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The B.1.1.529 (Omicron) variant of SARS-CoV-2, the virus that causes COVID-19, was first clinically identified in the United States on December 1, 2021, and spread rapidly. By late December, it became the predominant strain, and by January 15, 2022, it represented 99.5% of sequenced specimens in the United States* (1). The Omicron variant has been shown to be more transmissible and less virulent than previously circulating variants (2,3). To better understand the severity of disease and health care utilization associated with the emergence of the Omicron variant in the United States, CDC examined data from three surveillance systems and a large health care database to assess multiple indicators across three high-COVID-19 transmission periods: December 1, 2020-February 28, 2021 (winter 2020-21); July 15-October 31, 2021 (SARS-CoV-2 B.1.617.2 [Delta] predominance); and December 19, 2021-January 15, 2022 (Omicron predominance). The highest daily 7-day moving average to date of cases (798,976 daily cases during January 9-15, 2022), emergency department (ED) visits (48,238), and admissions (21,586) were reported during the Omicron period, however, the highest daily 7-day moving average of deaths (1,854) was lower than during previous periods. During the Omicron period, a maximum of 20.6% of staffed inpatient beds were in use for COVID-19 patients, 3.4 and 7.2 percentage points higher than during the winter 2020-21 and Delta periods, respectively. However, intensive care unit (ICU) bed use did not increase to the same degree: 30.4% of staffed ICU beds were in use for COVID-19 patients during the Omicron period, 0.5 percentage points lower than during the winter 2020-21 period and 1.2 percentage points higher than during the Delta period. The ratio of peak ED visits to cases (event-to-case ratios) (87 per 1,000 cases), hospital admissions (27 per 1,000 cases), and deaths (nine per 1,000 cases [lagged by 3 weeks]) during the Omicron period were lower than those observed during the winter 2020-21 (92, 68, and 16 respectively) and Delta (167, 78, and 13, respectively) periods. Further, among hospitalized COVID-19 patients from 199 U.S. hospitals, the mean length of stay and percentages who were admitted to an ICU, received invasive mechanical ventilation (IMV), and died while in the hospital were lower during the Omicron period than during previous periods. COVID-19 disease severity appears to be lower during the Omicron period than during previous periods of high transmission, likely related to higher vaccination coverage

Summary Background In the USA, COVID-19 vaccines became available in mid-December, 2020, with adults aged 65 years and older among the first groups prioritised for vaccination. We estimated the national-level impact of the initial phases of the US COVID-19 vaccination programme on COVID-19 cases, emergency department visits, hospital admissions, and deaths among adults aged 65 years and older. Methods We analysed population-based data reported to US federal agencies on COVID-19 cases, emergency department visits, hospital admissions, and deaths among adults aged 50 years and older during the period Nov 1, 2020, to April 10, 2021. We calculated the relative change in incidence among older age groups compared with a younger reference group for pre-vaccination and post-vaccination periods, defined by the week when vaccination coverage in a given age group first exceeded coverage in the reference age group by at least 1%; time lags for immune response and time to outcome were incorporated. We assessed whether the ratio of these relative changes differed when comparing the pre-vaccination and post-vaccination periods. Findings The ratio of relative changes comparing the change in the COVID-19 case incidence ratio over the post-vaccine versus pre-vaccine periods showed relative decreases of 53% (95% CI 50 to 55) and 62% (59 to 64) among adults aged 65 to 74 years and 75 years and older, respectively, compared with those aged 50 to 64 years. We found similar results for emergency department visits with relative decreases of 61% (52 to 68) for adults aged 65 to 74 years and 77% (71 to 78) for those aged 75 years and older compared with adults aged 50 to 64 years. Hospital admissions declined by 39% (29 to 48) among those aged 60 to 69 years, 60% (54 to 66) among those aged 70 to 79 years, and 68% (62 to 73), among those aged 80 years and older, compared with adults aged 50 to 59 years. COVID-19 deaths also declined (by 41%, 95% CI –14 to 69 among adults aged 65–74 years and by 30%, –47 to 66 among those aged ≥75 years, compared with adults aged 50 to 64 years), but the magnitude of the impact of vaccination roll-out on deaths was unclear. Interpretation The initial roll-out of the US COVID-19 vaccination programme was associated with reductions in COVID-19 cases, emergency department visits, and hospital admissions among older adults. Funding None.

To determine if the number of participants with psychiatric disorders increased in association with failures on symptom validity tests (SVTs) and a performance validity test (PVT) in Veterans admitted for evaluation of possible seizures.The 254 participants were Veterans undergoing inpatient video-EEG monitoring for the diagnosis of possible seizures. DSM-IV psychiatric disorders were diagnosed with the SCID IV. Symptom exaggeration was assessed with the MMPI-2-RF and performance validity with the TOMM.On the MMPI-2-RF, 27.6%-32.7% showed symptom exaggeration. Participants who exaggerated on the MMPI-2-RF were more often diagnosed with psychiatric disorders. The TOMM was failed by 15.4% of the sample. Participants who failed the TOMM were more often diagnosed with an Axis I disorder but not with a personality disorder. The MMPI-2-RF was invalid in more cases than the TOMM, but 7.9% of the sample generated a valid MMPI-2-RF and an invalid TOMM.The correlational design does not allow conclusions about cause and effect. The invalid groups may have had a higher rate of psychopathology. The number of participants with psychiatric disorders increased in association with symptom exaggeration and performance invalidity. Symptom exaggeration was more frequent than performance invalidity, but the TOMM made a unique contribution to identification of invalidity. The routine clinical use of SVTs and PVTs is supported. The results also suggest the need for caution in diagnosing psychiatric disorders when there is symptom exaggeration or performance invalidity, because diagnostic validity is dependent on the accuracy of symptom reporting.

Concentrating solar power plays a vital role in the transformation of global energy landscape towards sustainable and environmentally sound energy supply. Currently, tower systems with molten salt tubular receivers are most common in commercial scale applications. Operational optimization of such systems necessitates detailed knowledge of operating limits of receiver components exposed to inhomogeneous solar flux densities of up to 1 MW / m 2 and local salt temperatures of in part more than 600 ° C , fluctuating at various time scales. Traditionally, the operating limits aforementioned are captured in a simplified manner via the top-down concept of allowable flux density. To the authors’ view, there is considerable room for improvement over this approach as far as optimization of inherent thermomechanical and damage modeling are concerned. What is more, an alternative bottom-up concept, though implying more stringent requirements on model and processing performance, promises notably increased economic viability essentially due to reduced safety margins in operation and condition-based maintenance strategies. In this paper, essential approaches and assumptions of thermomechanical and damage modeling methods in topical literature are comprehensively discussed and assessed in terms of their potential for the approach outlined to be demonstrated at a pilot scale test facility. As a result, it is concluded that modeling can be substantially improved applying extended analytical methods from the literature. In addition, depending on model complexity and available computational resources, a few heuristic-numerical models are potentially applicable in favor of more detailed thermomechanical modeling regarding i.a. actual receiver geometry and local boundary conditions.

Background Correctional and detention facilities are disproportionately affected by COVID-19 due to shared space, contact between staff and detained persons, and movement within facilities. On March 18, 2020, Cook County Jail, one of the United States’ largest, identified its first suspected case of COVID-19 in a detained person. Methods This analysis includes SARS-CoV-2 cases confirmed by molecular detection among detained persons and Cook County Sheriff's Office staff. We examined occurrence of symptomatic cases in each building and proportions of asymptomatic detained persons testing positive, and timing of interventions including social distancing, mask use, and expanded testing and show outbreak trajectory in the jail compared to case counts in Chicago. Results During March 1-April 30, 907 symptomatic and asymptomatic cases of SARS-CoV-2 infection were detected among detained persons (n = 628) and staff (n = 279). Among asymptomatic detained persons in quarantine, 23.6% tested positive. Programmatic activity and visitation stopped March 9, cells were converted into single occupancy beginning March 26, and universal masking was implemented for staff (April 2) and detained persons (April 13). Cases at the jail declined while cases in Chicago increased. Discussion/Conclusions Aggressive intervention strategies coupled with widespread diagnostic testing of detained and staff populations can limit introduction and mitigate transmission of SARS-CoV-2 infection in correctional and detention facilities.

Rickettsial diseases (RDs) are transmitted to humans by ectoparasites, including ticks and fleas. Symptoms range from mild febrile illness, to severe disease or death. Doxycycline is the treatment of choice for patients of all ages; early treatment based on clinical diagnosis is critical to prevent severe outcomes. We conducted a descriptive analysis using insurance claims data captured by IBM MarketScan® research databases to describe demographics, treatment patterns, and outcomes of patients diagnosed with RDs in the United States during 2005–2017. Overall, 14,830 patients had a RD diagnosis during 2005–2017; 7,517 (50.7%) spotted fever rickettsiosis (SFR), 4,571 ( 30.8%) ehrlichiosis, 1,362 (9.2%) typhus group rickettsiosis (TGR), and 1,193 (8.0%) other rickettsial diseases. Among all patients diagnosed, 53.1% received doxycycline. Prescription rates varied by diagnosis and age; 24.1% of TGR and 61.1% of SFR patients received doxycycline; 23.9% of persons

We present an alternative derivation of the relation between temperature and volume for a reversible, adiabatic process involving an ideal gas. The derivation for a monatomic gas starts with the Sackur–Tetrode equation and takes only one step. We also address the extension to diatomic gases.

Mature gametocytes ofPlasmodium(P.)falciparumdisplay a banana (falciform) shape conferred by a complex array of subpellicular microtubules (SPMT) associated to the inner membrane complex (IMC). Microtubule associated proteins (MAPs) define MT populations and modulate interaction to pellicular components. Several MAPs have been identified inToxoplasma gondiiand homologues can be found in the genome ofPlasmodiumspecies, but the function of these proteins for asexual and sexual development of malaria parasites is still unknown. Here we identified a novel subpellicular MAP, termed SPM3, that is conserved within the genusPlasmodium., especially within theLaveraniasubgenus, but absent in other Apicomplexa. Conditional knockdown and targeted gene disruption ofPfspm3inP. falciparumcause severe morphological defects during gametocytogenesis leading to round, non-falciform gametocytes with an aberrant SPMT pattern. In contrast,Pbspm3knockout inP. berghei, a species with round gametocytes, caused no defect in gametocytogenesis, but sporozoites displayed an aberrant motility and a dramatic defect in sporozoite invasion of salivary glands leading to a decreased efficiency in transmission. Electron microscopy revealed a dissociation of the SPMT from the IMC inPbspm3knockout parasites suggesting a function of SPM3 in anchoring MTs to the IMC. Overall, our results highlight SPM3 as a pellicular component with essential functions for malaria parasite transmission.IMPORTANCEA key structural feature driving the transition between different life cycle stages of the malaria parasite is the unique three membrane “pellicle”, consisting of the parasite plasma membrane (PPM) and a double membrane structure underlying the PPM termed the “inner membrane complex” (IMC). Additionally, there are numerous linearly arranged intramembranous particles (IMPs) linked to the IMC, which likely link the IMC to the subpellicular microtubule cytoskeleton. Here we identify, localize and characterize a novel subpellicular microtubule associated protein unique to the genusPlasmodium(P.). The knockout of this protein in the human infectingP. falciparumspecies result in malformed gametocytes and aberrant microtubules. We confirmed the microtubule association in theP. bergheirodent malaria homologue and show that its knockout results in a perturbated microtubule architecture, aberrant sporozoite motility and decreased transmission efficiency.

BackgroundIn the United States, national ecological studies suggest a positive impact of COVID-19 vaccination coverage on outcomes in adults. However, the national impact of the vaccination program on COVID-19 in children remains unknown. To determine the association of COVID-19 vaccination with U.S. case incidence, emergency department visits, and hospital admissions for pediatric populations during the Delta and Omicron periods.MethodsWe conducted an ecological analysis among children aged 5–17 and compared incidence rate ratios (RRs) of COVID-19 cases, emergency department visits, and hospital admissions by pediatric vaccine coverage, with jurisdictions in the highest vaccine coverage quartile as the reference.ResultsRRs comparing states with lowest pediatric vaccination coverage to the highest pediatric vaccination coverage were 2.00 and 0.64 for cases, 2.96 and 1.11 for emergency department visits, and 2.76 and 1.01 for hospital admissions among all children during the Delta and Omicron periods, respectively. During the 3-week peak period of the Omicron wave, only children aged 12–15 and 16–17 years in the states with the lowest versus highest coverage, had a significantly higher rate of emergency department visits (RR=1.39 and RR=1.34, respectively).ConclusionsCOVID-19 vaccines were associated with lower case incidence, emergency department visits and hospital admissions among children during the Delta period but the association was weaker during the Omicron period. Pediatric COVID-19 vaccination should be promoted as part of a program to decrease COVID-19 impact among children; however, vaccine effectiveness may be limited when available vaccines do not match circulating viral variants.

The disaccharide galactose-α-1,3-galactose (alpha-gal) is expressed in mammals other than humans, apes, and old-world monkeys. In humans, elevated immunoglobulin-E (IgE) antibodies specific for alpha-gal can result in allergic hypersensitivity known as alpha-gal syndrome (AGS). Case reports and series suggest that tick bites can induce alpha-gal specific IgE antibodies.Evaluate tick exposure as a risk factor for AGS and elevated alpha-gal specific IgE (sIgE).We conducted a case-control study comparing AGS patients from a North Carolina allergy clinic with controls who were patients at a nearby internal medicine clinic. Cases and controls were administered a questionnaire to obtain information about demographics, home environment, outdoor activities, and recollection of tick bite. Serum samples taken at the time of enrollment were tested for total IgE, alpha-gal sIgE, and antibodies to other tickborne pathogens.AGS patients were more likely to recall finding a tick on themselves (OR=11.20, 95% CI 4.97-25.15), live near wooded forest (OR=2.27, 95% CI 0.92-5.55), and spend 17 or more hours per week outdoors in wooded areas (OR=5.58, 95% CI 2.56-12.19). AGS patients were also more likely to report 4 or more tick bites (OR=33.05, 95% CI 9.92-155.12) and reactions at the site of tick bites (OR=7.93, 95% CI 3.74-16.80). Elevated alpha-gal sIgE was also observed in 33% of controls and was also associated with tick exposure in the controls (OR=4.25, 95% CI 2.21-8.18).The results define tick bite as a risk factor for AGS and elevated alpha-gal sIgE.

Alpha-gal syndrome (AGS) is an IgE-mediated allergy to galactose-alpha-1,3-galactose. Clinical presentation ranges from hives to anaphylaxis; episodes typically occur 2-6 h after exposure to alpha-gal-containing products. In the United States, lone star tick bites are associated with the development of AGS. To characterize features of AGS, we evaluated a cohort of patients presenting for care at the University of North Carolina, focusing on symptoms, severity, and identifying features unique to specific alpha-gal-containing product exposures.We performed a chart review and descriptive analysis of 100 randomly selected patients with AGS during 2010-2019.Median age at onset was 53 years, 56% were female, 95% reported White race, 86% reported a history of tick bite, and 75% met the criteria for anaphylaxis based on the involvement of ≥2 organ systems. Those reporting dairy reactions were significantly less likely to report isolated mucocutaneous symptoms (3% vs. 24%; ratio [95% CI]: 0.1 [0.1, 0.3]) than those who tolerated dairy, and were more likely to report gastrointestinal symptoms (79% vs. 59%; ratio [95% CI]: 1.3 [0.7, 2.6]), although this difference was not statistically significant. Dairy-tolerant patients demonstrated higher alpha-gal sIgE titers (as a percentage of total IgE) than dairy-reactive patients (GM 4.1 [95% CI: 2.7, 6.1] vs. GM 2.5 [95% CI: 1.3, 4.8], respectively; ratio -1.6 [95% CI: -1.0, 3.9]).While tick exposure is common in the southern United States, nearly all AGS patients reported a tick bite. Gastrointestinal symptoms were prominent among those reporting reactions to dairy. Anaphylaxis was common, underscoring the severity and need to raise awareness of AGS among patients and providers.

In this pilot study, intraindividual variability in neurocognitive test performance was examined in 24 healthy individuals with high levels of education and average full-scale IQ of 121.9 on a short neuropsychological battery across multiple cognitive domains. Marked variability was found across all domains. Intraindividual differences between the highest and lowest z-scores ranged from 2.05 to 6.92 (M = 3.89, SD = 1.25). Based on the definitions of abnormality proposed by Lezak, Wechsler and Heaton, 46% of our sample participants had at least one score that was more than 2 standard deviations below the population mean; 50% had at least one score that was less than the 5th percentile (z 1.0 SD) across our sample. Our findings suggest the need for caution when inferring the presence of cerebral dysfunction in high academic achievers, particularly in a medical legal setting where false-positive diagnoses may be of particular consequence.

Earlier age of menopause and bilateral oophorectomy are associated with accelerated biologic aging based on epigenetic clocks. While these relationships suggest women with greater epigenetic age acceleration (AgeAccel) might be at a reduced risk of postmenopausal breast cancer, prior studies conflict with this theory. We hypothesized this paradox may be attributable to an interaction between epigenetic and reproductive aging on cancer risk. We evaluated this premise among 5,044 postmenopausal women in the Women’s Health Initiative (WHI) Observational Study and Clinical Trial with AgeAccel estimated in whole blood. Among a subset of 1,135 of these women, estradiol (E2) and sex hormone-binding globulin were assayed in baseline serum samples. For WHI participants with DNA methylation assays, we modeled the log odds of incident postmenopausal breast cancer during follow-up as a function of AgeAccel, adjusting for age at menopause, race/ethnicity, age at WHI screening, bilateral oophorectomy, nulliparity, alcohol consumption, smoking, body mass index, duration of postmenopausal hormone therapy use, exercise, clinical trial arm, and hysterectomy status at baseline. We repeated this analysis among the subset of participants with DNA methylation and E2 assays, and appraised the degree to which bioavailable E2 levels contributed to the observed association between AgeAccel and incident postmenopausal breast cancer. Finally, we evaluated whether bioavailable E2 levels modified the relationship between AgeAccel and cancer risk. Generalized estimating equations were used to model associations with AgeAccel, integrating repeated measures among a subset of participants and using inverse probability weights to account for sample selection probabilities. Based on our fully adjusted models, increased extrinsic AgeAccel was associated with decreased odds of incident postmenopausal invasive breast cancer during follow-up. This association was consistent among the subset of participants with E2 assays, and robust to adjustment for bioavailable E2 concentration. We found the inverse relationship between extrinsic AgeAccel and incident breast cancer was strongest among white non-Hispanic women with low levels of bioavailable E2. This study represents the largest investigation of the association between AgeAccel and postmenopausal breast cancer risk, and the first evaluation of how bioavailable E2 levels may influence this relationship. Our analyses inform our understanding of the relationship between the epigenetic and reproductive aging process, and the potential implications for postmenopausal breast cancer risk. Citation Format: Alexandra M. Binder, Lesley Tinker, Robert Wallace, JoAnn E. Manson, Lihong Qi, Parveen Bhatti, Eric A. Whitsel, Andrea Z. LaCroix, Steve Horvath. Association between epigenetic age acceleration and postmenopausal breast cancer risk in the Women’s Health Initiative [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS7-28.

Correctional and detention facilities have been disproportionately affected by coronavirus disease 2019 (COVID-19) because of shared space and movement of staff members and detained persons within facilities (1,2). During March 1-April 30, 2020, at Cook County Jail in Chicago, Illinois, >900 COVID-19 cases were diagnosed across all 10 housing divisions, representing 13 unique buildings.† Movement within the jail was examined through network analyses and visualization, a field that examines elements within a network and the connections between them. This methodology has been used to supplement contact tracing investigations for tuberculosis and to understand how social networks contribute to transmission of sexually transmitted infections (3-5). Movements and connections of 5,884 persons (3,843 [65%] detained persons and 2,041 [35%] staff members) at the jail during March 1-April 30 were analyzed. A total of 472 (12.3%) COVID-19 cases were identified among detained persons and 198 (9.7%) among staff members. Among 103,701 shared-shift connections among staff members, 1.4% occurred between persons with COVID-19, a percentage that is significantly higher than the expected 0.9% by random occurrence alone (p

Objective To assess the validity of embedded measures of performance validity, the effort index (EI) and effort scale (ES) of the repeatable battery for the assessment of neuropsychological status (RBANS), in Veterans with seizures; to compare the frequency of failure on the test of memory malingering (TOMM) in patients with epileptic versus psychogenic nonepileptic seizures (PNES). Methods Seizure diagnosis was established for 309 participants in epilepsy monitoring units using conventional diagnostic criteria who completed both the TOMM and RBANS. The criterion for performance invalidity was failure on any trial of the TOMM. We examined multiple EI and ES cutoffs to establish optimal sensitivity and specificity. Results An RBANS EI cutoff score of greater than three was optimal with specificity of .98, sensitivity of.19, and positive Likelihood Ratio of 10 but was not useful when below this cutoff. Confidence intervals indicate the need for confirmation of a failed EI with another performance validity test (PVT). No ES cutoff had sufficient specificity for clinical use. Invalid TOMM performance but not invalid RBANS performance was significantly more common in persons with PNES than in persons with epileptic seizures. Conclusions In Veterans undergoing seizure monitoring, the RBANS EI was useful as a screen when positive that requires confirmation with another PVT. The RBANS ES was not useful. Invalid performance on the TOMM was more common in persons with PNES than in persons with epileptic seizures.

Scholars in both digital humanities and media studies have noted an apparent disconnect between computation and the interpretive methods of the humanities. Alan Liu has argued that literary...

ImportancePatients with cancer experience acute declines in physical function, hypothesized to reflect accelerated aging driven by cancer-related symptoms and effects of cancer therapies. No study has examined long-term trajectories of physical function by cancer site, stage, or treatment compared with cancer-free controls.ObjectiveExamine trajectories of physical function a decade before and after cancer diagnosis among older survivors and cancer-free controls.Design, Setting, and ParticipantsThis prospective cohort study enrolled patients from 1993 to 1998 and followed up until December 2020. The Women’s Health Initiative, a diverse cohort of postmenopausal women, included 9203 incident cancers (5989 breast, 1352 colorectal, 960 endometrial, and 902 lung) matched to up to 5 controls (n = 45 358) on age/year of enrollment and study arm.ExposuresCancer diagnosis (site, stage, and treatment) via Medicare and medical records.Main Outcomes and MeasuresTrajectories of self-reported physical function (RAND Short Form 36 [RAND-36] scale; range: 0-100, higher scores indicate superior physical function) estimated from linear mixed effects models with slope changes at diagnosis and 1-year after diagnosis.ResultsThis study included 9203 women with cancer and 45 358 matched controls. For the women with cancer, the mean (SD) age at diagnosis was 73.0 (7.6) years. Prediagnosis, physical function declines of survivors with local cancers were similar to controls; after diagnosis, survivors experienced accelerated declines relative to controls, whose scores declined 1 to 2 points per year. Short-term declines in the year following diagnosis were most severe in women with regional disease (eg, −5.3 [95% CI, −6.4 to −4.3] points per year in regional vs −2.8 [95% CI, −3.4 to −2.3] for local breast cancer) or who received systemic therapy (eg, for local endometrial cancer, −7.9 [95% CI, −12.2 to −3.6] points per year with any chemotherapy; −3.1 [95% CI, −6.0 to −0.3] with radiation therapy alone; and −2.6 [95% CI, −4.2 to −1.0] with neither, respectively). While rates of physical function decline slowed in the later postdiagnosis period (eg, women with regional colorectal cancer declined −4.3 [95% CI, −5.9 to −2.6] points per year in the year following diagnosis vs −1.4 [95% CI, −1.7 to −1.0] points per year in the decade thereafter), survivors had estimated physical function significantly below that of age-matched controls 5 years after diagnosis.Conclusions and RelevanceIn this prospective cohort study, survivors of cancer experienced accelerated declines in physical function after diagnosis, and physical function remained below that of age-matched controls even years later. Patients with cancer may benefit from supportive interventions to preserve physical functioning.

In the present paper, recent progress regarding additive manufacturing (AM) of pure tungsten (W) by means of laser powder bed fusion (LPBF) is discussed. In this context, several aspects are highlighted: The influence of the raw powder material characteristics on the resulting W part quality is briefly discussed, examples for complexly shaped additively manufactured W lattice structure samples are shown, the application of an additively manufactured W structure as preform for a tungsten-copper (W-Cu) composite is illustrated and thermal shock experiments on additively manufactured bulk W samples with the electron beam facility JUDITH 2 are described. The latter demonstrates that W material consolidated by means of LPBF is capable of surviving intense thermal shock loads. This is an encouraging result indicating that the thermal performance and stability of W fabricated by means of LPBF is comparable to that of conventionally fabricated W which in turn implies that the further investigation of additively manufactured W as candidate material with regard to applications in highly loaded plasma-facing components (PFCs) of future magnetic confinement thermonuclear fusion devices can be considered worthwhile.

Life course epidemiology approaches disease aetiology and prevention from the perspective of risk and protective factors that influence health and disease throughout the lifespan. The integration of a life course approach to epidemiologic research is central for identifying effective policies and programmes to promote population health and health equity. This chapter will introduce life course concepts and models and analytical approaches for research on life course determinants of health. It will discuss threats to causal inference, approaches for overcoming these difficulties, and future directions in life course epidemiology. For example, in addition to expanding epidemiologic research with a life course perspective to include people with diverse life experiences, new areas of development include life course research extending beyond one human lifespan to include intergenerational and transgenerational life course research, as well as the application of innovative methods.

Higher maternal pre-pregnancy body mass index (ppBMI) is associated with increased neonatal morbidity, as well as with pregnancy complications and metabolic outcomes in offspring later in life. The placenta is a key organ in fetal development and has been proposed to act as a mediator between the mother and different health outcomes in children. The overall aim of the present work is to investigate the association of ppBMI with epigenomewide placental DNA methylation (DNAm) in 10 studies from the PACE consortium, amounting to 2631 mother-child pairs. We identify 27 CpG sites at which we observe placental DNAm variations of up to 2.0% per 10 ppBMI-unit. The CpGs that are differentially methylated in placenta do not overlap with CpGs identified in previous studies in cord blood DNAm related to ppBMI. Many of the identified CpGs are located in open sea regions, are often close to obesity-related genes such as GPX1 and LGR4 and altogether, are enriched in cancer and oxidative stress pathways. Our findings suggest that placental DNAm could be one of the mechanisms by which maternal obesity is associated with metabolic health outcomes in newborns and children, although further studies will be needed in order to corroborate these findings., French Centre National de la Recherche Scientifique (CNRS)-Institut National des Sciences de l'Univers (INSU), Swiss National Science Foundation (SNSF), European Commission, Ministry of Science and Innovation, Spain (MICINN), Spanish Government FJC2018-036729, European Development Fund, European Social Fund (ESF)

The purpose of this paper is to describe a three-year limited-run offer of an energy science certificate in the University of Hawaii at Hilo campus, along with lessons learned that can be of use to other institutions considering comparable programs. Energy science is a loosely defined discipline that traditionally straddles physics and mechanical, electrical, and chemical engineering, and that can be offered based in any one or a combination of the above programs. Significant components in the life sciences and social sciences can be included as well. With the global trend to switch to clean or renewable energies, a significant number of job openings in this field is expected.

Our aim in this paper is to describe an opportunity for physics students and faculty to learn about an environmental issue of much current interest: the quantification, or footprint analysis, of carbon dioxide (CO2) and reactive nitrogen emissions. These can originate from human activities such as energy use, food consumption, and transportation, and are among the greenhouse gases (GHG) that contribute to global warming and rising sea levels. Moreover, nitrogen compounds also have effects on the chemistry and biology of the environment. Analyzing both of these footprints together captures multiple environmental impacts from the local to the global levels and can suggest mitigation strategies. We focus on the experiences of interdisciplinary teams, which included physics students and faculty, and that used the leading greenhouse gas analysis platform SIMAP (Sustainability Indicator Management and Analysis Platform).

The rise of social media has recently inspired a renewed debate about the decentering of the subject. Some scholars have responded to Facebook’s seemingly intrusive influence over people’s emotions by reviving humanistic notions of the autonomous subject, while others have continued to insist on the subject’s constructedness. This article provides a historical perspective on this issue by revisiting another moment that, in some ways, parallels contemporary anxieties about social media. In the mid-18th century, critics worried that the increasing popularity of reading was producing unruly emotions and extreme opinions. These concerns inspired a number of attempts to reassert the primacy of spoken language, including programs of elocution instruction that trained people in reading out loud. Focusing on James Burgh’s 1761 book The Art of Speaking, this article argues that the elocution movement employed a different conception of selfhood from the modern notion of subjectivity: rather than treating the subject as the ultimate source of emotion, the elocutionists judged emotional reactions to texts based on a normative notion of the general good. I argue that this ethically grounded view of the self could provide a useful framework for understanding the stakes of the present anxiety about the emotional effects of media.

Health-related quality of life (HRQoL) is compromised in civilians with epileptic seizures (ES) or psychogenic nonepileptic seizures (PNES). U.S. Veterans are a distinct patient group with regard to gender, age, and background. We studied HRQoL in Veterans and asked the following: (1) Is there a difference in HRQoL in Veterans with ES vs. PNES?; (2) What factors influence HRQoL in each group?; (3) What factors influenced the difference between seizure groups?We studied consecutive Veterans entering the epilepsy monitoring units (EMUs) of three VA Epilepsy Centers of Excellence. Patients underwent continuous video-EEG monitoring. Seizure diagnoses followed established criteria. Health-related quality of life was measured with the Quality of Life in Epilepsy Inventory-31 (QOLIE-31). Evaluations included the Structured Clinical Interview for Diagnostic and Statistical Manual-IV (DSM IV), the posttraumatic stress disorder (PTSD) Checklist (PCL), the Beck Depression Inventory II (BDI-II), and the Minnesota Multiphasic Personality Inventory-2 Restructured form (MMPI-2RF). Between-group differences were tested with Wilcoxon tests. Nested regression analysis was used to evaluate the influence of demographic, social, military, seizure-related, and psychological factors on QOLIE-31 scores.The median QOLIE-31 total score was 14 points lower in Veterans with PNES vs. ES (p 0.001; Cohen's d = 0.73). Within each seizure group, psychological factors accounted for ≥50% of the variance in QOLIE scores while combined demographic, social, and seizure-related factors accounted for 18% (group with ES) and 7% (PNES). Psychological measures, particularly PCL and the BDI-II scores, accounted for all of the difference in QOLIE-31 total scores between Veterans with ES and those with PNES.Health-related quality of life as measured by the QOLIE-31 is worse in Veterans with PNES as compared with those with ES. Psychological factors account for the most of the variance in QOLIE-31 scores regardless of seizure type and also account for the difference between groups with PNES and ES. Demographic, military, social, and seizure-related factors have minimal influence on HRQoL. These results in U.S. Veterans are similar to those found in civilians despite differences in patient age, gender, and background.

Significant effort has been made over the last few decades to develop automated passive acoustic monitoring (PAM) systems capable of classifying cetaceans at the species level. The utility of such systems depends on the systems' ability to operate across a wide range of ocean acoustic environments; however, anecdotal evidence suggests that site-specific propagation characteristics impact the performance of PAM systems. Variability in propagation characteristics leads to differences in how each cetacean vocalization is altered as it propagates along the source-receiver path. A propagation experiment was conducted in the Gulf of Mexico to investigate the range-dependent impacts of acoustic propagation on the performance of an automated classifier. Modified bowhead and humpback vocalizations were transmitted over ranges from 1 to 10 km. When the classifier was trained with signals collected near the sound source, it was found that the performance decreased with increasing transmission range-this appeared to be largely explained by decreasing signal-to-noise ratio (SNR). Generation of performance matrices showed that one method to develop a classifier that maintains high performance across many ranges is to include a varied assortment of ranges in the training data; however, if the training set is limited, it is best to train on relatively low SNR vocalizations.

Phthalate exposure is widespread among pregnant women and may be a risk factor for preterm birth.To investigate the prospective association between urinary biomarkers of phthalates in pregnancy and preterm birth among individuals living in the US.Individual-level data were pooled from 16 preconception and pregnancy studies conducted in the US. Pregnant individuals who delivered between 1983 and 2018 and provided 1 or more urine samples during pregnancy were included.Urinary phthalate metabolites were quantified as biomarkers of phthalate exposure. Concentrations of 11 phthalate metabolites were standardized for urine dilution and mean repeated measurements across pregnancy were calculated.Logistic regression models were used to examine the association between each phthalate metabolite with the odds of preterm birth, defined as less than 37 weeks of gestation at delivery (n = 539). Models pooled data using fixed effects and adjusted for maternal age, race and ethnicity, education, and prepregnancy body mass index. The association between the overall mixture of phthalate metabolites and preterm birth was also examined with logistic regression. G-computation, which requires certain assumptions to be considered causal, was used to estimate the association with hypothetical interventions to reduce the mixture concentrations on preterm birth.The final analytic sample included 6045 participants (mean [SD] age, 29.1 [6.1] years). Overall, 802 individuals (13.3%) were Black, 2323 (38.4%) were Hispanic/Latina, 2576 (42.6%) were White, and 328 (5.4%) had other race and ethnicity (including American Indian/Alaskan Native, Native Hawaiian,1 racial identity, or reported as other). Most phthalate metabolites were detected in more than 96% of participants. Higher odds of preterm birth, ranging from 12% to 16%, were observed in association with an interquartile range increase in urinary concentrations of mono-n-butyl phthalate (odds ratio [OR], 1.12 [95% CI, 0.98-1.27]), mono-isobutyl phthalate (OR, 1.16 [95% CI, 1.00-1.34]), mono(2-ethyl-5-carboxypentyl) phthalate (OR, 1.16 [95% CI, 1.00-1.34]), and mono(3-carboxypropyl) phthalate (OR, 1.14 [95% CI, 1.01-1.29]). Among approximately 90 preterm births per 1000 live births in this study population, hypothetical interventions to reduce the mixture of phthalate metabolite levels by 10%, 30%, and 50% were estimated to prevent 1.8 (95% CI, 0.5-3.1), 5.9 (95% CI, 1.7-9.9), and 11.1 (95% CI, 3.6-18.3) preterm births, respectively.Results from this large US study population suggest that phthalate exposure during pregnancy may be a preventable risk factor for preterm delivery.

The well-known Stroop interference effect has been instrumental in revealing the highly automated nature of lexical processing as well as providing new insights to the underlying lexical organization of first and second languages within proficient bilinguals. The present cross-linguistic study had two goals: 1) to examine Stroop interference for dynamic signs and printed words in deaf ASL-English bilinguals who report no reliance on speech or audiological aids; 2) to compare Stroop interference effects in several groups of bilinguals whose two languages range from very distinct to very similar in their shared orthographic patterns: ASL-English bilinguals (very distinct), Chinese-English bilinguals (low similarity), Korean-English bilinguals (moderate similarity), and Spanish-English bilinguals (high similarity). Reaction time and accuracy were measured for the Stroop color naming and word reading tasks, for congruent and incongruent color font conditions. Results confirmed strong Stroop interference for both dynamic ASL stimuli and English printed words in deaf bilinguals, with stronger Stroop interference effects in ASL for deaf bilinguals who scored higher in a direct assessment of ASL proficiency. Comparison of the four groups of bilinguals revealed that the same-script bilinguals (Spanish-English bilinguals) exhibited significantly greater Stroop interference effects for color naming than the other three bilingual groups. The results support three conclusions. First, Stroop interference effects are found for both signed and spoken languages. Second, contrary to some claims in the literature about deaf signers who do not use speech being poor readers, deaf bilinguals' lexical processing of both signs and written words is highly automated. Third, cross-language similarity is a critical factor shaping bilinguals' experience of Stroop interference in their two languages. This study represents the first comparison of both deaf and hearing bilinguals on the Stroop task, offering a critical test of theories about bilingual lexical access and cognitive control.