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Studies have shown that quality of care affects patient health outcomes and well-being. In this study, we examine the relationship between perceived quality of prenatal care, birth outcomes, and postpartum depression (PPD).We use data from the third wave of the Listening to Mothers dataset (2013). After removing missing data, the analytic sample size included 2168 women. Through linear and logistic regression analyses, we test the following hypotheses: higher perceived quality of prenatal care will have a positive association with a likelihood of vaginal delivery and normal birth weight outcomes, and a negative association with a likelihood of preterm birth; and higher perceived quality of prenatal care will have a negative association with a likelihood of PPD risk.Women who perceived higher quality of prenatal care were significantly less likely to have a preterm birth relative to women who reported lower quality care. Women who reported (any) medical jargon during their prenatal visits were less likely to have a normal birth weight baby. Women who reported provider use of medical jargon, lower perceived quality of interaction with a prenatal care provider, and lower perceived quality of US maternity care in general were more likely to be at risk for PPD.Negative prenatal care experiences may exacerbate adverse patient outcomes. Positive prenatal care experiences may buffer/improve adverse outcomes. Quality of care measures were most consistently predictive of PPD outcomes. Providers should focus on improving the quality of prenatal care as one of the means to improve maternal and infant health and well-being.

Motivating property owners to mitigate seismic risks for existing buildings is a major challenge for many earthquake-prone regions. This article identifies primary factors that may affect the adoption of seismic retrofit by owners of commercial and residential buildings, assesses the influence of economic, social, regulatory, and individual factors on retrofit implementation in three California cities, and discusses potential approaches to promoting seismic retrofits. Data for three retrofit programs are utilized to create predictive models for retrofit probability. The results suggest that retrofit probability for multifamily residential buildings may increase with building height, median housing value, educational attainment, and population density in the neighborhood, but may decrease with building age, building size, land value, and housing vacancy rate in the neighborhood. The retrofit decision for commercial buildings is strongly correlated with the number of stories and rooms, land value, vacancy rate, and population density, while the retrofit decision for residential buildings is highly associated with building age, number of rooms, land value, median housing value, median contract rent, and educational attainment. Overall, promoting seismic retrofits requires careful consideration of different motivators and impediments to owner’s retrofit actions for commercial and residential buildings, and for older, taller, larger buildings, which tend to be more vulnerable but are associated with higher retrofit costs. In addition, neighborhood characteristics including median housing value and vacancy rate may be strong indicators of the retrofit probability among building clusters.

Constituting the bulk of rare-earth elements, lanthanides need to be separated to fully realize their potential as critical materials in many important technologies. The discovery of new ligands for improving rare-earth separations by solvent extraction, the most practical rare-earth separation process, is still largely based on trial and error, a low-throughput and inefficient approach. A predictive model that allows high-throughput screening of ligands is needed to identify suitable ligands to achieve enhanced separation performance. Here, we show that deep neural networks, trained on the available experimental data, can be used to predict accurate distribution coefficients for solvent extraction of lanthanide ions, thereby opening the door to high-throughput screening of ligands for rare-earth separations. One innovative approach that we employed is a combined representation of ligands with both molecular physicochemical descriptors and atomic extended-connectivity fingerprints, which greatly boosts the accuracy of the trained model. More importantly, we synthesized four new ligands and found that the predicted distribution coefficients from our trained machine-learning model match well with the measured values. Therefore, our machine-learning approach paves the way for accelerating the discovery of new ligands for rare-earth separations.

Breastfeeding is an important public health issue that significantly intersects with work, gender, and family relationships. Prior research has focused on partner dynamics in the breastfeeding family and specifically shown that male partners heavily influence women’s breastfeeding decisions and experiences. Much of this research emphasizes net gains of men’s involvement in breastfeeding. While acknowledging the importance of involved fathers early on, we argue for recognizing the dual potential for men’s involvement in breastfeeding to be both affirming and undermining to their breastfeeding partners. As part of a workplace case study, we conducted semi-structured, in-depth interviews with 32 women who were currently or recently breastfeeding. We identified four major themes: (1) encouraging/discouraging breastfeeding, (2) acknowledging/overlooking breastfeeding labor, (3) supporting/undermining breastfeeding decisions and goals, and (4) assisting with/avoiding domestic labor. Education directed at men should address the issue that not all intended support actions may be perceived as supportive by breastfeeding women and should provide concrete guidance on how men can be supportive, centering the needs of breastfeeding women.

Difficulty with sustaining attention to a task is a hallmark of ADHD. It would be useful to know which measures of sustained attention best predict a diagnosis of ADHD. Participants were 129 children with a diagnosis of ADHD and 129 matched controls who completed the fixed Sustained Attention to Response Task (SART). The number of commission and omission errors, standard deviation of response time (SDRT), tau, fast and slow frequency variability, d-prime, and mu were able to successfully classify children with and without ADHD. The mean response time, criterion, and sigma were not able to classify participants. The best classifiers were d-prime (0.75 Area Under the Receiver Operated Characteristic), tau (.74), SDRT (0.74), omission errors (0.72), commission errors (0.71), and SFAUS (0.70). This list of the best classifier measures derived from the SART may prove useful for the planning of future studies.

Six2 binding is enriched at the promoters of genes previously shown to be critical for normal and cancer stem cell like function.

Time lapse video showing lipid droplet turnover in less motile cells away from the leading edge

Six2 is more highly expressed in the fetal mammary stem cell population compared to adult mouse mammary cells.

5 Supplementary Figures and legends Legends for 2 supplementary movies

The capacity for tumor cells to metastasize efficiently is directly linked to their ability to colonize secondary sites. Here we identify Six2, a developmental transcription factor, as a critical regulator of a breast cancer stem cell program that enables metastatic colonization. In several triple-negative breast cancer (TNBC) models, Six2 enhanced the expression of genes associated with embryonic stem cell programs. Six2 directly bound the Sox2 Srr2 enhancer, promoting Sox2 expression and downstream expression of Nanog, which are both key pluripotency factors. Regulation of Sox2 by Six2 enhanced cancer stem cell properties and increased metastatic colonization. Six2 and Sox2 expression correlated highly in breast cancers including TNBC, where a Six2 expression signature was predictive of metastatic burden and poor clinical outcome. Our findings demonstrate that a SIX2/SOX2 axis is required for efficient metastatic colonization, underscoring a key role for stemness factors in outgrowth at secondary sites.Significance:These findings provide novel mechanistic insight into stemness and the metastatic outgrowth of triple-negative breast cancer cells.

List of enriched pathways after GSEA Analysis

List of Oligos and Antibodies

Six2 OE leads to a change in the transcriptional program of 4T07 cells and differential expression of stemness-related genes and pathways

Levels of Six2 OE in 4T07 cells is comparable to levels in multiple other human TNBC cell lines with relatively high endogenous Six2 expression.

Time lapse video showing lipid droplet turnover in migratory leading-edge tumor cells

Six2 regulates Sox2 in multiple human TNBC models.

Oncogene-induced metabolic reprogramming is a hallmark of pancreatic cancer (PDAC), yet the metabolic drivers of metastasis are unclear. In PDAC, obesity and excess fatty acids accelerate tumor growth and increase metastasis. Here, we report that excess lipids, stored in organelles called lipid droplets (LD), are a key resource to fuel the energy-intensive process of metastasis. The oncogene KRAS controlled the storage and utilization of LD through regulation of hormone-sensitive lipase (HSL), which was downregulated in human PDAC. Disruption of the KRAS–HSL axis reduced lipid storage, reprogrammed tumor cell metabolism, and inhibited invasive migration in vitro and metastasis in vivo. Finally, microscopy-based metabolic analysis revealed that migratory cells selectively utilize oxidative metabolism during the process of migration to metabolize stored lipids and fuel invasive migration. Taken together, these results reveal a mechanism that can be targeted to attenuate PDAC metastasis.Significance:KRAS-dependent regulation of HSL biases cells towards lipid storage for subsequent utilization during invasion of pancreatic cancer cells, representing a potential target for therapeutic intervention.See related commentary by Man et al., p. 4886

Six2 and Sox2 mRNA positively correlate in breast cancer patient samples and upregulates genes associated with stemness and poorer prognosis

Sustaining attention is an important cognitive process for everyday functioning and arousal is thought to underpin its performance. Primate studies depict an inverted-u relation between sustained attention and arousal, in which sustained attention performance is most affected at the extreme levels of arousal and peak performance aligns with moderate arousal. Human research findings are, however, inconsistent. This study aimed to investigate the effects of arousal on sustained attention performance in humans using two approaches—a small-N study with an inbuilt replication to test within-participant variation, and a larger sample assessing between-participant variation. The Sustained Attention to Response Task (SART) was used to measure sustained attention performance and the Karolinska Sleepiness Scale (KSS) was used to measure arousal. In the small-N study five participants completed the SART and KSS once an hour between 7 a.m. and 7 p.m., repeated two weeks later. Significant, curvilinear variation in KSS across time-of-day was found. A linear association between SART response time variability (sigma) and KSS was noted, however no other consistent associations between the SART and KSS were found. In the large-N study, 161 participants completed the SART and KSS once, at a time of day of their choosing. There were no significant relations between SART measures and the KSS, indicating that subjective sleepiness was not related to sustained attention performance. Overall, the hypothesized inverted-u relation between arousal and sustained attention performance was not found. The results suggested that diurnal arousal variation does not modify sustained attention performance in adults.

Colorectal cancer (CRC) is a leading cause of cancer death in the United States. Standard treatment for advanced stage CRC for decades has included 5-fluorouracil based chemotherapy. More recently, targeted therapies for metastatic CRC are being used based on the individual cancer's molecular profile. In the past few years, several different molecular subtype schemes for human CRC have been developed. The molecular subtypes can be distinguished by gene expression signatures and have the potential to be used to guide treatment decisions. However, many subtyping classification methods were developed using mRNA expression levels of hundreds to thousands of genes, making them impractical for clinical use. In this study, we assessed whether an immunohistochemical approach could be used for molecular subtyping of colorectal cancers. We validated two previously published, independent sets of immunohistochemistry classifiers and modified the published methods to improve the accuracy of the scoring methods. In addition, we evaluated whether protein and genetic signatures identified originally in the mouse were linked to clinical outcomes of patients with CRC. We found that low DDAH1 or low GAL3ST2 protein levels in human CRCs correlate with poor patient outcome. The results of this study have the potential to impact methods for determining the prognosis and therapy selection for CRC patients.

OBJECTIVES: Lead exposure has devastating neurologic consequences for children and may begin in utero. The American College of Obstetricians and Gynecologists recommends prenatal lead screening using a risk factor-based approach rather than universal blood testing. The clinical utility of this approach has not been studied. We evaluated a risk-factor based questionnaire to detect elevated blood lead levels in pregnancy. METHODS: We performed a secondary analysis of a cohort of parturients enrolled to evaluate the association of lead with hypertensive disorders of pregnancy. We included participants in this analysis if they had a singleton pregnancy ≥34 weeks’ gestation with blood lead levels recorded. Participants completed a lead risk factor survey modified for pregnancy. We defined elevated blood lead as ≥2 μg/dL, as this was the clinically reportable level. RESULTS: Of 102 participants enrolled in the cohort, 92 had blood lead measured as part of the study. The vast majority (78%) had 1 or more risk factor for elevated lead using the questionnaire yet none had clinical blood lead testing during routine visits. Only two participants (2.2%) had elevated blood lead levels. The questionnaire had high sensitivity but poor specificity for predicting detectable lead levels (sensitivity 100%, specificity 22%). CONCLUSIONS FOR PRACTICE: Prenatal risk-factor based lead screening appears underutilized in practice and does not adequately discriminate between those with and without elevated blood levels. Given the complexity of the risk factor-based approach and underutilization, the benefit and cost-effectiveness of universal lead testing should be further explored.

Climate adaptation is context specific, and inclusion of diverse forms of knowledge is crucial for developing resilient social–ecological systems. Emphasis on local inclusion is increasing, yet participatory approaches often fall short of facilitating meaningful engagement of diverse forms of knowledge. A central challenge is the lack of a comprehensive and comparative understanding of the social–ecological knowledge that various stakeholders use to inform adaptation decisions. We employed cultural consensus analysis to quantitatively measure and compare social–ecological knowledge within and across three stakeholder groups: government employees, researchers, and local residents in rural coastal Maryland. The results show that 1) local residents placed more emphasis on addressing socioeconomic and cultural changes than researchers and government employees, and 2) that the greatest variation in social–ecological knowledge was found among local residents. These insights yielded by cultural consensus analysis are beneficial for facilitating more inclusive adaptation planning for resilient social–ecological systems.

Online coursework is becoming a teaching and learning staple in higher education, especially since the onset of the COVID-19 pandemic. However, there is minimal literature regarding academic courses for campus sexual violence prevention, particularly comparing online versus face-to-face modalities. This study examined whether the effectiveness of a semester-long credit-bearing course (GESS 1900), designed to educate first year college students about correlates of sexual violence in order to ultimately reduce campus sexual violence, differed by instructional mode. Two cohorts had completed GESS 1900 in-person when the COVID-19 pandemic struck; the third cohort was taught entirely online through synchronous instruction and with the exact same faculty instructors and course materials. This created a natural experiment to compare outcomes by instructional mode. We used a quasi-experimental, pretest–posttest survey design to compare in-person ( n = 92) versus online ( n = 45) GESS 1900 students across eight previously validated attitudinal measures related to gender, sexuality, and sexual violence. Results from a two-way, mixed-factorial ANOVA showed no significant differences related to instructional mode on seven of the eight measures. Findings further showed change over time in the desired direction for all students, regardless of instructional mode; many measures showed different starting points for the two groups, but similar rates of change over time. Thus both in-person and synchronous online versions of GESS 1900 were effective in shaping positive student outcomes. The findings have important implications for educators seeking new or multiple delivery methods to educate college students about the pressing health concern of sexual violence.

Sexual violence is a major problem on college campuses, and innovative solutions are needed. Our university created a semester-long, credit-bearing, academic course as a curricular intervention intended to reduce sexual violence on campus. In this article, we describe the multiple methods used to evaluate the course, including a pre–post online survey with a quasi-experimental design, a qualitative content analysis of student reflection papers, and semistructured interviews with previously enrolled students conducted by a peer interviewer 3 months after course completion. The synthesis of evaluation findings indicated that an academic course has the potential to positively affect campus climate around sexual violence. Furthermore, using multiple methods enabled us to create a theory of change that illustrates how key course components shaped students’ knowledge, attitudes, and behaviors about sexual violence, thereby ideally generating campus change. Results have been used by various stakeholders for both practice-based and scholarly purposes. We provide lessons learned and implications for practice that are transferable to other multimethod curricular intervention evaluations regardless of topical focus, including the many ways in which using multiple methods added value to the study; the considerable investment of time and resources needed when using multiple methods; the challenges that can arise when integrating findings across methods; the major benefits of having a multidisciplinary research team consisting of faculty and students; and the need to engage in critical reflexivity.

To determine whether a history of abortion is associated with the experience of infertility among women, 2,199 women who ever met medical criteria for infertility were studied. Data for the study c...

Objective The fetal risks and benefits of antihypertensives to treat gestational hypertension in pregnancy are understudied, particularly in low- and middle-income countries. Methods We performed a nested case-control study within a retrospective cohort of obstetrical patients in Botswana from 2014 to 2019. We included women carrying singletons who developed new onset non-severe hypertension (140-159 mm Hg systolic or 90-109 mm Hg diastolic blood pressure) after 20 weeks of pregnancy. Cases were defined as women with either small-for-gestational-age (SGA) infants or stillbirth, analyzed separately; controls were otherwise similar women without the adverse outcome in each analysis. Results We identified 1932 cases of SGA (7925 controls) and 316 cases of stillbirth (9619 controls). Cases with SGA were more likely to have used an anti-hypertensive than controls (33% vs 29%, adjusted odds ratio [aOR] 1.28, 95% confidence interval [CI] 1.15-1.43). Cases with stillbirth were more likely to have used an anti-hypertensive than controls (42% versus 29%, aOR 1.45, 95% CI 1.14-1.83). Conclusion Anti-hypertensive use for new-onset gestational hypertension was associated with an increased risk of having an SGA infant or a stillbirth among women who never developed severe hypertension. These data support conduct of a randomized clinical trial to determine the appropriate use of anti-hypertensives in non-severe gestational hypertension.

This article reviews the current state of practice in seismic risk mitigation, focusing on policies in ten of the most earthquake-prone countries around the world. In particular, the review compare...

Objective: To examine the associations between the number and type of memory complaints with memory and sustained attention performance in healthy middle-aged adults. Method: Sixty-six healthy individuals aged 35–64 years ( Mage = 47.73 years) were administered the seven Questions, Rey Auditory Verbal Learning Test, Sustained Attention to Response Task, and Depression Anxiety Stress Scales 21. Results: The number of memory complaints was not associated with memory or sustained attention performance but was associated with anxiety symptoms. The type of memory complaint was likewise not associated with memory or sustained attention performance. The complaints “recent change in ability to remember things” and “trouble remembering things from one second to the next” were associated with anxiety symptoms. Conclusion: Complaints about memory in otherwise healthy middle-aged adults do not reliably indicate memory or sustained attention performance. Rather, these complaints are more likely to be associated with heightened, but nevertheless subclinical, anxiety.

A substantial body of knowledge suggests that exposure to adverse family environments – including violence and neglect – influences many aspects of brain development. Relatively less attention has been directed toward the influence of “normative” differences in parenting behaviors. Given the rapid brain reorganization during late childhood, parenting behaviors are particularly likely to impact the structure of the brain during this time. This study investigated associations between maternal parenting behaviors and the organization of structural brain networks in late childhood, as measured by structural covariance. One hundred and forty‐five typically developing 8‐year‐olds and their mothers completed questionnaire measures and two observed interaction tasks; magnetic resonance imaging (MRI) scans were obtained from the children. Measures of maternal negative, positive, and communicative behavior were derived from the interaction tasks. Structural covariance networks based on partial correlations between cortical thickness estimates were constructed and estimates of modularity were obtained using graph theoretical analysis. High levels of negative maternal behavior were associated with low modularity. Minimal support was found for an association between positive maternal behaviors and modularity and between maternal communicative behaviors and modularity. Our findings suggest that variation in negative maternal behavior is associated with the structural organization of brain networks in children., Given the rapid brain reorganization during late childhood, “normative” differences in parenting behaviors are particularly likely to impact the structure of the brain during this time. For a 145 typically developing 8‐year‐olds, we found high levels of negative maternal behavior were associated with low modularity, where modules are clusters of nodes that are densely interconnected and sparsely connected to the rest of the brain network.

The transition from childhood to adolescence involves important neural function, cognition, and behavior changes. However, the links between maturing brain function and sustained attention over this period could be better understood. This study examined typical changes in network functional connectivity over childhood to adolescence, developmental differences in attention deficit/hyperactivity disorder (ADHD), and how functional connectivity might underpin variability in sustained attention development in a longitudinal sample. A total of 398 resting state scans were collected from 173 children and adolescents (88 ADHD, 85 control) at up to three timepoints across ages 9-14 years. The effects of age, sex, and diagnostic group on changes in network functional connectivity were assessed, followed by relationships between functional connectivity and sustained attention development using linear mixed effects modelling. The ADHD group displayed greater decreases in functional connectivity between salience and visual networks compared with controls. Lower childhood functional connectivity between the frontoparietal and several brain networks was associated with more rapid sustained attention development, whereas frontoparietal to dorsal attention network connectivity related to attention trajectories in children with ADHD alone. Brain network segregation may increase into adolescence as predicted by key developmental theories; however, participants with ADHD demonstrated altered developmental trajectories between salience and visual networks. The segregation of the frontoparietal network from other brain networks may be a mechanism supporting sustained attention development. Frontoparietal to dorsal attention connectivity can be a focus for further work in ADHD.

Hepatocytes metabolize energy-rich cytoplasmic lipid droplets (LDs) in the lysosome-directed process of autophagy. An organelle-selective form of this process (macrolipophagy) results in the engulfment of LDs within double-membrane delimited structures (autophagosomes) before lysosomal fusion. Whether this is an exclusive autophagic mechanism used by hepatocytes to catabolize LDs is unclear. It is also unknown whether lysosomes alone might be sufficient to mediate LD turnover in the absence of an autophagosomal intermediate. We performed live-cell microscopy of hepatocytes to monitor the dynamic interactions between lysosomes and LDs in real-time. We additionally used a fluorescent variant of the LD-specific protein (PLIN2) that exhibits altered fluorescence in response to LD interactions with the lysosome. We find that mammalian lysosomes and LDs undergo interactions during which proteins and lipids can be transferred from LDs directly into lysosomes. Electron microscopy (EM) of primary hepatocytes or hepatocyte-derived cell lines supports the existence of these interactions. It reveals a dramatic process whereby the lipid contents of the LD can be “extruded” directly into the lysosomal lumen under nutrient-limited conditions. Significantly, these interactions are not affected by perturbations to crucial components of the canonical macroautophagy machinery and can occur in the absence of double-membrane lipoautophagosomes. These findings implicate the existence of an autophagic mechanism used by mammalian cells for the direct transfer of LD components into the lysosome for breakdown. This process further emphasizes the critical role of lysosomes in hepatic LD catabolism and provides insights into the mechanisms underlying lipid homeostasis in the liver.

Purpose: To evaluate whether a semester-long course for first-year undergraduates influenced knowledge, attitudes, and behavioral intentions about gender, sexuality, and sexual violence. Design: Quasi-experimental survey design. Setting: A private university in the Southeastern US. Participants: Undergraduates enrolled in an intervention (n = 49) or comparison (n = 60) course in Fall 2018. Measures: Sociosexual Orientation Inventory, Sexual Conservatism, Heteronormative Attitudes and Beliefs, Illinois Rape Myth Acceptance Scale, Bystander Efficacy Scale, Consent Myths, Sexual Misconduct Apathy, Campus Resource Awareness Index. Analysis: A 2-way mixed-factorial ANOVA. Results: Relative to the comparison group, students in the intervention course had significantly greater rates of change in reducing heteronormative views, decreasing sexual misconduct apathy, and increasing awareness of campus resources for sexual violence. Conclusion: A semester-long course targeting first-year undergraduates can potentially influence knowledge, attitudes, and behavioral intentions regarding sexual violence and create a more positive campus climate.

Summary SMRTER (SMRT-related and ecdysone receptor interacting factor) is the Drosophila homologue of the vertebrate proteins SMRT and N-CoR, and forms with them a well-conserved family of transcriptional corepressors. Molecular characterization of SMRT-family proteins in cultured cells has implicated them in a wide range of transcriptional regulatory pathways. However, little is currently known about how this conserved class of transcriptional corepressors regulates the development of particular tissues via specific pathways. In this study, through our characterization of multiple Smrter (Smr) mutant lines, mosaic analysis of a loss-of-function Smr allele, and studies of two independent Smr RNAi fly lines, we report that SMRTER is required for the development of both ovarian follicle cells and the wing. In these two tissues, SMRTER inhibits not only the ecdysone pathway, but also the Notch pathway. We differentiate SMRTER9s influence on these two signaling pathways by showing that SMRTER inhibits the Notch pathway, but not the ecdysone pathway, in a spatiotemporally restricted manner. We further confirm the likely involvement of SMRTER in the Notch pathway by demonstrating a direct interaction between SMRTER and Suppressor of Hairless [Su(H)], a DNA-binding transcription factor pivotal in the Notch pathway, and the colocalization of both proteins at many chromosomal regions in salivary glands. Based on our results, we propose that SMRTER regulates the Notch pathway through its association with Su(H), and that overcoming a SMRTER-mediated transcriptional repression barrier may represent a key mechanism used by the Notch pathway to control the precise timing of events and the formation of sharp boundaries between cells in multiple tissues during development.

Objectives Lead exposure has been associated with hypertensive disorders of pregnancy. Angiogenic factors, including soluble fms-like tyrosine kinase 1 (sFlt1) and placental growth factor (PlGF), are aberrant in preeclampsia, but have not been correlated with lead levels. We evaluated the association of lead exposure with angiogenic factors. Study design This cross sectional study utilized a convenience sample of singleton pregnancies ≥34 weeks’ gestation. Blood lead and angiogenic factors were measured before delivery; bone lead was measured postpartum. We dichotomized bone and blood lead into the top tertile versus the bottom tertiles and used log-binomial regression to assess the association between lead and a high angiogenic ratio. Main outcome measures The outcomes were high sFlt1 to PlGF ratio and development of a hypertensive disorder of pregnancy. Results We enrolled 102 participants, of whom 98 had at least one lead measurement and an angiogenic factor result. Median bone lead was 3.8 ug/g (2.0 – 6.6) and median blood lead was 0.2 ug/dL (0.2 – 0.4). Incidence of hypertensive disorders of pregnancy was 31%. When comparing the highest tertile of bone lead to the bottom two tertiles, there was no association with a high sFlt1/PlGF ratio or hypertensive disorders of pregnancy. Similar results were observed for the exposure of blood lead. Conclusions Lead exposure was not an important contributor to an elevated angiogenic factor ratio or hypertensive disorders of pregnancy in our U.S. population. However, lead exposure was modest in our population and we cannot exclude a relationship with hypertensive disorders of pregnancy.

The role of community colleges in training public health professionals is of growing importance to the continuum of public health education. Some 5 years have passed since the Framing the Future initiative outlined curricular models at community colleges, and colleges deploying these models are serving as learning sites for public health education at community colleges. While past research has focused on capturing insights from community college executives and program administrators, this study captures perspectives from teaching faculty. Drawing on a national sample of teaching faculty at community colleges and universities accepting transfer students throughout the United States, an online survey of teaching faculty affiliated with public health programs was coupled with follow-up interviews. This study characterizes the nature and scope of public health programming in community colleges and transfer settings, and highlights associated challenges and opportunities as public health becomes further integrated into health professions pathways in 2-year settings and beyond.

Hummingbirds have evolved to learn song from conspecifics independently of other bird clades that show this behaviour, such as parrots and oscine passerines. Little is known about how vocal learning occurs in hummingbirds. To determine the conditions necessary and sufficient for learning, we raised young Costa's hummingbirds, Calypte costae, in isolation in two experiments. The first experiment tested whether three pairs of males, raised either in silence or with only acoustic exposure to song, would produce wild-type song. They did not: each pair instead produced ‘isolate’ songs dissimilar to wild-type song. Each pair produced a unique isolate song with subtle differences from other pairs. Thus, exposure to song alone is insufficient to trigger learning. The second experiment tested whether individually housed males would learn songs when exposed to a live male model plus playback of song (1 h/day, 3 days/week, for 3 months). Seven of eight birds that heard Costa's-like songs learned to sing their tutor song. Each individual produced song that matched idiosyncratic features of the individual songs played to them, demonstrating attention to, and learning of the exact acoustic stimuli received. Two control birds exposed to acoustically dissimilar Anna's hummingbird, Calypte anna, song developed isolate song. Thus, exposure to species-specific song with a conspecific male is sufficient to trigger learning. The sensory phase began after fledging, around 23 days posthatch, and the sensorimotor phase began around 50 days posthatch, when singing also began. Song crystallization occurred approximately 125 days posthatch. Costa's also appear to be statistical learners; they learn to sing the songs they hear most often. Hummingbird song ontogeny appears to be similar to song ontogeny in passerines, despite its convergent origin.

Three new compounds containing a heptadentate lanthanide (LnIII ) ion chelator functionalized with oligothiophenes, nThept(COOH)4 (n=1, 2, or 3), were isolated. Their LnIII complexes not only display the characteristic metal-centered emission in the visible or near-infrared (NIR) but also generate singlet oxygen (1 O2 ). Luminescence efficiencies (ϕLn ) for [Eu1Thept(COO)4 ]- and [Eu2Thept(COO)4 ]- are ϕEu =3 % and 0.5 % in TRIS buffer and 33 % and 3 % in 95 % ethanol, respectively. 3Thept(COO)4 4- does not sensitize EuIII emission due to its low-lying triplet state. Near infra-red (NIR) luminescence is observed for all NIR-emitting LnIII and ligands with efficiencies of ϕYb =0.002 %, 0.005 % and 0.04 % for [YbnThept(COO)4 ]- (n=1, 2, or 3), and ϕNd =0.0007 %, 0.002 % and 0.02 % for [NdnThept(COO)4 ]- (n=1, 2, or 3) in TRIS buffer. In 95 % ethanol, quantum yields of NIR luminescence increase and are ϕYb =0.5 %, 0.31 % and 0.05 % for [YbnThept(COO)4 ]- (n=1, 2, or 3), and ϕNd =0.40 %, 0.45 % and 0.12 % for [NdnThept(COO)4 ]- (n=1, 2, or 3). All complexes are capable of generating 1 O2 in 95 % ethanol with ϕ1Ο2 efficiencies which range from 2 % to 29 %. These complexes are toxic to HeLa cells when irradiated with UV light (λexc =365 nm) for two minutes. IC50 values for the LnIII complexes are in the range 15.2-16.2 μm; the most potent compound is [Nd2Thept(COO)4 ]- . The cell death mechanisms are further explored using an Annexin V-propidium iodide assay which suggests that cell death occurs through both apoptosis and necrosis.

BACKGROUND: High obesity rates among young black and Hispanic children place them at a higher risk for adult obesity and its co-morbidities. Neighborhoods with predominately racial and ethnic minority residents have fewer healthful food options, which may contribute to obesity disparities. Yet few studies have assessed the relationship between neighborhood food environments and obesity in this population. METHODS: Electronic health records from two pediatric primary care clinics serving predominately low-income, black and Hispanic children were used to create a cohort of 3,724 2-5 year-olds, encompassing 7,256 visits from 2007 to 2012 (mean 1.9 visits per patient, range: 1-5 visits per child). Longitudinal regression was used to model the association of mean body mass index z-score (BMI-z) over time and 3 measures of the neighborhood food environment: healthful food availability, availability of stores accepting the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) benefits, and fast food availability. RESULTS: Compared to peers in neighborhoods with no or few stores accepting WIC, children in neighborhoods with many WIC stores had higher BMI-z at age 2 years (average difference of 0.272 95% CI 0.041 – 0.503; p=0.021). No relationship was found for healthful food or fast food availability. Although children in neighborhoods with low fast food availability did not have statistically significantly different BMI-z at age 2 as compared to children in areas with high fast food availability, they did have a statistically significantly higher change in average BMI-z over time (0.006 per month, 0.000 – 0.012, p=0.024). CONCLUSIONS: Access to WIC stores was associated with lower obesity rates and more healthful average BMI-z over time and represents a potentially important neighborhood food environment characteristic influencing racial/ethnic disparities in childhood obesity among young black and Hispanic children. More studies are needed to assess what aspects of WIC stores may underlie the observed association. WHAT’S NEW: Access to WIC stores represents a potentially important neighborhood food environment characteristic influencing racial and ethnic disparities in childhood obesity among young black and Hispanic children.

Studies of medical help-seeking presume that self-identifying as having a health problem precedes medical contact, but this ordering of the identity-behavior relationship has not been systematically examined. We used longitudinal data from the National Survey of Fertility Barriers (2004 to 2010) on 412 women with infertility to document the temporal relationship between self-identifying as having a fertility problem and making medical contact. The symbolic interactionist perspective suggests that infertility will be perceived as identity disruption and that in response women will align self-identity and medical behavior over time. Cross-tabulation analysis indicated that more women do self-identify as having a fertility problem first (24 percent) as opposed to making medical contact first (5.5 percent). There was also a tendency toward aligning self-identification and behavior over time. Latent class analyses revealed six patterns: 1) consistently involved, 2) early consulters, 3) consistently uninvolved, 4) consistent perceivers, 5) medical dropouts, and 6) early perceivers. Strong fertility intent and primary infertility, two identity-relevant characteristics, had the strongest associations with latent class membership. The relationship between self-identification and medical help-seeking is thus dynamic and complex.

Lanthanide ion (LnIII ) complexes, [Ln(3Tcbx)2 ]3+ (LnIII =YbIII , NdIII , ErIII ) are isolated with a new pyridine-bis(carboxamide)-based ligand with a 2,2':5',2''-terthiophene pendant (3TCbx), and their resulting photophysical properties are explored. Upon excitation of the complexes at 490 nm, only LnIII emission is observed with efficiencies of 0.29 % at 976 nm for LnIII =YbIII and 0.16 % at 1053 nm for LnIII =NdIII . ErIII emission is observed but weak. Upon excitation at 400 nm, concurrent 1 O2 formation is seen, with efficiencies of 11 % for the YbIII and NdIII complexes and 13 % for the ErIII complex. Owing to the concurrent generation of 1 O2 , as expected, the efficiency of metal-centered emission decreases to 0.02 % for YbIII and 0.05 % for NdIII . The ability to control 1 O2 generation through the excitation wavelength indicates that the incorporation of 2,2':5',2''-terthiophene results in access to multiple sensitization pathways. These energy pathways are unraveled through transient absorption spectroscopy.

We expand prior research on the sociology of birth by testing race and class effects on women’s capacity to realize their childbirth preferences in hospital settings. Drawing on data from the U.S. Listening to Mothers survey, we use Poisson regression and logistic regression to examine the extent to which women’s preferences are associated with actual experiences of medical intervention during perinatal care. We find that 1) less privileged women were significantly less likely to have certain interventions and had fewer interventions overall; but 2) less privileged women with natural birth preferences were significantly more likely to have certain medical interventions, compared to their race/class privileged counterparts. Thus, less privileged women simultaneously receive less and more childbirth interventions—both of which appear to be out of sync with their birthing preferences. Our results support previous research which has found race and social class inequities in medical treatment, which we interpret here as “privilege in the delivery room.”