Lifetime years married held steady for men with a BA degree since 1960 but dropped to lowest level since 1880 for men without a BA.

Trends in life expectancy and marriage patterns work together to determine expected lifetime years married. In 1880, adult life expectancy was short and marriages were more likely to end by death than divorce. Since then, although there have been substantial life expectancy gains in adulthood, marriage has been increasingly delayed or forgone and cohabitation and divorce are far more prevalent. Whether adults today can expect to spend more or fewer years married than in the past depends on the relative magnitude of changes in mortality and marriage. We estimate trends in men's expected lifetime years married (and in other marital statuses) from 1880 to 2019 and by bachelor's degree (BA) status from 1960 to 2019. Our results show a rise in men's expected lifetime years married between 1880 and the Baby Boom era and a subsequent fall. There are large and growing differences by BA status. Men with a BA have had high and relatively stable expected lifetime years married since 1960. For men without a BA, expected lifetime years married has plummeted to lows not seen among men since 1880. Cohabitation accounts for a substantial fraction, although not all, of these declines. Our results demonstrate how increasing inequality in both life expectancy and marriage patterns combine to amplify educational differences in lifetime experiences of coresidential partnerships.

Novel grid and sectoral analyses in monitoring corneal scars.

PURPOSE: We aim to design two sampling methods, the grid and sectoral methods, to provide more precise detection of focal corneal scar changes with time following pterygium excision with the Pentacam imaging system. METHODS: This is a retrospective study of our previous prospective observational case series. Thirty patients underwent primary pterygium excision with adjuvant topical mitomycin-C application were followed up and imaged with Pentacam system at postoperative weeks 1, 4, 12 and month 18. Grid and sectoral methods were used to sample density changes (in grayscale units, GSU) over the scarred areas as well as the clear pole of the same cornea. RESULTS: Using the grid method, the average corneal densities were 39.4, 37.1, 36.7 and 34.7 GSU at postoperative 1, 4, 12 weeks and 18 months, respectively. On the other hand, using the sectoral method, the average corneal densities were 35.3, 33.3, 32.5 and 31.9 GSU at postoperative 1, 4, 12 weeks and 18 months, respectively. Paired t tests achieved statistical significance when comparing all follow-up time points to first postoperative visit. A statistically significant effect of time on the average density was shown on ANOVA (p < 0.001) using both analyses over the scarred areas, but not over the clear pole of the same cornea (p > 0.05). CONCLUSION: Our novel approach to monitor corneal density changes using the grid or sectoral sampling methods seemingly enhances the power in monitoring density changes in corneal scars when compared to conventional total-diameter average densitometry.

Effectiveness of Continuous Subcutaneous Insulin Infusion on Parental Quality of Life and Glycemic Control Among Children With T1D: Meta-Analysis.

BACKGROUND: Type 1 diabetes (T1D) is one of the most common chronic diseases in childhood. Daily diabetes management poses a major challenge for parents. Intensive insulin therapy using continuous subcutaneous insulin infusion (CSII) or multiple daily injections (MDI) are recommended for patients with T1D, but evidence for their effectiveness on parental quality of life (QOL) and glycemic control among children with T1D is inconclusive. OBJECTIVES: A systematic review was conducted to determine the best available evidence regarding the effectiveness of CSII compared to MDI on parental QOL and glycemic control among children with T1D. METHODS: Studies in English and Chinese from 1978 to March 2015 were identified by searching electronic databases, published references, and unpublished studies. Randomized controlled trials (RCTs) comparing CSII with MDI related to parental QOL and glycemic control (HbA1c) among patients aged 18 years or below with T1D were included. Secondary outcomes were episodes of severe hypoglycemia (SH) and diabetic ketoacidosis (DKA). RESULTS: Seven RCTs were identified. Parental QOL was reported in two studies, with one study reporting no significant improvement in the CSII group and one reporting a significant reduction in diabetes-related worry in the CSII group but increased frequency of stress relating to child medical care in the MDI group. Meta-analysis of seven RCTs involving 220 patients demonstrated that CSII was associated with significant decrease in HbA1c level (MD = -0.24%, 95% CI = -0.41 to -0.07, p = .006) compared to MDI. There were no significant differences in episodes of SH and DKA between the CSII and MDI groups. LINKING EVIDENCE TO ACTION: CSII slightly reduced HbA1c by .24% compared to MDI. Based on two RCTs with small sample sizes, there is insufficient evidence to draw any conclusions on the beneficial effects of CSII compared with MDI on parental QOL among children with T1D. More RCTs with larger samples are needed.

Carcinogenic HPV infection in the cervical squamo-columnar junction.

Recent studies have suggested the involvement of a unique population of cells at the cervical squamo-columnar junction (SCJ) in the pathogenesis of early (squamous intraepithelial lesion or SIL) and advanced (squamous cell and adeno-carcinomas) cervical neoplasia. However, there is little evidence to date showing that SCJ cells harbour carcinogenic HPV or are instrumental in the initial phases of neoplasia. This study was designed to (1) determine if normal-appearing SCJ cells contained evidence of carcinogenic HPV infection and (2) trace their transition to early SIL. Sections of cervix from high-risk reproductive age women were selected and SCJ cells were analysed by using several techniques which increasingly implicated HPV infection: HPV DNA (genotyping and in situ hybridization)/RNA (PCR), immunostaining for HPV16 E2 (an early marker of HPV infection), p16(ink4), Ki67, and HPV L1 protein. In 22 cases with a history of SIL and no evidence of preneoplastic lesion in the excision specimen, HPV DNA was isolated from eight of ten with visible SCJ cells, six of which were HPV16/18 DNA-positive. In five of these latter cases, the SCJ cells were positive for p16(ink4) and/or HPV E2. Transcriptionally active HPV infection (E6/E7 mRNAs) was also detected in microdissected SCJ cells. Early squamous atypia associated with the SCJ cells demonstrated in addition diffuse p16(ink4) immunoreactivity, elevated proliferative index, and rare L1 antigen positivity. We present for the first time direct evidence that normal-appearing SCJ cells can be infected by carcinogenic HPV. They initially express HPV E2 and their progression to SIL is heralded by an expanding metaplastic progeny with increased proliferation and p16(ink4) expression. Whether certain SCJs are more vulnerable than others to carcinogenic HPV genotypes and what variables determine transition to high-grade SIL remain unresolved, but the common event appears to be a vulnerable cell at the SCJ.

Essential Readings in Diversity, Equity, and Inclusion in Behavior Analytic Training Programs.

Cultural responsiveness is imperative for the success of behavior analysts. As topics within diversity, equity, and inclusion are emphasized within coursework and supervision, there is a growing need for resources. To date, there is limited research on suggested readings within diversity, equity, and inclusion for behavior analysts. We surveyed behavior analysts to construct a list of essential readings within diversity, equity, and inclusion and reported common publications that instructors assigned and students were assigned within behavior analytic coursework.

Biomimetic Proteoglycans Strengthen the Pericellular Matrix of Normal and Osteoarthritic Human Cartilage.

In osteoarthritis (OA), degradation of cartilage pericellular matrix (PCM), the proteoglycan-rich immediate cell microniche, is a leading event of disease initiation. This study demonstrated that biomimetic proteoglycans (BPGs) can diffuse into human cartilage from both normal and osteoarthritic donors and are preferentially localized within the PCM. Applying immunofluorescence (IF)-guided AFM nanomechanical mapping, we show that this localization of BPGs increases the PCM micromodulus of both normal and OA specimens. These results illustrate the capability of BPGs to integrate with degenerative tissues and support the translational potential of BPGs for treating human OA and other diseases associated with proteoglycan degradation.

Implementation of Frequency Building and Precision Teaching to Teach Sight Words via Synchronous Learning: A Case Study.

Frequency building, a method of instruction by which learners perform timed repetitions of the behavior followed by corrective feedback, is often used in conjunction with precision teaching wherein individuals' performances are continuously measured on a standard celeration chart (SCC) to facilitate data-based decisions. The present case study utilized a synchronous teaching method to teach caregivers to implement frequency building in-home to teach young learners to identify sight words while learner performance was measured on a SCC. Four participants, with little previous exposure to sight words, were taught using precision teaching as implemented by caregivers. Results indicate that synchronous teaching is a viable method to teach caregivers to implement precision teaching, but care should be given to the method of teaching as well as procedural fidelity during precision teaching trials.

Integrating Diversity, Equity, and Inclusion Readings within Coursework: Suggestions for Instructors Teaching Behavior Analysis.

Behavior analysis graduate programs must train their students to be culturally responsive so that they are prepared to effectively serve a diverse clientele. One important strategy for helping students gain a culturally responsive repertoire is embedding diversity, equity, and inclusion materials into behavior analysis graduate course sequences. However, little guidance exists for selecting content related to diversity, equity, and inclusion within behavior analysis to include in behavior analytic coursework. This article provides suggested readings for diversity, equity, and inclusion within behavior analysis that can be embedded into typical course structures in behavior analysis graduate programs. Each course requirement in the Association for Behavior Analysis International's Verified Course Sequence is given specific recommendations.

Randomised assessor-masked trial evaluating topical manuka honey (Optimel) in treatment of meibomian gland dysfunction.

PURPOSE: To evaluate the effects of manuka honey eye-drops in the treatment of meibomian gland dysfunction. METHODS: This is an assessor-masked (single-blind), randomised controlled trial comparing conventional treatment group with interventional group using Optimel 16% manuka honey topical eye-drops. 59 patients were recruited to the study and randomised into two groups: one given regular lubricants and the other given Optimel 16% manuka honey eye-drops. The Standard Patient Evaluation of Eye Dryness (SPEED) score was measured at baseline and on follow-up. 4 patients were lost to follow-up. Multiple ocular surface parameters were graded from slit lamp examination by a masked assessor. Results were compared from baseline to follow-up date 3 weeks later. RESULTS: Patients in the conventional treatment group demonstrated minimal difference in SPEED score at 3-week follow-up (mean difference 1.087, p=0.183), which was not statistically significant. However, measurements of tear film break-up time, corneal surface stain (Oxford), lid margin, conjunctival redness, as well as meibum quality and expressibility showed significant improvements at 3 weeks (p<0.01). Patients in the manuka honey eye-drops group showed significant difference after 3 weeks in SPEED score (mean difference 2.53, p=0.006), as well as in lid margin redness, conjunctival redness, corneal surface stain (Oxford), and meibum quality and expressibility (p=0.000). CONCLUSIONS: Optimel 16% manuka honey eye-drops showed significant improvement in symptoms and objective signs in meibomian gland dysfunction and are an effective alternative treatment for meibomian gland dysfunction. TRIAL REGISTRATION NUMBER: NCT04457648.

Women in Behavior Analysis: A Review of the Literature.

Women have played, and continue to play, an important role in behavior analysis. Their participation as authors of journal articles and as journal editors was first quantified in 1983 and has been the topic of several subsequent articles. Other articles have addressed other aspects of women's participation in the discipline, but no review of articles concerned with women in behavior analysis has appeared. The present review (a) describes articles that quantified the participation of women, (b) presents a novel data set providing an updated overview of women's participation in eight behavior-analytic journals, (c) reviews suggestions from prominent female behavior analysts, (d) discusses other topics that pertain to the participation of women, (e) presents data describing the gender of authors who have written about women in behavior analysis, and (f) makes suggestions for future research. Women's participation in behavior analysis has increased greatly over the past half-century. The articles we review clearly document that increase and may have contributed to it, although that contribution is speculative.

Invasive pneumococcal disease surveillance in Canada, 2020.

Background: Invasive pneumococcal disease (IPD), which is caused by Streptococcus pneumoniae, has been a nationally notifiable disease in Canada since 2000. The use of conjugate vaccines has markedly decreased the incidence of IPD in Canada; however, the distribution of serotypes has shifted in favour of non-vaccine types. This report summarizes the demographics, serotypes and antimicrobial resistance of IPD infections in Canada in 2020. Methods: The Public Health Agency of Canada's National Microbiology Laboratory (Winnipeg, Manitoba) collaborates with provincial and territorial public health laboratories to conduct national surveillance of IPD. A total of 2,108 IPD isolates were reported in 2020. Serotyping was performed by Quellung reaction and antimicrobial susceptibilities were determined in collaboration with the University of Manitoba/Canadian Antimicrobial Resistance Alliance. Population-based IPD incidence rates were obtained through the Canadian Notifiable Disease Surveillance System. Results: Overall incidence of IPD in Canada decreased significantly from 11.5 (95% confidence interval [CI]: 10.1-13.1) to 6.0 (95% CI: 5.0-7.2), and from 10.0 (95% CI: 9.7-10.3) to 5.9 (95% CI: 5.7-6.2) cases per 100,000 from 2019 to 2020; in those younger than five years and those five years and older, respectively. The most common serotypes overall were 4 (11.2%, n=237), 3 (10.9%, n=229) and 8 (7.2%, n=151). From 2016 to 2020, serotypes with increasing trends (p<0.05) included 4 (6.4%-11.2%), 3 (9.5%-10.9%), 8 (5.2%-7.2%) and 12F (3.6%-5.7%). The overall prevalence of PCV13 serotypes increased over the same period (30.3%-34.9%, p<0.05). Antimicrobial resistance rates in 2020 included 23.0% clarithromycin and 9.9% penicillin (IV meningitis breakpoints). Multidrug-resistant IPD has significantly increased since 2016 (4.2%-9.5%, p<0.05). Conclusion: Though the incidence of IPD decreased in 2020 in comparison to previous years across all age groups, disease due to PCV13 serotypes 3 and 4, as well as non-PCV13 serotypes such as 8 and 12F, increased in prevalence. Continued surveillance of IPD is imperative to monitor shifts in serotype distribution and antimicrobial resistance.

Invasive group A streptococcal disease surveillance in Canada, 2020.

Background: Invasive group A streptococcal (iGAS) disease (caused by Streptococcus pyogenes) has been a nationally notifiable disease in Canada since 2000. This report summarizes the demographics, emm types and antimicrobial resistance of iGAS infections in Canada in 2020. Methods: The Public Health Agency of Canada's National Microbiology Laboratory (Winnipeg, Manitoba) collaborates with provincial and territorial public health laboratories to conduct national surveillance of invasive S. pyogenes. Emm typing was performed on all isolates using the Centers for Disease Control and Prevention emm sequencing protocol. Antimicrobial susceptibilities were determined using Kirby-Bauer disk diffusion according to Clinical and Laboratory Standards Institute guidelines. Population-based iGAS disease incidence rates up to 2019 were obtained through the Canadian Notifiable Disease Surveillance System. Results: Overall, the incidence of iGAS disease in Canada has increased from 4.0 to 8.1 cases per 100,000 population from 2009 to 2019. The 2019 incidence represents a slight decrease from the 2018 rate of 8.6 cases per 100,000 population. A total of 2,867 invasive S. pyogenes isolates that were collected during 2020 are included in this report, representing a decrease from 2019 (n=3,194). The most common emm types in 2020 were emm49 (16.8%, n=483) and emm76 (15.0%, n=429), both increasing significantly in prevalence since 2016 (p<0.001). The former most prevalent type, emm1, decreased to 7.6% (n=217) in 2020 from 15.4% (n=325) in 2016. Antimicrobial resistance rates in 2020 included 11.5% resistance to erythromycin, 3.2% resistance to clindamycin and 1.6% nonsusceptibility to chloramphenicol. Conclusion: Though the number of collected invasive S. pyogenes isolates decreased slightly in 2020 in comparison to previous years, iGAS disease remains an important public health concern. The emm distribution in Canada has been subtly shifting over the past five years, away from common and well-known emm1 and towards emm49 and emm76. It is important to continue surveillance of S. pyogenes in Canada to monitor expanding replacement emm types, as well as outbreak clones and antimicrobial resistance.

Solidarity: The Role of Non-Black People of Color in Promoting Racial Equity.

Multicultural behavior analysts must stand together to address the issues of systemic racism collectively, show solidarity, and support Black lives. This article discusses the role of culturally and linguistically diverse behavior analysts, the mechanisms underlying barriers to showing solidarity, and the mechanisms required for cultural evolution to promote a compassionate and nurturing approach to racial equity. It is critical that non-Black people of color actively participate in antiracist advocacy to express solidarity with the Black Lives Matter movement.

Citations of Murray Sidman's work in JEAB: Evidence of a long and large contribution.

We examined citations of Murray Sidman's publications in the Journal of the Experimental Analysis of Behavior from the journal's inception in 1958 through May 2020. On average, he was cited 35.6 times per year. The rate of citation did not change substantially across time and the cumulative citation count was 2,212. His 10 publications cited most often deal with behavior-analytic research methods, stimulus equivalence, and unsignaled free-operant (or Sidman) avoidance. Our data provide clear evidence of the breadth and depth of Sidman's influence on the experimental analysis of behavior across 7 decades. His contributions were both exceptional and praiseworthy and his legacy will long endure.

Commit Heresy: Stop Using "Contingency".

The term "contingency" has long been widely used by behavior analysts, but their uses of the term are inconsistent with the vernacular definition of the term. Moreover, the term is not consistently defined by behavior analysts, but is instead used to refer to a variety of relations between and among stimuli and responses. In the interest of reducing jargon and potential confusion, we argue that behavior analysts should stop using "contingency" and related terms.

Participants in Behavior-Analytic Sports Studies: Can Anybody Play?

Participating in athletics confers a wide range of benefits, regardless of participants' gender or disability status. Our review of 95 behavior-analytic sports-performance articles revealed that over half of them included at least 1 female participant, but only 5 included at least 1 participant with a reported developmental disability. Given that females are often underrepresented as research participants, and that female athletes face unique barriers, it is heartening that so many articles involved female participants. Moreover, there were more female than male participants overall. However, it is surprising and distressing that so few articles involved participants with a developmental disability. Participating in sports can be a lifelong source of fitness, friends, and fun. Practitioners should encourage people of all ages, races, and genders, and from all disability categories, to find a sport they like, to learn to do it well enough to enjoy it, and to do it regularly. Researchers should give them the tools necessary to make those efforts as easy, and as fruitful, as possible. Nothing but good can come from these efforts.

A 5-year analysis of endothelial vs penetrating keratoplasty graft survival in Chinese patients.

AIM: To determine if there is any difference in long term graft survival between Descemet's stripping endothelial keratoplasty (DSEK) and penetrating keratoplasty (PK). METHODS: A retrospective 5-year cases analysis of bullous keratopathy secondary to Fuchs' endothelial dystrophy or pseudophakic bullous keratopathy, receiving either DSEK or PK. A total of 42 DSEK cases and 25 PK cases were included in the analysis. RESULTS: In the 5-year analysis, graft survival rates were very similar in the two groups (DSEK 77.1% vs PK 76.0%, P=0.918, 95%CI: -6.3 to 33.4). Sub-analyses at 1y (DSEK 81% vs PK 95%, P=0.085, 95%CI: -29 to 3.6) and 2y (DSEK 81% vs PK 88%, P=0.381, 95%CI: -25.9 to 11.8) show a trend towards lower survival rates of DSEK vs PK, but the results were not statistically significant. CONCLUSION: Long term 5-year graft survival is similar between the DSEK and PK methods of corneal transplant in Chinese patients with bullous keratopathy.

Self- and cross-citations in the Journal of Applied Behavior Analysis and the Journal of the Experimental Analysis of Behavior: 2004-2018.

We examined self- and cross-citations in the Journal of Applied Behavior Analysis (JABA) and the Journal of the Experimental Analysis of Behavior (JEAB) from 2004 through 2018. Mean annual levels of self-citations for JABA and JEAB were 40.1% and 28.7%, respectively. Overall, 5.1% of JABA citations were JEAB articles, and 2.3% of JEAB citations were JABA articles. Although overall cross-citation levels were relatively low, 28.7% of the JABA articles reviewed had at least one JEAB citation, and 27.5% of the JEAB articles reviewed had at least one JABA citation. Authors in both journals cited articles addressing the topics of matching and motivating operations. The extent to which the basic and applied sectors of behavior analysis interact depends on how the interaction is measured. Nonetheless, the degree of interaction is growing, which is a good thing for the discipline.

Using a Lottery to Promote Physical Activity by Young Adults with Developmental Disabilities.

Exercise benefits adults with developmental disabilities. A prior study demonstrated that a treatment package comprising goal setting and fixed-ratio 1 reinforcement for goal attainment substantially increased walking. However, continuous reinforcement delivery may be untenable due to cost and time. In an effort to develop a more practical package intervention, we evaluated a procedure that involved setting goals for steps taken each 6-h school day and a lottery system for awarding prizes for goal completion. Three of the four participants took substantially more steps when the intervention was in effect, and all of them rated it as highly acceptable.

The Gender Pay Gap for Behavior Analysis Faculty.

We examined publicly available faculty salaries for men and women faculty members at 16 university programs accredited by the Association for Behavior Analysis International (ABAI). Overall, 52.4% of the 103 faculty members were women, although there were twice as many men as women at the full-professor level. Our data suggest that ABAI-accredited training programs pay women less than men at all academic levels. Both in absolute terms and relative to the wage gap reported in other areas of psychology, the difference in mean wages for women and men in our sample was substantial. The mean salaries of men were 13%, 6%, and 15% greater than those of women at the assistant-, associate-, and full-professor levels, respectively. At all levels, the highest salary reported was earned by a man, and the lowest salary was earned by a woman. This is an embarrassment for our discipline. It is time for a change, and we behavior analysts have the tools to make change happen. Let us put those tools to good use.