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In June 2019, California expanded Supplemental Nutrition Assistance Program (SNAP) eligibility to Supplemental Security Income (SSI) beneficiaries for the first time. This research assesses the experience and impact of new SNAP enrollment among older adult SSI recipients, a population characterized by social and economic precarity. We conducted semi-structured, in-depth interviews with 20 SNAP participants to explore their experiences with new SNAP benefits. Following initial coding, member-check groups allowed for participants to provide feedback on preliminary data analysis. Findings demonstrate that SNAP enrollment improved participants’ access to nutritious foods of their choice, contributed to overall budgets, eased mental distress resulting from poverty, and reduced labor spent accessing food. For some participants, SNAP benefit amounts were too low to make any noticeable impact. For many participants, SNAP receipt was associated with stigma, which some considered to be a social “cost” of poverty. Increased benefit may be derived from pairing SNAP with other public benefits. Together, the impacts of and barriers to effective use of SNAP benefits gleaned from this study deepen our understanding of individual- and neighborhood-level factors driving health inequities among low-income, disabled people experiencing food insecurity and SNAP recipients.

Acute myopericarditis is primarily a pericarditic syndrome with variable myocardial involvement, as evidenced by elevated cardiac enzymes. It is a rare entity, exclusively seen in male adolescents and accounts for less than 2% of the cases of inpatient admissions for chest pain/pericarditis in the pediatric age group. The electrocardiographic changes of pericarditis include J point/ST segment elevation, which needs to be differentiated from the benign early repolarization pattern that is common in young adolescents and the subtle anterior ST segment elevation myocardial infarction. Differentiating acute myopericarditis from acute coronary syndromes can be challenging because they share the presenting triad of acute chest pain, ST segment changes, and elevated cardiac enzymes. The accurate distinction of myopericarditis from acute myocarditis or acute coronary syndrome is important because of their differences in risk for specific complications, prognosis, and treatment implications. We present a case of acute myopericarditis in an adolescent who presented with atypical precordial chest pain, accompanied by inferolateral focal electrocardiographic changes and significant elevation of cardiac enzymes. The differential diagnosis and management of myopericarditis is reviewed with a focus on electrocardiographic changes and troponin assays.

Postnatal management of infant with prenatally diagnosed fetus with Echogenic fetal lung depends on the infant’s system at the time of delivery. Infant with large lesions can present with symptomatology at birth whereas a symptomatic infant with normal X-ray requires CT scan or more advance MRI studies between 4-6 weeks prior to discharge from birth facility.

Probabilistic text data modeling is usually considered with Bernoulli or multinomial event models. The main problem of text mining is the large amount of zero account in the matrix representation. Recently a document visualization technique incorporating the Zero Inflated Poisson model in the Generative Topographic Mapping algorithm has been proposed. This probabilistic model can be applied as a text document visualization tool. In this work, an algorithm for automatically extracting the clusters in the visualization results is presented. The combination of visualization-cluster extraction algorithms allows to obtain and evaluate document collections. Several results are presented for 20-Newsgroups and Reuters data.

• Objective. —To study the epidemiologic and clinical features of infection withMycobacterium tuberculosisin human immunodeficiency virus (HIV)–infected children and their families. Patients and Clinical Setting. —Sixty families of children with HIV infection, children of HIV indeterminate status, and seroreverters underwent follow-up in a comprehensive multidisciplinary program for children and families. Methods. —Infection withM tuberculosiswas diagnosed based on a positive Mantoux test result or a positive culture. Results. —Mycobacterium tuberculosisinfection was diagnosed in seven children (three infected with HIV, three seroreverters, and one uninfected sibling of an infected child) from four families (6%). All infections were detected in the period from March 1990 through January 1992. Six of seven children had a history of exposure toM tuberculosisin an HIV-infected adult (parent) who was an intravenous drug user, homeless, and/or noncompliant with the medical regimen. All HIV-infected children and one seroreverter had pulmonary tuberculosis. One child died of complications of tuberculosis and HIV infection. TheM tuberculosisisolated from this child was resistant to isoniazid, rifampin, and streptomycin sulfate. Conclusions. —Tuberculosis is a growing problem among inner-city children born to HIV-infected parents. Children infected with HIV in this study had symptomatic and severe disease with tuberculosis, which reflected the drug susceptibility pattern ofM tuberculosisseen in our community. (AJDC. 1993;147:320-324)

During a 6-year period, 14 consecutive children with penetrating craniocerebral gunshot wounds (GSW) were studied. Eleven patients were comatose on admission. Five had an admission Glasgow Coma Scale (GCS) score of 4 or less and developed clinical signs of brain death within 12 hours despite maximum therapeutic efforts. The remaining six patients, all of whom had three or more of the previously described unfavorable prognostic features, were aggressively managed with prophylaxis and treatment of intracranial hypertension. Intracranial pressure (ICP) was controlled with mechanical hyperventilation, mannitol osmotherapy, pentobarbital, and surgical decompression. Substantial intracranial hypertension occurred for up to 10 days after admission. There were four survivors. Neurobehavioral and intellectual functions were evaluated over a period of 1 to 2 years. Although serious cognitive deficits were noted, all survivors had sufficient functional recovery to warrant aggressive cardiopulmonary resuscitation and measures to control ICP in the management of comatose victims of craniocerebral GSW.