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Parental input is considered a key predictor of language achievement during the first years of life, yet relatively few studies have assessed its effects on longer-term outcomes. We assess the effects of parental quantity of speech, use of parentese (the acoustically exaggerated, clear, and higher-pitched speech), and turn-taking in infancy, on child language at 5 years. Using a longitudinal dataset of daylong LENA recordings collected with the same group of English-speaking infants (N=44) at 6, 10, 14, 18, 24 months and then again at 5 years, we demonstrate that parents’ consistent (defined as stable and high) use of parentese in infancy was a potent predictor of lexical diversity, mean length of utterance, and frequency of conversational turn-taking between children and adults at Kindergarten entry. Together, these findings highlight the potential importance of a high-quality language learning environment in infancy for success at the start of formal schooling.

We study systematics associated with estimating simple stellar population (SSP) parameters -- age, metallicity [M/H], $\alpha$-enhancement [$\alpha$/Fe] and IMF shape -- and associated $M_*/L$ gradients, of elliptical slow rotators (E-SRs), fast rotators (E-FRs) and S0s from stacked spectra of galaxies in the MaNGA survey. These systematics arise from (i) how one normalizes the spectra when stacking; (ii) having to subtract emission before estimating absorption line strengths; (iii) the decision to fit the whole spectrum or just a few absorption lines; (iv) SSP model differences (e.g. isochrones, enrichment, IMF). The MILES+Padova SSP models, fit to the H$_\beta$, $\langle$Fe$\rangle$, TiO$_{\rm 2SDSS}$ and [MgFe] Lick indices in the stacks, indicate that out to the half-light radius $R_e$: (a) ages are younger and [$\alpha$/Fe] values are lower in the central regions but the opposite is true of [M/H]; (b) the IMF is more bottom-heavy in the center, but is close to Kroupa beyond about $R_e/2$; (c) this makes $M_*/L$ about $2\times$ larger in the central regions than beyond $R_e/2$. While the models of Conroy et al. (2018) return similar [M/H] and [$\alpha$/Fe] profiles, the age and (hence) $M_*/L$ profiles can differ significantly even for solar abundances and a Kroupa IMF; different responses to non-solar abundances and IMF parametrization further compound these differences. There are clear (model independent) differences between E-SRs, E-FRs and S0s: younger ages and less enhanced [$\alpha$/Fe] values suggest that E-FRs and S0s are not SSPs, but relaxing this assumption is unlikely to change their inferred $M_*/L$ gradients significantly., Comment: 22 pages, 23 figures, accepted for publication in MNRAS

Constraints on cosmological parameters are often distilled from sky surveys by fitting templates to summary statistics of the data that are motivated by a fiducial cosmological model. However, recent work has shown how to estimate the distance scale using templates that are more generic: the basis functions used are not explicitly tied to any one cosmological model. We describe a Bayesian framework for (i) determining how many basis functions to use and (ii) comparing one basis set with another. Our formulation provides intuition into how (a) one's degree of belief in different basis sets, (b) the fact that the choice of priors depends on basis set, and (c) the data set itself, together determine the derived constraints. We illustrate our framework using measurements in simulated datasets before applying it to real data., 10 pages, 7 figures; v2: minor clarifications, fixed some typos, accepted in MNRAS

In general relativity (GR), the internal dynamics of a self-gravitating system under free-fall in an external gravitational field should not depend on the external field strength. Recent work has claimed a statistical detection of an `external field effect' (EFE) using galaxy rotation curve data. We show that large uncertainties in rotation curve analyses and inaccuracies in published simulation-based external field estimates compromise the significance of the claimed EFE detection. We further show analytically that a qualitatively similar statistical signal is, in fact, expected in a $\Lambda$-cold dark matter ($\Lambda$CDM) universe without any violation of the strong equivalence principle. Rather, such a signal arises simply because of the inherent correlations between galaxy clustering strength and intrinsic galaxy properties. We explicitly demonstrate the effect in a baryonified mock catalog of a $\Lambda$CDM universe. Although the detection of an EFE-like signal is not, by itself, evidence for physics beyond GR, our work shows that the $\textit{sign}$ of the EFE-like correlation between the external field strength and the shape of the radial acceleration relation can be used to probe new physics: e.g., in MOND, the predicted sign is opposite to that in our $\Lambda$CDM mocks., Comment: 11 pages, 6 figures; v2: minor changes and added discussion, accepted in MNRAS

Purpose: To evaluate the density of the central corneal endothelial cell before and after a small incision cataract surgery with posterior chamber intraocular lens implantation and also determine the association between endothelial cell loss and post-operative visual acuity. Methods: A total of 205 eyes of 205 patients undergoing SICS were included in surgery. Patients underwent complete ophthalmic evaluation and endothelial cell density was measured with TOPCON SP1P specular microscope preoperatively and postoperatively day 7 and at 1 month. Results: The majority of the patients were in the age group 61-70 years. The mean endothelial cell count pre operatively was 2689.65 cells/mm2, post operatively on 7th day 2433.27 cells/mm2 and at 1 month was 2367.01 cells/ mm2. At 1 month postoperative mean visual acuity between 20/30-20/70. Conclusion: There is 11.21% endothelial cell count after SICS, which is comparable with other modes of cataract surgery like extracapsular cataract extraction and phacoemulsification.

Daily antiretroviral pre-exposure prophylaxis (PrEP) is a safe and effective method of preventing HIV. Clinicians' assumptions, biases, and judgments may impede access to PrEP. Specifically, concern that patients will engage in more condomless sex ("risk compensation") has been cited by clinicians as a reason for not prescribing PrEP.In this experimental study among medical students, we systematically varied race (White or Black) and condom-use behaviors (continued-use, planned-discontinuation, or continued-nonuse) of a fictional patient (all men with multiple male sex partners). Participants indicated the patients' assumed adherence to PrEP, patients' overall HIV risk, and willingness to prescribe PrEP. Participants completed an implicit association test to detect implicit racism and measures of heterosexism and attitudes toward nonmonogamy, which were examined as moderators of patient race and condom-use effects on participants' assumptions and ultimate willingness to prescribe PrEP.Participants ( N = 600) were most willing to prescribe PrEP to the continued-nonuse patient and least willing to prescribe to the planned-discontinuation patient. No differences were identified based on patient race. The continued-nonuse (vs. continued-use) patient was perceived as less likely to adhere to PrEP, which was associated with lower willingness to prescribe. Negative attitudes toward nonmonogamy exacerbated this effect. No effects of implicit racism or explicit heterosexism were identified.Participants were least willing to prescribe PrEP to patients who planned to discontinue condom use. Patients seeking PrEP are exhibiting agency over their sexual health, and clinicians should fulfill their role in ensuring access to this primary preventative therapy. Training and curricular reform regarding PrEP are needed.

Introduction: Serological surveys estimating the cumulative incidence of the disease are powerful and effective tools for monitoring the epidemic and in determining the immunity status. Objectives: To compare the percentage sero-positivity for IgG antibodies against SARS-CoV2 at two different time period in the same population to understand the pandemic and predict about the immunity status of the population. Methods: As a part of Covid19 pandemic management, two separate population based sero-survey within a gap of 1½ months were carried in Ahmedabad city to scientifically document the progress of the Covid19 pandemic. Various demographic factors and other parameters from both the survey were compared with seropositivity for valid and precise estimation of disease situation as well as immunity status of the population. Results: The study documents an increase in seropositivity by 5.32% (from 17.92% to 23.24%). The seropositivity shows increasing trend with increase in the age group and the seropositivity is significantly higher among females. Overall higher seropositivity against the reported cases in the first sero-survey and the narrow increase in the seropositivity during the subsequent sero-survey inspite of high number of cases may indicate temporary status of the antibodies. This may also be due to the difference in the level of stigma, health care service delivery, service utilization and related field level situation affecting the asymptomatic/unreported case positivity. Conclusion: The result of seropositivity comparison indicates the scopes for further research to confirm and generate greater evidences regarding the factors affecting seropositivity.

Background A recently proposed risk factor for periprosthetic joint infections (PJI) in men is benign prostatic hyperplasia (BPH). The objective was to explore the association of BPH on 1) 90-day complications, 2) length of stay (LOS), 3) readmission rates, and 4) healthcare expenditures following total shoulder arthroplasty (TSA). Methods A retrospective query was performed using a nationwide claims database from January 2005 to March 2014 for male patients undergoing primary TSA. The study cohort included 5067 patients with BPH while 50,720 patients served as the comparison cohort. Logistic regression determined the association of BPH on complications and readmissions. A p value less than 0.001 was significant. Results Patients with BPH had higher incidence and odds (36.8 vs. 6.2%; OR: 2.73, p Conclusions BPH is associated with increased complications and healthcare expenditures following total shoulder arthroplasty. The investigation can be used to educate BPH patients of the possible adverse events which may occur within ninety-days following primary TSA for the treatment of glenohumeral osteoarthritis.

Background: Although survival has improved dramatically for most adolescents and young adults (AYA; 15–39 years old) with cancer, it remains poor for those presenting with metastatic disease. To better characterize this subset, we conducted a landscape survival comparison with older adults (40–79 years). Methods: Using Surveillance, Epidemiology, and End Results Program data from 2000 to 2016, we examined incident cases of poor-prognosis metastatic cancers (5-year survival < 50%) among AYAs (n = 11,518) and older adults (n = 345,681) and compared cause-specific survival by sociodemographic characteristics (race/ethnicity, sex, and socioeconomic status). Adjusted HRs (aHR) for death from metastatic disease [95% confidence intervals (95% CI)] were compared between AYAs and older adults (Pint). Results: AYAs had significantly better survival than older adults for every cancer site except kidney, where it was equivalent (range of aHRs = 0.91; 95% CI, 0.82–1.02 for kidney cancer to aHR = 0.33; 95% CI, 0.26–0.42 for rhabdomyosarcoma). Compared with their older adult counterparts, greater survival disparities existed for AYAs who were non-Hispanic Black with uterine cancer (aHR = 2.20; 95% CI, 1.25–3.86 versus aHR = 1.40; 95% CI, 1.28–1.54; Pint = 0.049) and kidney cancer (aHR = 1.51; 95% CI, 1.15–1.98 versus aHR = 1.10; 95% CI, 1.03–1.17; Pint = 0.04); non-Hispanic Asian/Pacific Islanders with ovarian cancer (aHR = 1.47; 95% CI, 1.12–1.93 versus aHR = 0.89; 95% CI, 0.84–0.95; Pint Conclusions: AYAs diagnosed with these metastatic cancers have better survival than older adults, but outcomes remain dismal. Impact: Overcoming the impact of metastasis in these cancers is necessary for continuing progress in AYA oncology. Sociodemographic disparities affecting AYAs within kidney, uterine, ovarian, and colorectal cancer could indicate plausible effects of biology, environment, and/or access and should be explored.

Objective: To estimate Covid19 seropositivity among contacts of cases and to compare the seropositivity among different types of contact for assessing the differential risk & transmission dynamics.Material and Methods: A large-scale population-based serosurvey was carried out among the general population of Ahmedabad during the second half of October 2020. The contacts of cases were selected based on the population proportion and enrolled as an additional category. The seropositivity among the contacts was estimated using the enzyme-linked immunosorbent assay and compared with different types of contact and available demographic factors.Results: As of October 2020, the seropositivity against Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV2) among contacts of cases in Ahmedabad was 26.0% [95% confidence interval 24.2–28.0]. The seropositivity among family contacts was significantly higher (28.8%) compared to other contacts (24.4%) (Z=2.19, p-value=0.028). This trend was seen across all age groups and both sexes. The seropositivity was higher among females (27.7%) compared to males (24.5%) but the difference was statistically not significant (Z=1.64, p-value=0.101). In terms of age groups, the positivity had an increasing trend up to 60 years but declined after that.Conclusion: A seropositivity of 26.0% among contacts indicates that a large proportion of contacts demonstrated Immunoglobulin-G antibodies. This highlights asymptomatic transmission and/or low sensitivity of the diagnostic tests. The current strategy for contact tracing and testing among contacts is justified based on the significantly higher seropositivity among family contacts.

Hirayama disease is a rare neurological condition and is characterized by a sporadic juvenile muscular atrophy of distal upper extremity in young males. The disease is more prevalent in Japan and other Asian countries, though a few cases have been reported in Western countries as well. It manifests as a self-limiting, gradually progressive atrophic weakness of forearm and hand. The anterior displacement of posterior dura during neck flexion leading to cervical cord atrophy has been hypothesized. We discuss a case of a 21-year-old male patient with progressive distal upper extremity weakness, diagnosed with Hirayama disease, and literature review for the same. Keywords: Hirayama Disease, Juvenile muscular atrophy, Monomelic amyotrophy

In analytical models of structure formation, protohalos are routinely assumed to be peaks of the smoothed initial density field, with the smoothing filter being spherically symmetric. This works reasonably well for identifying a protohalo's center of mass, but not its shape. To provide a more realistic description of protohalo boundaries, one must go beyond the spherical picture. We suggest that this can be done by looking for regions of fixed volume, but arbitrary shape, that minimize the enclosed energy. Such regions are surrounded by surfaces over which (a slightly modified version of) the gravitational potential is constant. We show that these equipotential surfaces provide an excellent description of protohalo shapes, orientations and associated torques., 5 pages, 6 figures

Background The COVID-19 pandemic has exacerbated health inequities in the United States. People with unhealthy opioid use (UOU) may face disproportionate challenges with COVID-19 precautions, and the pandemic has disrupted access to opioids and UOU treatments. UOU impairs the immunological, cardiovascular, pulmonary, renal, and neurological systems and may increase severity of outcomes for COVID-19. Objective We applied machine learning techniques to explore clinical presentations of hospitalized patients with UOU and COVID-19 and to test the association between UOU and COVID-19 disease severity. Methods This retrospective, cross-sectional cohort study was conducted based on data from 4110 electronic health record patient encounters at an academic health center in Chicago between January 1, 2020, and December 31, 2020. The inclusion criterion was an unplanned admission of a patient aged ≥18 years; encounters were counted as COVID-19-positive if there was a positive test for COVID-19 or 2 COVID-19 International Classification of Disease, Tenth Revision codes. Using a predefined cutoff with optimal sensitivity and specificity to identify UOU, we ran a machine learning UOU classifier on the data for patients with COVID-19 to estimate the subcohort of patients with UOU. Topic modeling was used to explore and compare the clinical presentations documented for 2 subgroups: encounters with UOU and COVID-19 and those with no UOU and COVID-19. Mixed effects logistic regression accounted for multiple encounters for some patients and tested the association between UOU and COVID-19 outcome severity. Severity was measured with 3 utilization metrics: low-severity unplanned admission, medium-severity unplanned admission and receiving mechanical ventilation, and high-severity unplanned admission with in-hospital death. All models controlled for age, sex, race/ethnicity, insurance status, and BMI. Results Topic modeling yielded 10 topics per subgroup and highlighted unique comorbidities associated with UOU and COVID-19 (eg, HIV) and no UOU and COVID-19 (eg, diabetes). In the regression analysis, each incremental increase in the classifier’s predicted probability of UOU was associated with 1.16 higher odds of COVID-19 outcome severity (odds ratio 1.16, 95% CI 1.04-1.29; P=.009). Conclusions Among patients hospitalized with COVID-19, UOU is an independent risk factor associated with greater outcome severity, including in-hospital death. Social determinants of health and opioid-related overdose are unique comorbidities in the clinical presentation of the UOU patient subgroup. Additional research is needed on the role of COVID-19 therapeutics and inpatient management of acute COVID-19 pneumonia for patients with UOU. Further research is needed to test associations between expanded evidence-based harm reduction strategies for UOU and vaccination rates, hospitalizations, and risks for overdose and death among people with UOU and COVID-19. Machine learning techniques may offer more exhaustive means for cohort discovery and a novel mixed methods approach to population health.

We study the radial acceleration relation (RAR) between the total (atot) and baryonic (abary) centripetal acceleration profiles of central galaxies in the cold dark matter (CDM) paradigm. We analytically show that the RAR is intimately connected with the physics of the quasi-adiabatic relaxation of dark matter in the presence of baryons in deep potential wells. This cleanly demonstrates how the mean RAR and its scatter emerge in the low-acceleration regime ($10^{-12}{\rm \, m\, s}^{-2}\lesssim a_{\rm bary}\lesssim 10^{-10}{\rm \, m\, s}^{-2}$) from an interplay between baryonic feedback processes and the distribution of CDM in dark haloes. Our framework allows us to go further and study both higher and lower accelerations in detail, using analytical approximations and a realistic mock catalogue of ${\sim}342\, 000$ low-redshift central galaxies with Mr ≤ −19. We show that, while the RAR in the baryon-dominated high-acceleration regime ($a_{\rm bary}\gtrsim 10^{-10}{\rm \, m\, s}^{-2}$) is very sensitive to details of the relaxation physics, a simple ‘baryonification’ prescription matching the relaxation results of hydrodynamical CDM simulations is remarkably successful in reproducing the observed RAR without any tuning. And in the (currently unobserved) ultra-low-acceleration regime ($a_{\rm bary}\lesssim 10^{-12}{\rm \, m\, s}^{-2}$), the RAR is sensitive to the abundance of diffuse gas in the halo outskirts, with our default model predicting a distinctive break from a simple power-law-like relation for H i-deficient, diffuse gas-rich centrals. Our mocks also show that the RAR provides more robust, testable predictions of the ΛCDM paradigm at galactic scales, with implications for alternative gravity theories than the baryonic Tully–Fisher relation.

Having metastatic disease at diagnosis poses the great risk of death among AYAs with cancer from all sociodemographic subgroups. This “landscape” study utilized United States Surveillance, Epidemiology, and End Results Program data from 2000–2016 to identify subgroups of AYAs at highest risk for presenting with metastases across twelve cancer sites having a poor-prognosis (5-year survival

BACKGROUND Post-traumatic cerebrospinal fluid (CSF) leaks of the anterior skull base may arise after traumatic brain injury (TBI). Onset of CSF rhinorrhea may be delayed after TBI and without prompt treatment may result in debilitating consequences. Operative repair of CSF leaks caused by anterior skull base fractures may be performed via open craniotomy or endoscopic endonasal approaches (EEAs). The authors’ objective was to review their institutional experience after EEA for repair of TBI-related anterior skull base defects and CSF leaks. OBSERVATIONS A retrospective review of prospectively collected data from a major level 1 trauma center was performed to identify patients with TBI who developed CSF rhinorrhea. Persistent or refractory post-traumatic CSF leaks and anterior skull base defects were repaired via EEA in four patients. Intrathecal fluorescein was administered before EEA in three patients (75%) to help aid identification of the fistula site(s). CSF leaks were eventually repaired in all patients, though one reoperation was required. During a mean follow-up of 8.75 months, there were no instances of recurrent CSF leakage. LESSONS Refractory, traumatic CSF leaks may be effectively repaired via EEA using a multilayer approach and nasoseptal flap reconstruction, thereby potentially obviating the need for additional craniotomy in the post-TBI setting.

Background: Frailty, quantified using the 5-item modified frailty index (mFI-5), has been shown to predict adverse outcomes in orthopaedic surgery. The utility in total elbow arthroplasty (TEA) patients is unclear. We evaluated if increasing frailty would correlate with worse postoperative outcomes. Methods: A retrospective assessment of patients in the American College of Surgeons National Surgery Quality Improvement Program undergoing primary TEA was performed. The mFI-5 was calculated by assigning 1 point for each comorbidity (diabetes, hypertension, congestive heart failure, chronic obstructive pulmonary disease, and functionally dependent health status). Poisson regression was used to evaluate mFI-5 scores on complications, length of stay (LOS), and adverse discharge. A significance threshold was at P < .05. Results: In total, 609 patients were included; 34.5% (n = 210) were not frail (mFI = 0), 44.0% (n = 268) were slightly frail (mFI = 1), and 21.5% (n = 131) were frail (mFI ≥ 2). As mFI score increased from 0 to ≥ 2, the following rates increased: any complication (9.0%-19.8%), major complication (11.0%-20.6%), cardiac complication (0.0%-2.3%), hematologic complication (3.3%-9.2%), adverse discharge (2.9%-22.9%), and LOS from 2.08 to 3.97 days (all P < .048). Following adjustment, Poisson regression demonstrated patients with a mFI ≥ 2 had increased risk of major complication (risk ratio [RR]: 2.13; P = .029), any complication (RR: 2.49; P = .032), Clavien-Dindo IV complication (RR: 5.53; P = .041), and adverse discharge (RR: 5.72; P < .001). Conclusions: Frailty is not only associated with longer hospitalizations, but more major complications and non-home discharge. The mFI-5 is a useful risk stratification that may assist in decision-making for TEA.

Background: Assessing population based seroprevalence can help in monitor the pandemic, and suggest appropriate corrective public health measures. Aims and Objectives: To study seroprevalence of IgG antibodies against SARS-CoV2 to understand the pandemic status and deriving valid conclusions for guiding the public health measures for managing the covid19 pandemic. Materials and Methods: A serosurveillance study was carried out using population based stratified sampling for the general population of Ahmedabad city. Seroprevalence for Cases, Contacts and Health Care Workers (HCWs) was also estimated as separate additional categories. The seroprevalence was compared with various demographic factors for valid and precise predictions regarding the immunity status of the population. Results: As on October 2020, the seroprevalence for IgG antibodies against SARS-CoV2 in the general population of Ahmedabad is 24.20% (95% Confidence Interval 23.57%–24.85%) The sero-positivity has increasing trend with age and is higher among females (24.83%) than males (23.72%) but is statistically not significant. The zone wise positivity ranged from 18.70% to 33.52%. The seropositivity among HCWs, contacts and cases are 20.84%, 26.05% and 54.51% respectively and it closely correlate with the risk. Conclusion: As on October 2020, general population demonstrate a seropositivity of 24.20%. The seropositivity among various groups is according to the risk of contracting the disease. Results also indicate the possibility of undetectable level or disappearing IgG during the post-covid period. Results also indicate that the preventive measures must be strongly followed for continued control of the pandemic situation till an effective vaccine is provided to the people at large.

Large-scale sky surveys require companion large volume simulated mock catalogs. To ensure precision cosmology studies are unbiased, the correlations in these mocks between galaxy properties and their large-scale environments must be realistic. Since galaxies are embedded in dark matter halos, an important first step is to include such correlations -- sometimes called assembly bias -- for dark matter halos. However, galaxy properties correlate with smaller scale physics in halos which large simulations struggle to resolve. We describe an algorithm which addresses and largely mitigates this problem. Our algorithm exploits the fact that halo assembly bias is unchanged as long as correlations between halo property $c$ and the intermediate-scale tidal environment $\alpha$ are preserved. Therefore, knowledge of $\alpha$ is sufficient to assign small-scale, otherwise unresolved properties to a halo in a way which preserves its large-scale assembly bias accurately. We demonstrate this explicitly for halo internal properties like formation history (concentration $c_{\rm 200b}$), shape $c/a$, dynamics $c_{v}/a_{v}$, velocity anisotropy $\beta$ and angular momentum (spin $\lambda$). Our algorithm increases a simulation's reach in halo mass and number density by an order of magnitude, with improvements in the bias signal as large as 45% for 30-particle halos, thus significantly reducing the cost of mocks for future weak lensing and redshift space distortion studies., Comment: 13 pages, 10 figures, minor revisions, accepted in MNRAS