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Introduction Type 2 diabetes mellitus (T2DM) is a powerful risk factor for cardiovascular disease (CVD), conferring a greater relative risk in women than men. We sought to examine sex differences in cardiometabolic risk factors and management in the contemporary cohort represented by the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE).Research design and methods GRADE enrolled 5047 participants (1837 women, 3210 men) with T2DM on metformin monotherapy at baseline. The current report is a cross-sectional analysis of baseline data collected July 2013 to August 2017.Results Compared with men, women had a higher mean body mass index (BMI), greater prevalence of severe obesity (BMI≥40 kg/m2), higher mean LDL cholesterol, greater prevalence of low HDL cholesterol, and were less likely to receive statin treatment and achieve target LDL, with a generally greater prevalence of these risk factors in younger women. Women with hypertension were equally likely to achieve blood pressure targets as men; however, women were less likely to receive ACE inhibitors or angiotensin receptor blockers. Women were more likely to be divorced, separated or widowed, and had fewer years of education and lower incomes.Conclusions This contemporary cohort demonstrates that women with T2DM continue to have a greater burden of cardiometabolic and socioeconomic risk factors than men, particularly younger women. Attention to these persisting disparities is needed to reduce the burden of CVD in women.Trial registration number ClinicalTrials.gov (NCT01794143)

In 2013, the Collaborative Crop Research Program (McKnight Foundation), initiated support for farmer research networks (FRNs). FRNs were envisaged as a general approach to networked participatory research aimed at supporting the agroecological intensification (AEI) of smallholder farming in ten countries in Africa and the Andes region in South America. The 30 FRNs ranged in size from 15 to more than 2,000 farmers. Rather than imposing a rigid FRN model, the programme used principles to guide action and reflection. The principles concerned ways of working with farmers, conducting research, and networking. This approach made it possible to reflect on how principles were interpreted, implemented, and used to guide learning in different contexts. This paper reports on insights gained from facilitated learning from 2013–2019 and focuses on subsets of diverse FRNs. Of the 30 FRNs supported, four were analyzed at some depth, reports and interviews were analyzed for 16, and a survey was conducted for 21. Relying on principles rather than an operational model has allowed for their progressive application, as participatory processes, farmer engagement, organizational capital, trust, and networks are built. Any reduced clarity and coherence seem outweighed by greater adaptability to context and resulting creativity.

An ensemble-variational inversion system is developed for the estimation of ammonia emissions using ammonia retrievals from the Cross-track Infrared Sounder (CrIS) for use in the Global Environmental Multiscale – Modelling Air quality and Chemistry (GEM-MACH) chemical weather model. A novel hybrid method to compare logarithmic retrieval parameters to model profiles is presented. Inversions for the monthly mean ammonia emissions over North America were performed for May to August 2016. Inversions using the hybrid comparison method increased ammonia emissions at most locations within the model domain, with total monthly mean emissions increasing by 11 %–41 %. The use of these revised emissions in GEM-MACH reduced biases with surface ammonia observations by as much as 25 %. The revised ammonia emissions also improved the forecasts of total (fine + coarse) ammonium and nitrate, as well as ammonium wet deposition, with biases decreasing by as much as 13 %, but they did not improve the forecasts of just the fine components of ammonium and nitrate. A comparison of biases resulting from inversions using different comparison methods shows favourable results for the hybrid comparison method.

We surveyed pediatric primary care clinicians working in Federally Qualified Health Centers about their perceptions of children's social-emotional wellbeing. We identified clinician's current methods for assessing social-emotional wellbeing in practices, perceived implementation barriers to providing behavioral health care, and interest in adopting a validated, low-burden developmentally sensitive parent-report instrument for screening for social-emotional wellbeing in young children. We surveyed 72 PCCs working in FQHCs from 9 US states. Analyses included examining central tendencies, correlations, analysis of variance, and group differences via t-tests. Average PCC perceptions of social-emotional wellbeing importance for overall health were statistically significantly higher than their confidence in providing care for common social-emotional wellbeing concerns (mean difference = 1.31, 95% CI = 1.13–1.49). PCCs expressed low satisfaction with currently available screening measures for identifying concerns in social-emotional wellbeing. Fewer than half of clinicians reported using any standardized parent-reported measure for identifying concerns in social-emotional wellbeing. Assessment methods and decision tools that improve clinician confidence concerning risk indications are needed, particularly at the critical early childhood period. Policymakers and payers ought to facilitate funding mechanisms that support pediatric PCCs in identifying early concerns in social-emotional wellbeing and providing referral guidance to evidence-based interventions to support parents and caregivers. [ABSTRACT FROM AUTHOR]

Background Reduced dorsiflexion range of motion (DFROM) which is commonly seen following lateral ankle sprain (LAS) has the potential to influence lower extremity biomechanics which have been linked to increased injury risk in the female athlete. Current research on the effect of sex and LAS history on DFROM is limited. Hypothesis/Purpose This study had three aims 1) to determine the effect of sex, leg dominance and LAS history on DFROM, 2) to determine the effect of sex and LAS history on magnitude of DFROM symmetry and 3) to examine the association of sex on direction (whether dominant or non-dominant limb had the higher DFROM) of symmetry. Study Design Cross-Sectional Study Methods DFROM was measured bilaterally in 105 recreational athletes all participating in multidirectional sports using the tape measurement method during the weight bearing lunge test (WBLT). A mean of three measurements was used for analysis. A 3-way mixed ANOVA was carried out to determine the interaction between sex, LAS history and leg dominance on DFROM and a 2-way ANOVA for the effect of sex and LAS history on asymmetry. A chi-square test was used to determine the association of sex and direction of asymmetry. Results The results indicate no significant effect of sex, LAS history, and leg dominance on DFROM (p=0.65). Main effects were significant for sex and LAS on DFROM. The mean asymmetry for all participants was reported as 12.25±14.76cm. No significant effect of sex and LAS history on magnitude of asymmetry was reported. There was a significant association of sex and direction of asymmetry (χ²(1) = 11.26, p = 0.00). Sixty-five-point two percent of males were shown to have higher DFROM of their non-dominant limb compared to 75% of females who were higher in their dominant limb. Conclusion Findings from this study suggest that DFROM is affected by sex and LAS history. While females have increased DFROM compared to males, those with LAS history are more likely to have a decreased DFROM on the involved side. The results also indicate that interlimb asymmetries in DFROM are present in athletes, therefore practitioners should exercise caution when using bilateral comparisons in injury and return to play assessments. Level of Evidence 2b. [ABSTRACT FROM AUTHOR]

Niobium dioxide has a volatile memristive phase change that occurs ∼800 °C that makes it an ideal candidate for future neuromorphic electronics. A straightforward optical system has been developed on a horizontal tube furnace for in situ spectral measurements as an as-grown Nb2O5 film is annealed and ultimately crystallizes as NbO2. The system measures the changing spectral transmissivity of Nb2O5 as it undergoes both reduction and crystallization processes. We were also able to measure the transition from metallic-to-non-metallic NbO2 during the cooldown phase, which is shown to occur about 100 °C lower on a sapphire substrate than fused silica. After annealing, the material properties of the Nb2O5 and NbO2 were assessed via x-ray photoelectron spectroscopy, x-ray diffraction, and 4-point resistivity, confirming that we have made crystalline NbO2. [ABSTRACT FROM AUTHOR]

Aim Method Results Interpretation To investigate non‐clinical factors that affect health‐related decision‐making in mothers with young ambulatory children living with cerebral palsy (CP).Guided by phenomenology, we asked parents to describe early experiences of raising a young ambulatory child living with CP. Conversations were audio‐recorded, transcribed, coded, and analysed using a qualitative inductive approach.Eighteen parents (all mothers) of 20 children participated. Five themes emerged related to decision‐making, each influencing goal setting, prioritization, and health service use. Mothers had to balance both child and family well‐being. Acceptance of their child's diagnosis and abilities changed over time, partially influenced by their child's emerging voice. Uncertainty arose when weighing multiple factors regarding child, family, and what the future held. Experiences were laden with system‐level burdens related to underinsurance and care coordination. Themes regularly overlapped and persisted.Our findings highlight the complexity of the decision‐making experienced by mothers of young ambulatory children living with CP. Probing this information can inform appropriate shared care planning that meets the preferences and circumstances of mothers and their families. [ABSTRACT FROM AUTHOR]

Teachers of developmental education are familiar with non-traditional students who are balancing innumerate stressors in their lives, in addition to the overwhelming stress of college. Stress relief methods like yoga and meditation are essential life management tools in helping new college students succeed, not only in their education but also in their careers and personal lives. When incorporated into a first-year seminar class, yoga and meditation can offer students healthy stress relief in order to successfully pursue their academic goals, in addition to offering lifelong stress management.

Superconducting qubits are a leading system for realizing large-scale quantum processors, but overall gate fidelities suffer from coherence times limited by microwave dielectric loss. Recently discovered tantalum-based qubits exhibit record lifetimes exceeding 0.3 ms. Here, we perform systematic, detailed measurements of superconducting tantalum resonators in order to disentangle sources of loss that limit state-of-the-art tantalum devices. By studying the dependence of loss on temperature, microwave photon number, and device geometry, we quantify materials-related losses and observe that the losses are dominated by several types of saturable two-level systems (TLSs), with evidence that both surface and bulk related TLSs contribute to loss. Moreover, we show that surface TLSs can be altered with chemical processing. With four different surface conditions, we quantitatively extract the linear absorption associated with different surface TLS sources. Finally, we quantify the impact of the chemical processing at single-photon powers, the relevant conditions for qubit device performance. In this regime, we measure resonators with internal quality factors ranging from 5 to 15×10^{6}, comparable to the best qubits reported. In these devices, the surface and bulk TLS contributions to loss are comparable, showing that systematic improvements in materials on both fronts are necessary to improve qubit coherence further.