROC model was implemented in 20/22 reports that met all inclusion criteria. Test accuracy data for health economic modelling was obtained from meta-analyses completely in four reports, partially in fourteen reports and not at all in four reports. Only 2/7 reports that used a quantitative test gave clear threshold recommendations. All 22 reports explored the effect of uncertainty in accuracy parameters but most of those that used multiple tests did not allow for dependence between test results. 7/22 tests were potentially suitable for primary care but the majority found limited evidence on test accuracy in primary care settings. Conclusions: The uptake of appropriate meta-analysis methods for synthesising evidence on diagnostic test accuracy in UK NIHR HTAs has improved in recent years. Future research should focus on other evidence requirements for cost-effectiveness assessment, threshold effects for quantitative tests and the impact of multiple diagnostic tests

Erratum to: Methods for evaluating medical tests and biomarkers

[This corrects the article DOI: 10.1186/s41512-016-0001-y.]