Knowing Your Patient Population: Techniques to Capture Infants at High Risk for Physical Abuse in a Trauma Registry.

BACKGROUND: Physical abuse is a major public health concern and a leading cause of morbidity and mortality in infants. Clinical decision tools derived from trauma registries can facilitate timely risk-stratification. The Trauma Quality Improvement Program (TQIP) database does not report age for children <1 year who are at highest risk for abuse. We report a method to capture these infants despite the missing age. METHODS: Patients ≤17 years were identified from TQIP (2017-2019). The primary outcomes included injuries resulting from confirmed or suspected child abuse captured by diagnosis codes or report/investigation of physical abuse, or different caregiver at discharge available in TQIP. We used two methods to select infants within TQIP. In the first, World Health Organization (WHO) growth standards for stature or length-for-age and weight-for-age were selected to capture children younger than 1 year. In the second, a K-means machine learning algorithm was used to cluster patients by weight and height. We compared outcome and injury data with and without patients <1 year. RESULTS: Using the WHO growth standard 19,916 children <1 year were identified. A total of 20,513 patients had a report of physical abuse filed, and 9393 were infants <1 year. Increased age-adjusted odds ratios [95% CI] were seen for fractures of the upper limb (1.28 [1.22-1.34]), vertebrae (1.89 [1.68-2.13]), ribs (5.2 [4.8-5.63]), and spinal cord (3.39 [2.85-4.02]) and head injuries (1.55 [1.5-1.6]) with infants included. CONCLUSIONS: In a nationwide trauma registry, WHO growth standards can be used to capture patients under one year who are more adversely impacted by maltreatment. TYPE OF STUDY: Retrospective, Cross-sectional. LEVEL OF EVIDENCE: Level III, Diagnostic.

IL-1ß expression driven by androgen receptor absence or inactivation promotes prostate cancer bone metastasis.

We report the inverse association between the expression of androgen receptor (AR) and interleukin-1beta (IL-1ß) in a cohort of patients with metastatic castration resistant prostate cancer (mCRPC). We also discovered that AR represses the IL-1ß gene by binding an androgen response element (ARE) half-site located within the promoter, which explains the IL-1ß expression in AR-negative (ARNEG) cancer cells. Consistently, androgen-depletion or AR-pathway inhibitors (ARIs) de-repressed IL-1ß in ARPOS cancer cells, both in vitro and in vivo. The AR transcriptional repression is sustained by histone de-acetylation at the H3K27 mark in the IL-1ß promoter. Notably, patients' data suggest that DNA methylation prevents IL-1ß expression, even if the AR-signaling axis is inactive. Our previous studies show that secreted IL-1ß supports metastatic progression in mice by altering the transcriptome of tumor-associated bone stroma. Thus, in prostate cancer patients harboring ARNEG tumor cells or treated with ADT/ARIs, and with the IL-1ß gene unmethylated, IL-1ß could condition the metastatic microenvironment to sustain disease progression.

Relationships between Electrolyte Concentration and the Supercapacitive Swing Adsorption of CO2.

We quantitatively investigate the influence of the NaCl electrolyte concentration on the adsorptive and energetic characteristics of supercapacitive swing adsorption (SSA) for the separation of CO2 from a simulated flue gas mixture containing 15% CO2 and 85% N2. The investigated concentrations were that of deionized water, 0.010, 0.10, 1.0, 3.0, and 5.0 M NaCl. We find that the energetic metrics strongly improve with the increasing NaCl concentration, whereas the adsorptive metrics improve by a comparatively small degree. The CO2 adsorption capacity increases up to 1.0 M NaCl and then remains constant. The adsorption rate remains near constant for all concentrations, except that it is somewhat smaller for deionized water. The charge efficiency also remains near constant for all experiments with 30 min potentiostatic holding steps but near doubles for pure water when the potential holding step is doubled, because the chemical adsorption equilibrium is reached only after 60 min. The results can be most satisfactorily explained by assuming that both ionic and nonionic adsorption mechanisms contribute to the SSA effect.

Cyberbullying among Youth with and without Disabilities.

Cyberbullying refers to bullying that occurs through the Internet and text messaging. While strides have been made in understanding the frequency with which cyberbullying occurs and its correlates, only a handful of published studies have examined cyberbullying among individuals with disabilities. Thus, this study examined cyberbullying prevalence rates and correlates among 231 participants age 16 to 20 (M = 19.32) with and without disabilities (51% male; 70.6% Caucasian). The study also examined the influence of disability status on participants' ability to detect the presence/absence of cyberbullying. Both individuals with and without disabilities displayed high prevalence rates of cyberbullying victimization, with youth with disabilities displaying significantly higher rates. Perpetration rates did not differ significantly between the two groups. Disability status (present/absent) did not influence the ability of participants to detect the presence or absence of cyberbullying. Implications of the findings for prevention/intervention efforts are discussed.

Bullying and cyberbullying in adulthood and the workplace.

Two studies generated profiles of cyberbullying/cyberincivility and traditional bullying/incivility in adults, particularly within the workplace. In Study 1, 20% of 3,699 participants had the majority of cyberbullying victimization and 7.5% had the majority of traditional bullying victimization occur in adulthood, with 30% saying they were bullied at work. Relationships between bullying and negative outcomes were found. Because of the clear evidence of bullying and cyberbullying in the workplace in Study 1, Study 2 addressed the relationship of these constructs to workplace incivility. Workplace face-to-face incivility and bullying were related among 321 participants, as were workplace cyberbullying and cyberincivility. Face-to-face incivility was more common than online incivility, face-to-face bullying, or online bullying, yet all four behaviors were associated with negative outcomes. Differences in intentionality, acceptability, and severity were observed, with workplace face-to-face bullying perceived as the most severe and having the greatest intentionality to harm. These results emphasize the importance of studying bullying among adults, and highlight the conceptual independence of bullying and incivility. Correlates of workplace aggression are discussed using job demands-resources theory.

Functional Testing Differences in Anterior Cruciate Ligament Reconstruction Patients Released Versus Not Released to Return to Sport.

BACKGROUND: No standardized return-to-activity or sport guidelines currently exist after anterior cruciate ligament (ACL) reconstruction. Isokinetic testing and unilateral hop testing, which have construct validity, are often used to make the determination of when a patient is ready to return to sport. Neither of these measures has been reported to be predictive of subsequent injuries. PURPOSE: To compare the performance on 2 functional tests of ACL reconstruction patients released to return to activity versus those who have not been released based on clinical impairment measures. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A total of 98 patients were examined by the treating orthopaedic surgeon 6 months after ACL reconstruction for traditional impairment measures, including swelling, range of motion, strength, and graft stability. After this examination, all subjects completed the functional testing, consisting of the Functional Movement Screen (FMS) and the Lower Quarter Y Balance Test (YBT-LQ), by an experienced tester who was blinded to the results of the clinical examination. On the basis of the clinical examination, all patients were grouped as being ready to return to sport or not being ready. Performance on the functional tests, as measured by overall performance and side-to-side asymmetry, was compared between the 2 groups using independent-samples t tests (P < .05). RESULTS: No difference existed between the groups with regard to the descriptive characteristics, with the exception that the group not cleared was younger (21.0 ± 7.4 years) than the group that was cleared (25.6 ± 13.2 years). Performance on the YBT-LQ revealed that no differences existed between groups when examining reach symmetry for any of the reach directions. In addition, no differences were found between groups when looking at the average reach score normalized to limb length for either the surgical or nonsurgical leg. Patients in the cleared group exhibited a similar score on the FMS (12.7 ± 2.9) compared with the noncleared group (12.8 ± 2.7). Similarly, no differences were observed for the number of asymmetries; however, both groups averaged 1 asymmetry during the testing. CONCLUSION: Clinical impairment measures do not appear to be related to measured functional ability. Performance on both functional tests, the FMS and YBT-LQ, at 6 months would suggest that the typical patient in both groups would be at a greater risk of lower extremity injury, based on currently published research.