Variability in Infant Acute Pain Responding Meaningfully Obscured By Averaging Pain Responses

Given the inherent variability in pain responding, using an "average" pain score may pose serious threats to internal and external validity of current research findings. Using growth mixture modeling (GMM), the paper first examines if infants can be differentiated into stable groups based on their pain response patterns over a two-minute post-needle period. Secondary analyses, to specifically address the issue of averaging pain scores to represent a sample, qualitatively described clinically meaningful differences between pain scores of the discerned groups and the overall mean (irrespective of groups). Infants were part of Canadian longitudinal cohort naturalistically observed during their 2- , 4-, 6-, and/or 12-month immunization appointments (Ns = 458 to 574) at 3 pediatrician clinics between 2007 and 2012. At every age, GMM analyses discerned distinct groups of infants with significantly variable patterns of pain responding over the 2 minutes post-needle. Our secondary analyses suggested that the overall mean pain score immediately post-needle reflected most groups well at every age. However, for older infants (6 and 12 months, especially), the overall mean pain responses at 1 and 2 minutes post-needle significantly over or underestimated groups that contained 48% to 100% of the sample. These results combined highlight the significant variability of infant pain responding patterns between groups of infants and furthermore, calls into question the validity of using an overall mean in research with older infants during the regulatory phase post-needle

A spatial approach to combatting wildlife crime

Poaching can have devastating impacts on animal and plant numbers, and in many countries has reached crisis levels, with illegal hunters employing increasingly sophisticated techniques. We used data from an 8‐year study in Savé Valley Conservancy, Zimbabwe, to show how geographic profiling—a mathematical technique originally developed in criminology and recently applied to animal foraging and epidemiology—can be adapted for use in investigations of wildlife crime. The data set contained information on over 10,000 incidents of illegal hunting and the deaths of 6,454 wild animals. We used a subset of data for which the illegal hunters’ identities were known. Our model identified the illegal hunters’ home villages based on the spatial locations of the hunting incidences (e.g., snares). Identification of the villages was improved by manipulating the probability surface inside the conservancy to reflect the fact that although the illegal hunters mostly live outside the conservancy, the majority of hunting occurs inside the conservancy (in criminology terms, commuter crime). These results combined with rigorous simulations showed for the first time how geographic profiling can be combined with GIS data and applied to situations with more complex spatial patterns, for example, where landscape heterogeneity means some parts of the study area are less likely to be used (e.g., aquatic areas for terrestrial animals) or where landscape permeability differs (e.g., forest bats tend not to fly over open areas). More broadly, these results show how geographic profiling can be used to target antipoaching interventions more effectively and more efficiently and to develop management strategies and conservation plans in a range of conservation scenarios.TRAFFIC Southern and East Africa, the European Union, Wilderness Trust, Chicago Board of Trade, and the African Wildlife Conservation Fund.http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1523-17392019-06-01hj2018Mammal Research InstituteZoology and Entomolog

Beyond the Refugee Crisis how the UK news media represent asylum seekers across national boundaries

Migration is one of the most pressing, divisive issues in global politics today, and media play a crucial role in how communities understand and respond. This study examines how UK newspapers (n = 974) and popular news websites (n = 1044) reported on asylum seekers throughout 2017. It contributes to previous literature in two important ways. First, by examining the ‘new normal’ of daily news coverage in the wake of the 2015 ‘refugee crisis’ in Europe. Second, by looking at how asylum seekers from different regions are represented. The content analysis finds significant variations in how asylum seekers are reported, including terminology use and topics they are associated with. The paper also identifies important commonalities in how all asylum seekers are represented - most notably, the dominance of political elites as sources across all media content. It argues that Entman’s ‘cascade network model’ can help to explain this, with elites in one country able to influence transnational reports

Predicting postoperative troponin in patients undergoing elective hip or knee arthroplasty: A comparison of five cardiac risk prediction tools

BACKGROUND: Elderly patients undergoing hip or knee arthroplasty are at a risk for myocardial injury after noncardiac surgery (MINS). We evaluated the ability of five common cardiac risk scores, alone or combined with baseline high-sensitivity cardiac troponin I (hs-cTnI), in predicting MINS and postoperative day 2 (POD2) hs-cTnI levels in patients undergoing elective total hip or knee arthroplasty. METHODS: This study is ancillary to the Genetics-InFormatics Trial (GIFT) of Warfarin Therapy to Prevent Deep Venous Thrombosis, which enrolled patients 65 years and older undergoing elective total hip or knee arthroplasty. The five cardiac risk scores evaluated were the atherosclerotic cardiovascular disease calculator (ASCVD), the Framingham risk score (FRS), the American College of Surgeon\u27s National Surgical Quality Improvement Program (ACS-NSQIP) calculator, the revised cardiac risk index (RCRI), and the reconstructed RCRI (R-RCRI). RESULTS: None of the scores predicted MINS in women. Among men, the ASCVD ( CONCLUSION: In elderly patients undergoing elective hip or knee arthroplasty, several of the scores modestly predicted MINS in men and correlated with POD2 hs-cTnI

Adapted treatment guided by interim PET-CT scan in advanced Hodgkin's lymphoma

BACKGROUND: We tested interim positron-emission tomography-computed tomography (PET-CT) as a measure of early response to chemotherapy in order to guide treatment for patients with advanced Hodgkin's lymphoma. METHODS: Patients with newly diagnosed advanced classic Hodgkin's lymphoma underwent a baseline PETCT scan, received two cycles of ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) chemotherapy, and then underwent an interim PET-CT scan. Images were centrally reviewed with the use of a 5-point scale for PET findings. Patients with negative PET findings after two cycles were randomly assigned to continue ABVD (ABVD group) or omit bleomycin (AVD group) in cycles 3 through 6. Those with positive PET findings after two cycles received BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone). Radiotherapy was not recommended for patients with negative findings on interim scans. The primary outcome was the difference in the 3-year progression-free survival rate between randomized groups, a noninferiority comparison to exclude a difference of 5 or more percentage points. RESULTS: A total of 1214 patients were registered; 937 of the 1119 patients (83.7%) who underwent an interim PET-CT scan according to protocol had negative findings. With a median follow-up of 41 months, the 3-year progression-free survival rate and overall survival rate in the ABVD group were 85.7% (95% confidence interval [CI], 82.1 to 88.6) and 97.2% (95% CI, 95.1 to 98.4), respectively; the corresponding rates in the AVD group were 84.4% (95% CI, 80.7 to 87.5) and 97.6% (95% CI, 95.6 to 98.7). The absolute difference in the 3-year progression-free survival rate (ABVD minus AVD) was 1.6 percentage points (95% CI, -3.2 to 5.3). Respiratory adverse events were more severe in the ABVD group than in the AVD group. BEACOPP was given to the 172 patients with positive findings on the interim scan, and 74.4% had negative findings on a third PET-CT scan; the 3-year progression-free survival rate was 67.5% and the overall survival rate 87.8%. A total of 62 patients died during the trial (24 from Hodgkin's lymphoma), for a 3-year progression-free survival rate of 82.6% and an overall survival rate of 95.8%. CONCLUSIONS: Although the results fall just short of the specified noninferiority margin, the omission of bleomycin from the ABVD regimen after negative findings on interim PET resulted in a lower incidence of pulmonary toxic effects than with continued ABVD but not significantly lower efficacy

Serving highly vulnerable families in home-visitation programs

Home-visitation programs for families with young children are growing in popularity in the US. These programs typically seek to prevent child abuse and neglect and/or promote optimal development for infants, toddlers, and/or preschool-age children. This paper focuses on improving the capacity of home-visitation programs to meet the complex needs of highly vulnerable families with young children. Poverty, maternal depression and substance abuse, and domestic violence are noted as factors that place young children at risk for poor outcomes. The challenges of providing home-visitation services to families in which these risk factors are present are discussed. Family engagement, matching services to families’ needs, and staff capabilities are highlighted as areas in which improvements can be made to enhance home-visitation programs’ capacity to serve highly vulnerable families. Recommendations are given for improving the effectiveness of home-visitation programs in serving these families, as well for addressing policy and research issues related to the further development and evaluation of these programs.First author draf

Science Impacts of the SPHEREx All-Sky Optical to Near-Infrared Spectral Survey: Report of a Community Workshop Examining Extragalactic, Galactic, Stellar and Planetary Science

SPHEREx is a proposed SMEX mission selected for Phase A. SPHEREx will carry out the first all-sky spectral survey and provide for every 6.2" pixel a spectra between 0.75 and 4.18 $\mu$m [with R$\sim$41.4] and 4.18 and 5.00 $\mu$m [with R$\sim$135]. The SPHEREx team has proposed three specific science investigations to be carried out with this unique data set: cosmic inflation, interstellar and circumstellar ices, and the extra-galactic background light. It is readily apparent, however, that many other questions in astrophysics and planetary sciences could be addressed with the SPHEREx data. The SPHEREx team convened a community workshop in February 2016, with the intent of enlisting the aid of a larger group of scientists in defining these questions. This paper summarizes the rich and varied menu of investigations that was laid out. It includes studies of the composition of main belt and Trojan/Greek asteroids; mapping the zodiacal light with unprecedented spatial and spectral resolution; identifying and studying very low-metallicity stars; improving stellar parameters in order to better characterize transiting exoplanets; studying aliphatic and aromatic carbon-bearing molecules in the interstellar medium; mapping star formation rates in nearby galaxies; determining the redshift of clusters of galaxies; identifying high redshift quasars over the full sky; and providing a NIR spectrum for most eROSITA X-ray sources. All of these investigations, and others not listed here, can be carried out with the nominal all-sky spectra to be produced by SPHEREx. In addition, the workshop defined enhanced data products and user tools which would facilitate some of these scientific studies. Finally, the workshop noted the high degrees of synergy between SPHEREx and a number of other current or forthcoming programs, including JWST, WFIRST, Euclid, GAIA, K2/Kepler, TESS, eROSITA and LSST.Comment: Report of the First SPHEREx Community Workshop, http://spherex.caltech.edu/Workshop.html , 84 pages, 28 figure

Documenting ---- in Bloomington-Normal: A Community Report on Intolerance, Segregation, Accessibility, Inclusion, and Progress, and Improvement

For the local chapter of Not In Our Town, we document intolerance, discrimination, segregation, disparities of access, and disparities in the criminal justice system in Bloomington-Normal, IL. Using archival material, secondary data, and primary data, we examine these issues from the mid-1990s to the present. We also assess the position of the organization in the community and provide strategies for future success. In sum, Bloomington-Normal was and is intolerant; discrimination did and does take place in this community; there are disparities of access and in the criminal justice system; we are segregated. The community is also less of these things than it used to be and is less of these things than other places. Fifteen undergraduate students in Sociology 300, twelve graduate students in Sociology 477, a teaching assistant, and an instructor conducted this study in spring 2017