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Norovirus is a leading cause of acute gastroenteritis and imposes a substantial disease burden. In California, USA, norovirus surveillance is limited. We evaluated correlations between wastewater norovirus concentrations and available public health surveillance data. Wastewater surveillance for norovirus genotype GII in California provided timely, localized, and actionable data for public health authorities. [ABSTRACT FROM AUTHOR]

Biotechnology constitutes one of the most challenging, cutting-edge, and rapidly growing fields in science today. Both the practical implications and the hands-on nature of this "modern science" make the topic of biotechnology an attractive addition to the high school science curriculum. The current study is the first of its kind to explore how student characteristics and biotechnology course outcomes relate to one another. Results indicated that students' general attitudes about science and their overall math skills predicted success across a number of measures, including both self-reported skill ratings as well as the more traditional measures of course grade and exam score. The results also demonstrated the association between skill, as measured through self-reported proficiency ratings, and achievement on an articulation exam. It documented the relation between skills students learned in the course and the potential next steps in their educational and/or technical careers. The results of the current study also have implications for how student learning is measured. Researchers suggested that teachers use formative assessment as a tool to allow students to collaborate with others and express ideas in their own unique and creative ways. The results from this study indicate that self-reported proficiency measures might serve as an accurate formative measure when data are being collected on specific skills. The topic of biotechnology has been a new source of study within recent years as educators and researchers grapple with ways to achieve and measure student learning in relation to this modern science.

Do the cognitive benefits of "interleaving"--the method of alternating between two or more skills or concepts during training--extend to foreign language learning? In four experiments, we investigated the efficacy of interleaved versus conventional blocked practice for teaching adult learners to conjugate Spanish verbs in the "preterite" and "imperfect" past tenses. In the first two experiments, training occurred during a single session and interleaving between tenses began during the presentation of introductory content (Experiment 1) or during randomly ordered verb conjugation practice trials at the end of the training session (Experiment 2). This yielded, respectively, numerically higher performance in the blocked group and equivalent performance in the interleaved and blocked groups on a 2-day delayed test. In Experiments 3 and 4, the amount of training was increased across 2 weekly sessions in which the blocked group trained on 1 tense per session and the interleaved group trained on both tenses per session, with random interleaving occurring during verb conjugation practice trials. Interleaving yielded substantially better performance on a 1-week delayed test. Thus, although interleaving did not confer an advantage over blocking under 2 different single-session training schedules, it improved learning when used to practice conjugating verbs across multiple training sessions. These results constitute the first demonstration of an interleaving effect for foreign language learning.

Atmospheric rivers (ARs) deliver significant and essential precipitation to the western United States (US) with consequential interannual variability. The intensity and frequency of ARs strongly influence reservoir levels, mountain snowpack, and groundwater recharge, which are key drivers of water‐resource availability and natural hazards. Between October 2022 and April 2023, western states experienced exceptionally heavy precipitation from several families of powerful ARs. Using observations of surface‐loading deformation from Global Navigation Satellite Systems, we find that terrestrial water‐storage gains exceeded 100% of normal within vital California watersheds. Independent water‐storage solutions derived from different data‐analysis and inversion methods provide an important measure of precision. The sustained storage increases, which we show are closely associated with ARs at daily‐to‐weekly timescales, alleviated both meteorological and hydrological drought conditions in the region, with a lag in hydrological‐drought improvements. Quantifying water‐storage recovery associated with extreme precipitation after drought advances understanding of an increasingly variable hydrologic cycle. Plain Language Summary: Human communities in the western United States rely on seasonal mountain snowpack and precipitation for agriculture, industry, and the civilian water supply. Over the past two decades, increasingly severe drought conditions have plagued western states. In this study, we investigate gains in water storage related to recent atmospheric rivers, which are long and narrow corridors of atmospheric moisture associated with extreme precipitation, using an interdisciplinary approach called hydrogeodesy. Hydrogeodesy uses satellite‐ and ground‐based sensors to track subtle changes in the shape of the Earth and its gravity field caused by the redistribution of water through the Earth system. By treating the Earth as a natural scale, we can infer how much water is gained or lost from a particular area over time. Advancing our understanding of water‐resource availability, the Earth's water cycle, and the Earth's changing climate is critical for improving water‐resource management, sustaining natural ecosystems, and mitigating natural hazards. Key Points: We use surface deformation to assess changes in terrestrial water storage (TWS) associated with families of strong atmospheric rivers (ARs) in 2022–2023Large jumps in mountain water storage from ARs spurred recoveries from major California droughts in 2012–2015 and 2019–2022Early‐season water‐storage gains, driven by ARs, nearly equal precipitation inputs, indicating extensive reservoir recharge [ABSTRACT FROM AUTHOR]

Large-particle-size graded crushed stone mixtures (LPS-GCSMs) can improve the shortcomings of conventional graded crushed stone, such as low strength, high deformation, and a low modulus of resilience. At present, there is no systematic research on the gradation design and field evaluation of the LPS-GCSMs. In this study, compaction and California bearing ratio (CBR) tests and field construction conditions were combined to design six kinds of gradation of LPS-GCSM, and the optimum gradation was revealed. In order to improve the mechanical properties of LPS-GCSM, 2.5% cement was added to the mixture to prepare a low-content cement-modified LPS-GCSM (LCC-LPS-GCSM) based on the suggested gradation. The mechanical properties of the LCC-LPS-GCSM were investigated through unconfined compression strength (UCS) and compression rebound modulus (CRM) tests. Moreover, the compaction and deflection properties of LPS-GCSM and LCC-LPS-GCSM were examined through the test battery. The results showed that the optimum gradation of LPS-GCSM can be achieved with a combination of aggregate sizes of 20–40 mm, 10–20 mm, 5–10 mm, and 0–5 mm at a ratio of 44:20:10:26. The passing rates of 19 mm and 4.75 mm should be approximately at the median value of the gradation in view of field construction uniformity and a coarse aggregate interlocking effect. The UCS and CRM values of LCC-LPS-GCSM increased rapidly from 0 day to 28 days while they slowed after 28 days, which was similar to those of cement-stabilized materials. The field detection suggested that LPS-GCSM exhibited favorable compaction and that the addition of cement improved the stability of the field compaction of the mixture. Adding a subbase course of LPS-GCSM between the old pavement and the LCC-LPS-GCSM base can lead to more uniform stress on the base. The results of this study provide a reference for the gradation design of LPS-GCSM and optimization of the design indicators. [ABSTRACT FROM AUTHOR]

Does correctly answering a test question about a multiterm fact enhance memory for the entire fact? We explored that issue in 4 experiments. Subjects first studied Advanced Placement History or Biology facts. Half of those facts were then restudied, whereas the remainder were tested using "5 W" (i.e., "who, what, when, where", or "why") or analogous questions. Each question assessed a specific critical term of the fact. In the first 3 experiments, 1 test question was posed per tested fact; in the fourth experiment, up to 3 different test questions were posed per tested fact. After a delay of at least 24 hr, a final test involved questions that assessed the same terms that were tested during training, as well as questions that assessed a different term from that previously tested. Results showed that testing produced piecewise fact learning: Tested terms benefited relative to restudy, but untested terms did not. That pattern held when either fill-in-the-blank or multiple-choice questions were used during training, when 1 or 2 test trials were used during training, for both history and biology facts, and when more than 1 term from each fact was tested during training. Thus, across a range of circumstances, taking tests on complex facts results in a selective memory benefit for tested terms. In analogous applied settings, testing on multiple response terms should promote more comprehensive retention.

In the present study, we investigated genetic and environmental effects on motor impulsivity from childhood to late adolescence using a longitudinal sample of twins from ages 9 to 18 years. Motor impulsivity was assessed using errors of commission (no-go errors) in a visual go/no-go task at 4 time points: ages 9-10, 11-13, 14-15, and 16-18 years. Significant genetic and nonshared environmental effects on motor impulsivity were found at each of the 4 waves of assessment with genetic factors explaining 22%-41% of the variance within each of the 4 waves. Phenotypically, children's average performance improved across age (i.e., fewer no-go errors during later assessments). Multivariate biometric analyses revealed that common genetic factors influenced 12%-40% of the variance in motor impulsivity across development, whereas nonshared environmental factors common to all time points contributed to 2%-52% of the variance. Nonshared environmental influences specific to each time point also significantly influenced motor impulsivity. Overall, results demonstrated that although genetic factors were critical to motor impulsivity across development, both common and specific nonshared environmental factors played a strong role in the development of motor impulsivity across age.

Most research on parental bookreading has focused on mothers reading to their children. This study examined bookreading practices among approximately 800 fathers and mothers in low-income families. We looked at differences and similarities between families where both parents read frequently compared to families where only mothers read frequently. In more than a third of the low-income families in this study, both parents reported reading to their young children on a regular basis (daily or weekly). Parents who were higher educated, who had girls and who had children with better language and cognitive skills were more likely to read frequently to their children. Intervention efforts to increase reading in the home to toddlers and preschoolers in low-income families should be targeted at fathers, a relatively under-tapped resource, and should focus on families in which parents have lower levels of education and those whose children have less advanced cognitive and language skills. (Contains 2 notes, 6 tables, and 1 figure.)

Two novel genotypes of species human mastadenovirus D designated 109 and 110 were isolated from three epidemiologically unrelated cases of acute respiratory disease detected in January 2018 by surveillance efforts at the California/Mexico border. Both genotypes represent examples of intertypic recombination. Genotype D109 is most closely related to genotype D56 (97.68% genomic similarity) and features a type D22‐like penton base, a type D19‐like hexon gene, and a type D9‐like fiber [P22/H19/F9]. On the other hand, genotype D110 is most closely related to type D22 (96.94% genomic similarity) and features a type D67‐like penton base, a novel hexon gene, and a type D9‐like fiber [P67/H110/F9]. Importantly, the fibers of both novel genotypes are highly similar to those of genotypes D56 and D59, which have also been isolated from a few cases of respiratory infections. The present report shows data contributing to the understanding of the molecular determinants of the expanded tissue tropism of certain members of species HAdV‐D. [ABSTRACT FROM AUTHOR]

Using local materials to construct building elements as well as transport road facilities, including highways, intercity roads, and roads, in remote areas is a top topic of scholarly research all over the world. The main reason for that is the fact that these kinds of materials not only ease the intensity of material transportation but are also cost-efficient. In desert areas, aeolian sand is a commonly used local material and it has been investigated in unbound and cement-stabilized pavement base/subbase applications. However, the production of cement is associated with a high carbon footprint, leading this research to seek alternative low-carbon binders. This research investigated the strength properties and the carbon footprint of fly ash (FA) and a ground-granulated blast-furnace slag (S)-based geopolymer-stabilized aeolian sand. Setting time, compressive strength, California bearing ratio (CBR), and temperature shrinkage measurements of the stabilized aeolian sand were carried out in this research. The maximum strength of the stabilized aeolian sand was found at the optimal ratio of Si/Al ratio of 2.5 and Na/Al ratio of 1.0. The compressive strength increased as the geopolymer stabilizer content increased. A stabilizer content ranging between 8% and 20% is recommended in practice. The carbon footprint of the geopolymer-stabilized aeolian sand was lower than that of cement-stabilized aeolian sand. This tendency became more evident in the samples with higher strength, indicating the effectiveness of geopolymer as an alternative green soil stabilizer to traditional Portland cement. [ABSTRACT FROM AUTHOR]

307 Background: Since 2005, the United States Preventive Services Task Force (USPSTF) recommends that primary care (PC) clinicians identify and refer adults with a high-risk cancer family history to cancer genetic services (CGS), yet hereditary cancer risk assessment (HCRA) continues to be underutilized in PC. A population-based approach to HCRA in PC settings can expand access to cancer prevention and early detection to vulnerable populations and reduce disparities in cancer outcomes. The Chicago Cancer Screening and Testing Access Coalition (CCSTAC) is developing strategies to integrate HCRA in PC settings. We conducted an environmental scan to assess current capacity to deliver 1) HRCA in Federally Qualified Health Centers (FQHCs) and 2) follow-up CGS for high risk patients. Methods: In 2023, we administered two surveys to assess HCRA practices in Metro Chicago. We invited 22 FQHCs to complete a 21-item survey of current practices, readiness to implement, and barriers to HCRA. We also invited 21 CGS sites to complete a 25-item survey to understand staffing, utilization, referral patterns, and barriers to access. Surveys were administered electronically via Qualtrics. We conducted a descriptive analysis of survey data. Results: Twenty FQHCs (91%) completed the survey on HCRA in PC; 85% reported familiarity with USPSTF guidelines for HCRA. The majority (75%) reported no plans to implement HCRA. Clinic workflow, paucity of follow-up resources, cost, lack of provider knowledge, and absence of HCRA as a mandatory performance measure were cited as the most significant barriers to implementation. Genetic counselors (GCs) from 19 CGS hospital-based sites (90%) completed the survey on availability of genetic services. CGS were most often located in a cancer center (47%); no CGS were located in PC. Most referrals originated from oncology, surgery, or gastroenterology, with the lowest rate of referrals from community-based PC. Nearly half of CGS clinics (47%) reported capacity for at least a small increase in patient volume. Wait-time at the majority of CGS clinics was less than a month. GCs cited patient logistics (e.g. transportation, time off work), lack of referral information from providers, and systemic racism as significant barriers in patient access to CGS. Conclusions: After almost 20 years of evidence-based guidelines, use of HCRA is still very limited in the community-based PC setting. Our findings point to a need to bridge the gap between hospital-based CGS and FQHCs to ensure patients in vulnerable communities have access to guideline-concordant cancer prevention and screening strategies. Based on these findings, CCSTAC is designing strategies to integrate HCRA in primary care at FQHCs focused on provider education, well-designed clinic workflows, connections with existing CGS, and advocacy to align UDS and HEDIS measures with USPSTF guidelines. [ABSTRACT FROM AUTHOR]

217 Background: CIT causes dose reduction or delay of chemotherapy (chemo), bleeding, and platelet (PLT) transfusion. This phase 2/3 study aimed to assess the efficacy and safety of romiplostim N01 in CIT. Methods: This trial comprising Part A (open-label) and B (randomized double-blinded) recruited patients (pts) with solid tumors or lymphoma and with CIT. In Part A, pts with a PLT count ≤200×109/L before the day of chemo were included. Romiplostim N01 was injected subcutaneously per week (QW) for a 3-week chemo cycle at 1 μg/kg (group 1) or 2 μg/kg (group 2) for pts with a PLT count 100~200×109/L, and at 2 μg/kg (group 3) for pts with a PLT count <100×109/L. Primary endpoint was proportion of responders on the last day of chemo cycle, defined as pts who had an increase in PLT count of ≥30×109/L from baseline for pts with a PLT count 100~200×109/L, and an increase in PLT count of ≥30×109/L or a PLT count ≥100×109/L for pts with a PLT count <100×109/L. In Part B, pts with a PLT count 75~150×109/L were included and randomized 2:1 to receive romiplostim N01 or placebo QW at 2 μg/kg on day 1, and at 1 μg/kg on day 8 and 15 for two chemo cycles. Primary endpoint was proportion of responders, defined as pts resuming two consecutive chemo cycles without thrombocytopenia-induced dose modification (dose reduction by ≥15% or delay by ≥4 days or discontinuation) and without a rescue therapy. Results: In Part A, 50 pts were included between Mar 12, 2021 and Jul 29, 2021. The proportions of responders were 66.7% (10/15) in group 1, 53.3% (8/15) in group 2, and 90.0% (18/20) in group 3. Between Nov 8, 2022 and Jan 15, 2024, 63 pts were randomized in Part B. The proportion of responders in the romiplostim N01 group was significantly higher than that in placebo group (68.3% vs 40.9%). The adjusted rate difference was 27.6% (95% confidence interval [CI]: 2.1%, 50.2%). Treatment-related adverse events (TRAEs) occurred in 17 (41.5%) and 12 (54.5%) pts in the romiplostim N01 and placebo groups, of whom 1 (2.4%) and 0 were ≥grade 3. The most frequent TRAEs were nausea (12.2% vs 0), vomiting (12.2% vs 0), and increased aspartate aminotransferase (9.8% vs 4.5%). No treatment-related hemorrhage or death occurred. In pool analysis, the proportion of responders was 73.3% and 40.9% in pts treated with romiplostim N01 and placebo, respectively. The rate difference was 32.4% (95% CI: 9.2%, 52.9%). Conclusions: Romiplostim N01 showed promising efficacy and manageable safety in patients with CIT. Clinical trial information: PartA:NCT05851027; PartB:NCT05554913. Pool analysis of Part A (pts with PLT count ≥75×109/L) and Part B (all pts). Romiplostim N01 Placebo Rate Difference Part A+B (n=75) Part B (n=22) Romiplostim N01 (Part A+B) vs Placebo Lowest PLT count in Cycle 1, ×109/L 85±41 59±32 / Highest PLT count in Cycle 1, ×109/L 226±101 132±45 / Proportion of responders who completed the first chemo cycle without rescue therapy and without thrombocytopenia-induced dose modification of the second chemo cycle 55 (73.3%) 9 (40.9%) 32.4% 95% CI 61.9~82.9% 20.7~63.6% 9.2~52.9% [ABSTRACT FROM AUTHOR]

216 Background: Chemotherapy-induced peripheral neuropathy (CIPN) features debilitative neuropathic pain and neurologic deficits, commonly present in breast cancer population exposed to certain chemo-agents. Given suboptimal effects often rendered by limited therapeutic options, CIPN is associated to psychological distress and drug-seeking behaviors, which leads to heightened functional impairment and disease burden. Acupuncture has gained clinical recognitions for alleviating pain and mental distress, but its impact on medication uses for pain or psychiatric disorders in CIPN remains unclear. As such, this study aims to investigate the association between acupuncture and use of these medications among breast cancer patients experiencing CIPN. Methods: This survival analysis utilized data from the TriNetX Network comprising real-time electronic health records from over 60 healthcare organizations across the United States. Breast cancer patients over 18 at the index date within 01/01/1997 (inception of acupuncture practice in US) and 05/10/2023, diagnosed with CIPN after exposure to chemo-agents such as taxane, platinum, vinca alkaloids, thalidomide, or bortezomib, were identified as the baseline cohort. Patients who received at least three acupuncture sessions post CIPN diagnosis were compared to those without any acupuncture record. Endpoints included prescription of sedative/hypnotics, anti-depressants, anti-psychotics, anti-convulsant agents, and opioid analgesics, within a twelve-month follow-up period after index date. Antibiotics use was the negative control outcome. A 1:1 propensity-score-matching (PSM) method was applied for between-group balance of demographics, BMI, cancer treatment history, health comorbidities, and concurrent medications, followed by hazard ratios and 95% CI calculation using Cox regression model. Results: Among 398 PSM pairs, acupuncture group demonstrated significantly lower hazards of sedative/hypnotics (HR= 0.74, 95% CI 0.61-0.9), anti-depressants (HR= 0.75, 95% CI 0.61-0.93), anti-psychotics (HR= 0.74, 95% CI 0.58-0.96), anticonvulsants (HR= 0.48, 95% CI 0.27-0.87), and opioids (HR= 0.78, 95% CI 0.65-0.94) use, whereas antibiotics showed insignificant result (HR= 0.75, 95% CI 0.55-1.02). The significance sustained after sensitivity analyses, excluding patients with concurrent other cancers, and narrowing follow-up period down to the last nine months to concentrate on treatment effects. Conclusions: Our study suggests a decreased need of opioids and neuropsychiatric medication associated with acupuncture treatment among breast cancer patients endorsing CIPN. Rigorous clinical studies are warranted to validate the causal underpinnings. [ABSTRACT FROM AUTHOR]

Building energy simulation plays a significant role in buildings, with applications such as building performance evaluation, retrofit decisions and the optimization of building operations. However, the wide range of model inputs has limited much research into empirically customized case studies due to the insufficient availability of data inputs or the lack of systematic feature selection of key inputs. To address this gap, this study proposes the concept of minimum variable sets (MVSs) for building energy-prediction models to improve the general applicability of building energy prediction using forward simulation. An MVS, in this paper, refers to a variable set that contains the most indispensable energy-related variables/features for annual building energy prediction. This study developed MVSs for office buildings by applying feature engineering algorithms to a Building Performance Database (BPD), which was established by integrating the design of experiments (DoE) method with high-dimensional data-space metrics, as well as parallel simulation. Supervised feature dimension reduction methods and multiple statistical criteria were adopted to choose different numbers of indispensable variables from the primary 16 building variables. The hierarchical MVSs that consist of the selected variables are characterized by the most influential features for building energy prediction, with certain requirements for prediction accuracy. To further improve the feasibility of MVSs, this study utilized two separate office buildings located in Shanghai and California as validation cases and provided comparable prediction accuracies across different sizes of MVS. The results showed that the MVS that has 12 variables has higher prediction accuracy than that which has 9 variables, followed by that which has 7 variables. Finally, the quantitatively hierarchical correlations between different sizes of MVS with different prediction accuracies for annual building energy could provide potential support for reasonable decision-making regarding building energy model variables, especially when comprehensive consideration is needed of the limited cost and data availability, and the acceptable accuracy of building energy. [ABSTRACT FROM AUTHOR]

In seismic structural health monitoring (SHM), a structure is normally instrumented with limited sensors at certain locations to monitor its structural behavior during an earthquake event. To reconstruct the responses at non-instrumented locations, an effective regression method has to be used given the measured data from the sensed locations. In addition, determination of where to place the sensors directly affects the ability of the system to infer the behaviour of the entire structure. In this study, a practical framework is proposed for sensor placement and seismic response reconstruction at non-instrumented locations, which adopts a novel attention-based deep neural network (DNN). The developed DNN model is trained by using structural displacements at measured locations as input and the structural displacements at unmeasured locations of interest as output. The proposed framework is demonstrated by a case study of an instrumented long-span girder bridge in California. Different sensor placement schemes are investigated using the proposed DNN model. Real-time seismic assessment of the bridge is achieved by issuing each reconstructed output in 1.5 ms. The case study validates the effectiveness and accuracy of the proposed method to be used as part of a seismic SHM system. [ABSTRACT FROM AUTHOR]

BACKGROUND: Whether the presenting symptom of pain vs mass impacts survival of early-stage synovial sarcoma is not known. PATIENTS AND METHODS: The authors investigated patients with early-stage extremity/trunk synovial sarcoma diagnosed from 2005 to 2017 at Kaiser Permanente Northern California for associations between the presenting symptom and survival. RESULTS: Among 56 patients with early-stage extremity/trunk synovial sarcoma, median disease-free survival (DFS) was 20.3 months for the pain-only group (n = 19) vs 50.5 months for the mass ± pain group (n = 37) (p = 0.004), and median overall survival (OS) was 35.7 months vs 53.9 months (p = 0.009), respectively. Median DFS was 26.9 months for the pain ± mass group (n = 32) vs 48.6 months for the mass-only group (n = 24) (p = 0.047), whereas OS was not significantly different (49.6 vs. 53.6 months, p = 0.282). Pain at presentation was associated with a higher incidence of deep tumors and a higher risk of relapse. Cox regression model adjusting for age, sex, race, tumor location, tumor size, and wait-time to seek medical attention showed that pain at presentation was associated with 3-fold worse DFS and OS. CONCLUSION: Pain at presentation was an adverse risk factor for patients with early-stage extremity/trunk synovial sarcoma. [ABSTRACT FROM AUTHOR]

The substantial threat of concurrent air pollutants to public health is increasingly severe under climate change. To identify the common drivers and extent of spatiotemporal similarity of PM 2.5 and ozone (O 3), this paper proposed a log Gaussian–Gumbel Bayesian hierarchical model allowing for sharing a stochastic partial differential equation and autoregressive model of order one (SPDE-AR(1)) spatiotemporal interaction structure. The proposed model, implemented by the approach of integrated nested Laplace approximation (INLA), outperforms in terms of estimation accuracy and prediction capacity for its increased parsimony and reduced uncertainty, especially for the shared O 3 sub-model. Besides the consistently significant influence of temperature (positive), extreme drought (positive), fire burnt area (positive), gross domestic product (GDP) per capita (positive), and wind speed (negative) on both PM 2.5 and O 3 , surface pressure and precipitation demonstrate positive associations with PM 2.5 and O 3 , respectively. While population density relates to neither. In addition, our results demonstrate similar spatiotemporal interactions between PM 2.5 and O 3 , indicating that the spatial and temporal variations of these pollutants show relatively considerable consistency in California. Finally, with the aid of the excursion function, we see that the areas around the intersection of San Luis Obispo and Santa Barbara counties are likely to exceed the unhealthy O 3 level for USG simultaneously with other areas throughout the year. Our findings provide new insights for regional and seasonal strategies in the co-control of PM 2.5 and O 3. Our methodology is expected to be utilized when interest lies in multiple interrelated processes in the fields of environment and epidemiology. [Display omitted] • PM 2.5 and O 3 pollutants are jointly analysed in California through a log Gaussian–Gumbel Bayesian hierarchical joint model. • Distinct spatiotemporal interactions are revealed with a shared SPDE-AR structure; common drivers of PM 2.5 and O 3 are identified. • Hotspots at risk of simultaneously exceeding unhealthy O 3 levels are identified. [ABSTRACT FROM AUTHOR]

Vaccination and nonpharmaceutical interventions (NPIs) reduce transmission of severe acute respiratory syndrome coronavirus 2 infection, but their effectiveness depends on coverage and adherence levels. We used scenario modeling to evaluate their effects on cases and deaths averted and herd immunity. NPIs and vaccines worked synergistically in different parts of the pandemic to reduce disease burden. [ABSTRACT FROM AUTHOR]

This study aimed to investigate how land-use pattern affects crash frequency at traffic analysis zone (TAZ) level. Traffic, road network, land use, population and crash data were collected from Los Angeles County, California in 2014. K-means clustering analysis was first conducted to divide land use at each TAZ into five different patterns. Geographically weighted Poisson regression (GWPR) models were then developed to investigate the associations between crash counts and land-use patterns. The elasticity was calculated to compare the safety effect of each explanatory factor across different patterns. The results of this study indicated that land use combinations at TAZs can be divided into different patterns using land-use mix and proportions of different land use types, and that each land use combination can be assigned with a certain safety level. The effects of contributing factors on crash frequency are different across different land-use patterns. The results suggest that proper combinations of different land uses can improve safety performance at the urban and road network planning stage. [ABSTRACT FROM AUTHOR]

Background: It is estimated that vaccinating 50%-70% of school-aged children for influenza can produce population-wide indirect effects. We evaluated a city-wide school-located influenza vaccination (SLIV) intervention that aimed to increase influenza vaccination coverage. The intervention was implemented in ≥95 preschools and elementary schools in northern California from 2014 to 2018. Using a matched cohort design, we estimated intervention impacts on student influenza vaccination coverage, school absenteeism, and community-wide indirect effects on laboratory-confirmed influenza hospitalizations.Methods and Findings: We used a multivariate matching algorithm to identify a nearby comparison school district with pre-intervention characteristics similar to those of the intervention school district and matched schools in each district. To measure student influenza vaccination, we conducted cross-sectional surveys of student caregivers in 22 school pairs (2017 survey, N = 6,070; 2018 survey, N = 6,507). We estimated the incidence of laboratory-confirmed influenza hospitalization from 2011 to 2018 using surveillance data from school district zip codes. We analyzed student absenteeism data from 2011 to 2018 from each district (N = 42,487,816 student-days). To account for pre-intervention differences between districts, we estimated difference-in-differences (DID) in influenza hospitalization incidence and absenteeism rates using generalized linear and log-linear models with a population offset for incidence outcomes. Prior to the SLIV intervention, the median household income was $51,849 in the intervention site and $61,596 in the comparison site. The population in each site was predominately white (41% in the intervention site, 48% in the comparison site) and/or of Hispanic or Latino ethnicity (26% in the intervention site, 33% in the comparison site). The number of students vaccinated by the SLIV intervention ranged from 7,502 to 10,106 (22%-28% of eligible students) each year. During the intervention, influenza vaccination coverage among elementary students was 53%-66% in the comparison district. Coverage was similar between the intervention and comparison districts in influenza seasons 2014-2015 and 2015-2016 and was significantly higher in the intervention site in seasons 2016-2017 (7%; 95% CI 4, 11; p < 0.001) and 2017-2018 (11%; 95% CI 7, 15; p < 0.001). During seasons when vaccination coverage was higher among intervention schools and the vaccine was moderately effective, there was evidence of statistically significant indirect effects: The DID in the incidence of influenza hospitalization per 100,000 in the intervention versus comparison site was -17 (95% CI -30, -4; p = 0.008) in 2016-2017 and -37 (95% CI -54, -19; p < 0.001) in 2017-2018 among non-elementary-school-aged individuals and -73 (95% CI -147, 1; p = 0.054) in 2016-2017 and -160 (95% CI -267, -53; p = 0.004) in 2017-2018 among adults 65 years or older. The DID in illness-related school absences per 100 school days during the influenza season was -0.63 (95% CI -1.14, -0.13; p = 0.014) in 2016-2017 and -0.80 (95% CI -1.28, -0.31; p = 0.001) in 2017-2018. Limitations of this study include the use of an observational design, which may be subject to unmeasured confounding, and caregiver-reported vaccination status, which is subject to poor recall and low response rates.Conclusions: A city-wide SLIV intervention in a large, diverse urban population was associated with a decrease in the incidence of laboratory-confirmed influenza hospitalization in all age groups and a decrease in illness-specific school absence rate among students in 2016-2017 and 2017-2018, seasons when the vaccine was moderately effective, suggesting that the intervention produced indirect effects. Our findings suggest that in populations with moderately high background levels of influenza vaccination coverage, SLIV programs are associated with further increases in coverage and reduced influenza across the community. [ABSTRACT FROM AUTHOR]

Abstract Background A nasal influenza vaccine has been available only in a live attenuated form, which limits the range of recipients to immune-competent individuals. The present study evaluated a newly developed intranasal inactivated influenza vaccine with a novel adjuvant, heat-labile enterotoxin (LT) derived from E. coli (LTh(αK)). Methods The study was a randomized, double-blind, controlled phase I trial to evaluate the safety and immunogenicity of an intranasal vaccine containing the trivalent influenza HA antigen (7.5 µg each of A/California/7/09 (H1N1)-like virus, A/Victoria/210/2009 (H3N2) virus, and B/Brisbane/60/2008-like virus) in combination with 4 different doses of adjuvant LTh(αK) (7.5, 15, 30 or 45 μg) and 22.5 μg of influenza HA antigen alone (control vaccine). The vaccine was intranasally administered on Days 0 and 7. A safety evaluation commenced for 180 days, and hemagglutination inhibition (HI) antibody titers and nasal HA-specific IgA titers on Day 0 and Day 28 were assessed to determine whether an immunogenic response was elicited. Results From November 2012 to September 2013, a total of 36 subjects were enrolled. Twenty-four subjects received an adjuvanted vaccine, and 12 subjects received a control vaccine. The most common adverse event (AE) was mild nasal discomfort, and systemic AEs were mild fatigue and headache. Only two subjects discontinued the study because of an AE (one had grade 3 fever, and one had nodal arrhythmia). In the group with 45 μg of LTh(αK), the seroprotection rates were 100%, 100% and 80%, and the nasal IgA conversion factors were 7.90, 7.46 and 12.27 for the A/H3N2, A/H1N1 and split B strains, respectively. Adjuvant LTh(αK) vaccine showed a significant enhancement in mucosal immunity in split B -specific IgA. Conclusion The intranasal inactivated influenza vaccine is generally safe, and the LTh(αK)-adjuvanted vaccine is more immunogenic than non-adjuvanted control vaccine. ClinicalTrials.gov Identifier: NCT03293732. [ABSTRACT FROM AUTHOR]

There has been mounting evidence for the beneficial effect of green space on mental health among adults, but studies on the same topics are lacking for teens in the US. This study aimed to fill in this research gap by utilizing data from California Health Interview Survey (CHIS) 2011-2014. A total of 81,102 households (composed of 4538 teens and 81,102 adults) were retained for main analyses. Surrounding greenness was assessed by the Normalized Difference Vegetation Index (NDVI) within varying buffers of home residence. Survey logistic regressions accounted for sampling weights and design were conducted to examine the effects of greenness on serious psychological distress (SPD), adjusted for major socio-demographic factors, neighborhood socioeconomic status (SES) and co-respondent's psychological distress level within the same household. An inter-quartile increment of NDVI in 350 m buffer predicted decreased odds of SPDs by 36% in teens (OR = 0.64, 95% CI = [0.46, 0.91]). Mediation analyses revealed that this association remained almost unchanged even after adjusting for social cohesion. The NDVI-SPD association of adults was found to be significant only in the older group (OR = 0.81, 95% CI = [0.68, 0.95]). This study is one of the first population-based US studies extending the epidemiological evidence for benefits of green space on mental health from adults to teens. [ABSTRACT FROM AUTHOR]

In 2016, the EveryLife Foundation for Rare Diseases, in partnership with Dr Pan, who is a pediatrician and state senator in California, launched legislation to advance and expand newborn screening. Researchers have shown that newborn screening can be cost-effective and can greatly improve health outcomes for patients with rare diseases. However, adding additional diseases in newborn screening is a long process, requiring legislative approval in addition to new state funding. Such process delays can lead to protracted diagnostic odysseys for patients, especially those with rare diseases. These delays can result in irreversible morbidity and, in some cases, early mortality for patients. To improve this process, legislation known as Senate Bill 1095 was introduced to require California to adhere to the latest federal recommendations for newborn screening within 2 years. We provide insight and describe the process of advancing state legislation, coalition building, and managing opposition. Senate Bill 1095 would become law in 2016, requiring California to screen for 2 new rare diseases by August 2018: mucopolysaccharidosis type I and Pompe disease. This case study can serve as a model for advocates looking to expand state newborn-screening programs. [ABSTRACT FROM AUTHOR]

Objectives: The objective was to determine whether children surviving to hospital discharge after firearm assault (FA) and nonfirearm assault (NFA) are at increased risk of mortality relative to survivors of unintentional trauma (UT). Secondarily, the objective was to elucidate the factors associated with long‐term mortality after pediatric trauma. Methods: This was a multicenter, retrospective cohort study of pediatric patients aged 0 to 16 years who presented to the three trauma centers in San Francisco and Alameda counties, California, between January 2000 and December 2009 after 1) FA, 2) NFA, and 3) UT. The Social Security Death Master File and the California Department of Public Health Vital Statistics (2000–2014) were queried through December 31, 2014, to identify those who died after surviving their initial hospitalization and to delineate cause of death. Multivariate Cox proportional hazards regression was performed to determine associations between exposure to assault and long‐term mortality. Results: We analyzed 413 FA, 405 NFA, and 7,062 UT patients who survived their index hospital visit. A total of 75 deaths occurred, including 3.9, 3.2, and 0.7% of each cohort, respectively. Two‐thirds of all long‐term deaths were due to homicide. After multivariate adjustment, adolescent age, male sex, black race/ethnicity, and public insurance were independent risk factors for long‐term mortality. FA (adjusted hazard ratio [AHR] = 1.8, 95% confidence interval [CI] = 0.82–4.0) and NFA (AHR = 1.9, 95% CI = 0.93–3.9) did not convey a statistically significant difference in risk of long‐term mortality compared to UT. Being assaulted by any means (with or without a firearm), however, was an independent risk factor for long‐term mortality in the full study population (AHR = 1.9, 95% CI = 1.01–3.4) and among adolescents (AHR = 1.9, 95% CI = 1.01–3.6). Conclusion: Children and adolescents who survive assault, including by firearm, have increased long‐term mortality compared to those who survive unintentional, nonviolent trauma. [ABSTRACT FROM AUTHOR]

The shift in care from long-term hospitalization of individuals with mental illness to the community places a greater onus of responsibility on informal caregivers. The purpose of the current study was to explore the lived experiences of long-term caregivers of individuals with unipolar depression. A qualitative phenomenological methodology was used and two sets of semi-structured interviews were conducted with nine informal caregivers. Data were transcribed following Giorgi's phenomenological method. The following three themes were identified: Flooded by Emotions, Personal Growth and Satisfaction, and Psychosocial Effects and Challenges. Caregivers described adapting by adjusting their behavior to avoid conflict with care recipients. These adjustments had a detrimental effect on their well-being, where they described that they were "existing but not living." These findings highlight the need for ongoing support, which should be tailored to the unique needs and concerns of individuals who are providing long-term care to individuals with depression. [ABSTRACT FROM AUTHOR]

For cost-effectiveness and efficiency, many large-scale general-purpose cohort studies are being assembled within large health-care providers who use electronic health records. Two key features of such data are that incident disease is interval-censored between irregular visits and there can be pre-existing (prevalent) disease. Because prevalent disease is not always immediately diagnosed, some disease diagnosed at later visits are actually undiagnosed prevalent disease. We consider prevalent disease as a point mass at time zero for clinical applications where there is no interest in time of prevalent disease onset. We demonstrate that the naive Kaplan-Meier cumulative risk estimator underestimates risks at early time points and overestimates later risks. We propose a general family of mixture models for undiagnosed prevalent disease and interval-censored incident disease that we call prevalence-incidence models. Parameters for parametric prevalence-incidence models, such as the logistic regression and Weibull survival (logistic-Weibull) model, are estimated by direct likelihood maximization or by EM algorithm. Non-parametric methods are proposed to calculate cumulative risks for cases without covariates. We compare naive Kaplan-Meier, logistic-Weibull, and non-parametric estimates of cumulative risk in the cervical cancer screening program at Kaiser Permanente Northern California. Kaplan-Meier provided poor estimates while the logistic-Weibull model was a close fit to the non-parametric. Our findings support our use of logistic-Weibull models to develop the risk estimates that underlie current US risk-based cervical cancer screening guidelines. Published 2017. This article has been contributed to by US Government employees and their work is in the public domain in the USA. [ABSTRACT FROM AUTHOR]

BACKGROUND: Residential treatment for alcoholism is associated with high completion rates for clients, yet there appear to be gender disparities in patient referrals and treatment completion rates. We studied whether (A) gender is associated with differential patient placement to outpatient vs. residential treatment facilities and (B) completion rates differ by gender. METHODS: In this cross-sectional study, we analyzed the admission and discharge data from 185 publicly funded substance abuse treatment facilities across Los Angeles County between 2005 and 2010. RESULTS: Among the 33,745 studied cases, women were referred to residential treatment facilities less frequently than men (75% vs. 66%). The adjusted results derived from logistic regression models confirmed that females were more likely to be referred to outpatient treatment than to residential treatment facilities (odds ratio [OR]: 1.15, 95% confidence interval [CI]: 1.05-1.26). In addition, we observed that compared to White/Caucasian patients, all other races were associated with more referral to outpatient facilities (ie, less referral to residential facilities), indicating a racial disparity on the top of the observed gender disparity. However, there was no significant link between gender and treatment completion rates (OR: 0.93, 95% CI: 0.86-1.00). CONCLUSIONS: Women seem to have treatment completion rates comparable to men, yet they are less likely to be referred to residential treatment facilities. Hence, there still remains a gender disparity in alcoholic patient referrals. Further studies should delineate which specific therapeutic aspects and programmatic components of women-focused treatments are essential to augment positive treatment outcomes. [ABSTRACT FROM AUTHOR]

The article discusses the abolition of all non-medical exemptions in California following the passage of U.S Senate Bill 277 (SB277) in 2015. SB277 was said to be successful with sharp increases in vaccination rates seen in kindergarteners entering school. The kindergartener full-vaccination rate for the 2015-2016 school year increased to 92.6 percent after the passage of SB277. It is said that SB277 made no major changes to California law with regards to granting medical exemptions.

The aim is to study the trends of cigarette smoking from 2001 to 2012 using a California representative sample in the US. Data was taken from the California Health Interview Survey (CHIS) from 2001 to 2012, which is a population-based, biennial, random digit-dial telephone survey of the non-institutionalized population. The CHIS is the largest telephone survey in California and the largest state health survey in the US. 282,931 adults (n = 184,454 with age 18-60 and n = 98,477 with age >60) were included in the analysis. Data were weighted to be representative and adjusted for potential covariance and non-response biases. During 2001-2012, the prevalence of current smoking decreased from 18.86 to 15.4 % among adults age 18-60 (β = −0.8, p = 0.0041). As for adults age >60, the prevalence of current smoking trend decreased with variations, started from 9.66 % in 2001, slightly increased to 9.74 % in 2003, but then gradually decreased, falling to 8.18 % in 2012. In 2012, there was a 14 % reduction of daily smoking adults age 18-60 (OR 0.84, 95 % CI 0.76-0.93, p = 0.0006) compared to 2001, while no significant reduction of daily smoking was observed for those age >60. The reductions of smoking prevalence for adults younger than 60 are encouraging. However, there is a concern for smoking cessation rates among those older than 60 years of age, particularly for African Americans. [ABSTRACT FROM AUTHOR]

The article focuses on the 2015 Special Olympics World Games in Los Angeles, California, held in accordance with the 25th anniversary of the American with Disabilities Act (ADA), which promotes the theme of inclusion for all. Topics discussed include Unified Sports is one of the key components of Special Olympics, competition and coaching in Unified Sports, and the sport of Bocce.

Objective: To describe the incidence, antepartum, intrapartum and postpartum risk factors, and mortality rate of amniotic fluid embolism (AFE). Methods: We used 2001-2007 California health discharge data to identify cases of AFE by ICD-9 codes. Results: Of 3 556 567 deliveries during the time period, we identified 182 cases of AFE, resulting in a population incidence of 5.1 in 100 000. Twenty-four of the cases resulted in death, giving a case fatality rate of 13.2%. Non-Hispanic blacks had a higher than 2-fold odds of developing AFE. AFE increased significantly with maternal age, most significantly after age 39. Cardiac disease had a nearly 70-fold higher association with AFE, cerebrovascular disorders had a 25-fold higher association, while conditions such as eclampsia, renal disease, placenta previa and polyhydramnios had nearly 7- to 13-fold higher associations. Classical cesarean delivery, abruption placentae, dilation and curettage, and amnioinfusion were all procedures highly associated with AFE. Conclusion: Several antepartum and peripartum conditions and procedures are associated with significantly higher risks of amniotic fluid embolism. This information may contribute to a better understanding of the pathophysiology of AFE and potentially help identify those at the highest risk of developing this morbid condition. [ABSTRACT FROM AUTHOR]

Purpose: Colorectal cancer (CRC) incidence has decreased over the past three decades, due largely to screening efforts. Relatively little is known about CRC incidence among the young adult (YA) population ages 20-39, as screening typically commences at age 50 for average-risk individuals. We examined CRC incidence with a focus on YAs in order to identify high-risk subgroups. Methods: We analyzed 231,544 incident CRC cases from 1988-2009 (including 5617 YAs 20-39 years of age) from the California Cancer Registry. We assessed age-specific incidence rates by race/ethnicity, gender, and colorectal tumor location, and calculated the biannual percent change (BAPC) to monitor change in incidence over the 22-year study period. Results: The absolute incidence of CRC per 100,000 was low among YAs 20-29 and 30-39 years old (ranging from 0.7 per 100,000 among Hispanic and African American females aged 20-29 up to 5.0 per 100,000 among Asian/Pacific Islander males aged 30-39). However, we observed increasing CRC incidence rates over time among both males and females in the YA population, particularly for distal colon cancer in Hispanic females aged 20-29 (BAPC=+15.9%; p<0.042). Conclusion: The absolute incidence of CRC remains far lower for YAs than among adults aged 50 and over. However, CRC incidence is increasing among young adults, in contrast to the decreasing rates observed for adults in the screened population (aged 50 and above). More research is needed to better characterize YAs at increased risk for CRC. [ABSTRACT FROM AUTHOR]

The article reports on the occurrence of patients with acute flaccid paralysis (AFP) with anterior myelitis in California from June 2012 to June 2014. Topics discussed include the etiology and symptoms of AFP, neuroimaging of the spine indicating the presence of AFP with anterior myelitis in one limb, number of patients with onset of neurologic symptom from 2012-2014, and factors that should be included in the clinical and epidemiologic assessment of the disease.

Introduction. Branch retinal vein occlusion (BRVO) is a common retinal vascular condition that results in intraocular inflammatory changes. Ultra wide field fluorescein angiography (UWFFA) is a retinal imaging device that can capture peripheral retinal findings. The purpose of this study was to look for peripheral findings in the fellow eye of patients with BRVO using UWFFA. Methods. Retrospective imaging review of patients diagnosed with BRVO that had both eyes imaged with UWFFA. Images were graded for peripheral findings in other quadrants of the same eye as well as in all quadrants of the fellow eye. Results. Of 81 patients, 14 (17%) patients had late vascular leakage in a quadrant other than the BRVO distribution. Five (6%) findings were in the same eye, 8 (10%) findings were in the fellow eye, and 1 (1%) finding was in both the same eye and the fellow eye. Of these 14 patients, 11 (80%) patients had hypertension. Conclusion. Late peripheral retinal leakage in the fellow eye of patients with BRVO was detected in this cohort of patients with UWFFA. This novel finding may represent underlying systemic inflammation, hypertension, or bilateral BRVOs. [ABSTRACT FROM AUTHOR]

After the 2001 and 2004 Salmonellosis outbreaks that were associated with raw almonds, ensuring the microbial safety of almonds by treating them to achieve a minimum 4-log reduction of Salmonella population became mandatory in California, the world's largest almond producer. In this paper, we summarize potential pathways of microbial contamination during almond production and manufacturing. Furthermore, we review sanitization technologies, including chemical, thermal, and non-thermal methods, as well as proprietary systems with regard to microbial and sensory quality of almonds and compare various aspects of their use during almond processing. [ABSTRACT FROM AUTHOR]

In this study, the influence of climate change to California and Nevada regions was investigated through high-resolution (4-km grid spacing) dynamical downscaling using the WRF (Weather Research & Forecasting) model. The dynamical downscaling was performed to both the GFS (Global forecast model) reanalysis (called GFS-WRF runs) from 2000-2006 and PCM (Parallel Climate Model) simulations (called PCM-WRF runs) from 1997-2006 and 2047-2056. The downscaling results were first validated by comparing current model outputs with the observational analysis PRISM (Parameter-elevation Regressions on Independent Slopes Model) dataset. In general, the dominant features from GFS-WRF runs and PCM-WRF runs were consistent with each other, as well as with PRISM results. The influences of climate change on the California and Nevada regions can be inferred from the model future runs. The averaged temperature showed a positive trend in the future, as in other studies. The temperature increases by around 1-2°C under the assumption of business as usual over 50 years. This leads to an upward shifting of the freezing level (the contour line of 0°C temperature) and more rain instead of snow in winter (December, January, and February). More hot days (>32.2°C or 90°F) and extreme hot days (>37.8°C or 100°F) are predicted in the Sacramento Valley and the southern parts of California and Nevada during summer (June, July, and August). More precipitation is predicted in northern California but not in southern California. Rainfall frequency slightly increases in the coast regions, but not in the inland area. No obvious trend of the surface wind was indicated. The probability distribution functions (PDF) of daily temperature, wind and precipitation for California and Nevada showed no significant change in shape in either winter or summer. The spatial distributions of precipitation frequency from GFS-WRF and PCM-WRF were highly correlated (r = 0.83). However, overall positive shifts were seen in the temperature field; increases of 2°C for California and 3°C for Nevada in summer and 2.5°C for California and 1.5°C for Nevada in winter. The PDFs predicted higher precipitation in winter and lower precipitation in the summer for both California and Nevada. [ABSTRACT FROM AUTHOR]

A hybrid background error covariance (BEC) model for three-dimensional variational data assimilation of glider data into the Navy Coastal Ocean Model (NCOM) is introduced. Similar to existing atmospheric hybrid BEC models, the proposed model combines low-rank ensemble covariances with the heuristic Gaussian-shaped covariances to estimate forecast error statistics. The distinctive features of the proposed BEC model are the following: (i) formulation in terms of inverse error covariances, (ii) adaptive determination of the rank m of with information criterion based on the innovation error statistics, (iii) restriction of the heuristic covariance operator to the null space of , and (iv) definition of the BEC magnitudes through separate analyses of the innovation error statistics in the state space and the null space of . The BEC model is validated by assimilation experiments with simulated and real data obtained during a glider survey of the Monterey Bay in August 2003. It is shown that the proposed hybrid scheme substantially improves the forecast skill of the heuristic covariance model. [ABSTRACT FROM AUTHOR]

Background: The percentage of Latino clients entering outpatient substance abuse treatment (OSAT) in the United States has increased significantly in the past 10 years. Evidence suggests that a lack of services in Spanish is a significant barrier to treatment access among Latinos.Methods: Using a geographic information system (GIS) approach, data from the U.S. Census Bureau and the National Survey of Substance Abuse Treatment Services (N-SSATS) were analyzed to determine the geographic distance between OSAT facilities with services in Spanish and Latino communities throughout Los Angeles County, CA. Data from N-SSATS were also analyzed using logistic regression models to examine organizational characteristics and their association with offering services in Spanish. Our GIS methods are tested in their ability to provide baseline measures to inform future analysis comparing changes in demography and service infrastructure.Results: GIS analysis revealed cold spots representing high-density Latino communities with extensive travel distance to facilities offering services in Spanish. The average linear distance between Latino communities and facilities offering Spanish-language services ranged from 2 to 6 miles, while the location of the cold spots pointed to a need for services in Spanish in a particular subregion of the county. Further, secondary data analysis revealed that, on average, being privately owned (OR = .23, 95% CI = 0.06-0.90) was associated with a lower likelihood of providing services in Spanish compared to public facilities. Additionally, a facility with a state license (OR = 2.08, 95% CI = 1.12-3.88) or a higher number of Medicaid recipients (OR = 2.98, 95% CI = 1.76-5.05) was twice as likely to offer services in Spanish.Conclusion: Despite the significant presence of Latinos in L.A. County in 2000, low capacity was found in discrete Latino communities in terms of offering OSAT services in Spanish. Funding and regulation play a significant role in facilities' capacity to offer these services. Future studies should build from our multi-method approach to compare changes in population demography and system infrastructure and inform health care policy that seeks to improve providers' capacity to provide linguistically competent care. [ABSTRACT FROM AUTHOR]

Accessibility is a fundamental concept in theories of metropolitan spatial structure. Urban economic models explain urban structure as a function of access to jobs; accessibility is capitalised into land values, which in turn explain the population distribution. Studies of residential land values show that many factors contribute to the value of a given location: the characteristics of the housing unit, its location with respect to social and environmental amenities, as well as access to jobs, services and other economic opportunities. Empirical studies typically use job access as a proxy for more generalised access to economic activities. However, jobs represent many different activities, from retail shopping to heavy manufacturing, and the value of access to these activities may be positive or negative. In this paper, accessibility measures based on industry sectors have been developed, allowing the separating out of possible different effects. Their impacts are tested on residential land values using data from the Los Angeles region. A multilevel modelling approach is used in order to control for neighbourhood-level attributes common to multiple properties. It is found that the various access measures have different and significant effects on land values, but attributes of the dwelling unit, together with access to the coast, explain most of the variation. The multilevel model is confirmed; there is significant correlation among properties within the same neighbourhood. [ABSTRACT FROM PUBLISHER]

This study, initially presented at the SMFM Annual Conference in San Diego on 29 January 2009, sought to explore the risk factors for mortality from postpartum haemorrhage (PPH). A total of 138,316 cases of PPH from 1991 to 2000 were identified using the California Health Discharge Database. Data analysed included demographic information and clinical risk factors. PPH increased from 1.9% to 2.8%, while mortality rate decreased during the study period (1991–2000). Logistic regression showed that hysterectomy, hypertensive disorders, abruption, transverse caesarean delivery, and classical caesarean delivery, increased risk for PPH mortality, while manual placental extraction, episiotomy, and laceration repairs decreased risk. Two geographical regions, Inland Empire and Orange County, were associated with increased PPH mortality, despite having lower incidence of PPH. Teaching status and investor ownership of hospitals increased the risk of PPH mortality. There was no associated change in mortality based on hospital quality rating. [ABSTRACT FROM AUTHOR]

The article focuses on a report on hospitalized patients with influenza A (H1N1) virus infection in California from April to May 2009. About 96% of unsubtypable specimens have been confirmed as novel influenza A. The largest number of patients resided in San Diego and Imperial counties. Pneumonia and dehydration were the most common admission diagnoses. Sixty four percent of the patients had underlying medical conditions, the most common of which were chronic lung disease and chronic cardiac disease. A 32-year-old man was presented with a 3-day history of fever, chills and productive cough. A rapid antigen test and bronchoalveolar lavage culture were positive for influenza A, with confirmation of novel influenza A.

This paper summarizes a study on the economic impacts of a radiological bomb attack on a major office building in downtown Los Angeles financial district. A radiological bomb will generate effects within an extensive radiation plume that is divided into two zones with varying evacuation times: an Inner Zone with a 1-year evacuation and an Outer Zone with only a 1-month evacuation time. An up-to-date version of a Garin-Lowry-style regional input-output model called SCPM 2005 is employed to simulate household and firm relocation in three scenarios. The impact analysis focuses on business interruption effects only. Impact economique d'une attaque terroriste sur le quartier financier du centre de Los Angeles Resume Cet article concerne une etude sur l'impact economique d'une attaque par bombe radiologique sur un immeuble de bureaux dans le quartier financier du centre de Los Angeles. Une bombe radiologique engendre des effets au cæur d'un vaste panache radioactif, qui est divise en deux zones possedant des durees d'evacuation differentes. La duree d'evacuation est d'un an dans la zone interne, et d'un mois seulement dans la zone externe. Trois scenarios de delocalisation de menages et d'entreprises sont simules grace a l'utilisation d'une version actuelle d'un modele regional intrants-extrants de type Garin-Lowry, appele SCPM 2005. L'analyse de l'impact se concentre uniquement sur les effets de l'interruption du commerce. El impacto economico de un ataque terrorista en el distrito financiero del centro de Los Angeles Resumen Este trabajo resume un estudio sobre el impacto economico de un ataque de bomba radiologico en un importante edificio de oficinas en el distrito financiero del centro de Los Angeles. Una bomba radiologica generara efectos dentro de una pluma radioactiva extensiva, dividida en dos zonas con diferentes tiempos de evacuacion: una zona interna con un periodo de evacuacion de un ano y una zona externa con un periodo de evacuacion de solo un mes. Se emplea una version actualizada de un modelo estilo Garin-Lowry, de entrada-salida regional llamado SCPM 2005, para simular la relocalizacion de viviendas y firmas en tres escenarios. El analisis del impacto solo se enfoca en los efectos de la interrupcion del [image omitted] [ABSTRACT FROM AUTHOR]

This article discusses the concentrations of lead, cadmium and arsenic in soils from vegetable production areas in California. According to the authors, these harmful trace elements can be associated with micronutrient and phosphate fertilizers. They measured the concentrations of zinc and phosphorus as indicators of these inputs and showed that these trace elements had increased in some fields. Cluster analysis and principal component analysis resulted in three groups including those where enrichment of phosphorus and zinc were associated with harmful trace elements, those where zinc was associated with arsenic and those with no correlation.

This article discusses the emissions of volatile organic compounds and greenhouse gases from cows and manure in California. The authors measured emissions of methane, alcohols, phenols and volatile fatty acids from dry and lactating dairy cows and manure. With increasing accumulation of manure on the chamber floor, both alcohols increased over time. According to the authors, phenols and volatile fatty acid emissions were barely detectable. Enteric fermentation from cows was predominantly associated with methane emissions rather than the manure. Dry cows produced considerably less gaseous volatile organic compounds and greenhouse gases than lactating cows. They concluded that research is needed to find effective mitigation.

Objectives: To compare the percentage of diabetics admitted to the hospital due to hypoglycemia in 1990-1993 (period 1) to that in 1997-2000 (period 2).Methods: We analyzed data from the California Hospital Discharge Data Program. Eligibility included diabetic (ICD code 250) subjects aged > or =25 years old who were hospitalized due to hypoglycemia (ICD Codes 250.8) during the periods 1990-1993 and 1997-2000. Data were analyzed by demographics and health insurance status.Results: Of the 2,905,091 hospitalized diabetics, 50,017 (1.7%) were due to hypoglycemia. The percentage of hospitalization due to hypoglycemic varied by sex, age, race/ethnicity, and insurance status (P = .0001). Male, Hispanic, age 25-64 years, with Medical/Medicare insurance had higher odds of being hospitalized due to hypoglycemia relative to other groups (P < .001). The percentage of diabetics hospitalized due to hypoglycemia increased from period 1 to period 2 (1.3% vs. 2.0%, P = .0001). Diabetics hospitalized in period 2 had higher adjusted odds of being hospitalized due to hypoglycemia relative to those admitted in period 1 (OR = 1.6, P < .0001).Conclusion: Our data show an increase in the hospitalization due to hypoglycemia in diabetic patients. Enhanced patient education about self-monitoring of blood sugar and recognizing and treating the symptoms of hypoglycemia may help to minimize hypoglycemic hospitalizations. [ABSTRACT FROM AUTHOR]

This study examines distributional patterns of benthic diatom assemblages in relation to environmental characteristics in streams and rivers in the California Central Valley ecoregion. Benthic diatoms, water quality, and physical habitat conditions were characterized from 53 randomly selected sites. The stream sites were characterized by low mid-channel canopy cover and high channel substrate embeddedness. The waters at these sites were enriched with minerals and turbidity varied from 1.3 to 185.0 NTU with an average of 13.5 NTU. A total of 249 diatom taxa were identified. Average taxa richness was 41 with a range of 7–76. The assemblages were dominated by Staurosira construens (11%), Epithemia sorex (8%), Cocconeis placentula (7%), and Nitzschia amphibia (6%). Multivariate analyses (cluster analysis, classification tree analysis, and canonical correspondence analysis) all showed that benthic diatom assemblages were mainly affected by channel morphology, in-stream habitat, and riparian conditions. The 1st CCA axis negatively correlated with mean wetted channel width ( r = −0.66) and thalweg depth ( r = −0.65) (Table 4). The 2nd axis correlated with % coarse substrates ( r=0.60). Our results suggest that benthic diatoms can be used for assessing physical habitat alterations in streams. [ABSTRACT FROM AUTHOR]