Demographic differences in access to health/therapeutic services over first year of the pandemic: a SPARK COVID-19 impact survey analysis.

Introduction: This analysis examined changes in services received and service recovery one-year post-pandemic compared to pre-pandemic levels in children with ASD aged between 19 months and 17 years in various subgroups based on factors such as age, income, race/ethnicity, geographic location, and sex. Methods: An online, parent report survey was completed by the parents of children with ASD in the SPARK study cohort (N = 6,393). Descriptive statistics, chi-square analyses, and Spearman correlations were performed to study associations between various factors and service access, pre-pandemic and one-year, post-pandemic. Results: One year after pandemic, the lag in service recovery in children with ASD was greatest for PT/OT services followed by SLT. ABA services only recovered in half of the subgroups. In contrast, SES fully recovered and MH and MED services superseded pre-pandemic levels. Across majority of the timepoints, younger children received more SLT, PT/OT, and ABA services whereas older children received more SES, MH, and MED services. Higher income families accessed more SES, SLT, and ABA whereas lower income families received more MH services. White families received less SLT compared to non-white families. Hispanic families received more SLT services compared to non-Hispanic families. Compared to rural families, urban families received more ABA services at baseline which also recovered one year after the pandemic. Certain counterintuitive findings may be attributed to home/remote schooling leading to reduced access to related services. Conclusions: Future research and policy changes are needed to address the American healthcare vulnerabilities when serving children with ASD by enhancing the diversity of healthcare formats for continued service access during future pandemics and other similar crises.

Fast generation of Schrödinger cat states using a Kerr-tunable superconducting resonator.

Schrödinger cat states, quantum superpositions of macroscopically distinct classical states, are an important resource for quantum communication, quantum metrology and quantum computation. Especially, cat states in a phase space protected against phase-flip errors can be used as a logical qubit. However, cat states, normally generated in three-dimensional cavities and/or strong multi-photon drives, are facing the challenges of scalability and controllability. Here, we present a strategy to generate and preserve cat states in a coplanar superconducting circuit by the fast modulation of Kerr nonlinearity. At the Kerr-free work point, our cat states are passively preserved due to the vanishing Kerr effect. We are able to prepare a 2-component cat state in our chip-based device with a fidelity reaching 89.1% under a 96 ns gate time. Our scheme shows an excellent route to constructing a chip-based bosonic quantum processor.

Prevalence of eviction, home foreclosure, and homelessness among low-income US veterans: the National Veteran Homeless and Other Poverty Experiences study.

OBJECTIVES: Housing stability is essential for health and social well-being, and the United States is focused on preventing homelessness among veterans, so this study examined the prevalence of different events related to housing instability among low-income US veterans. STUDY DESIGN: This was a nationally representative survey. METHODS: Using a sample of 1004 low-income veterans in 2021, this study examined the lifetime prevalence and characteristics associated with eviction, home foreclosure, and homelessness among low-income US veterans. RESULTS: In the total sample, 10.9% reported a lifetime history of eviction, 8.0% reported a lifetime history of home foreclosure, and 19.9% reported a lifetime history of homelessness. Among those with a history of homelessness, 39.2% also reported a history of eviction, and 13.9% reported a history of home foreclosure. Hierarchical logistic regression analyses found that for eviction, sociodemographic characteristics (e.g. being Hispanic, having private insurance, and being from the Northeast was associated with lower risk of eviction) together explained 26% of the variance, and clinical characteristics explained an incremental 12% additional variance. For homelessness, sociodemographic characteristics explained 18% of the variance, and clinical characteristics explained an incremental 20% (e.g. diagnosis of schizophrenia or bipolar disorder, any history of suicide attempt, and lower physical health scores were associated with higher risk of homelessness). For home foreclosure, sociodemographic, clinical, and psychosocial variables together only explained 14% of the variance. CONCLUSION: Evictions, home foreclosures, and homelessness are discrete events and occur at relatively high rates among low-income veterans. In addition, homelessness was more associated with biosocial dysfunction, whereas eviction was more closely associated with socio-economic vulnerability, which may inform intervention efforts for both events.

Mental health and suicidal ideation in US military veterans with histories of COVID-19 infection.

INTRODUCTION: There have been reports of increased prevalence in psychiatric conditions in non-veteran survivors of COVID-19. To date, however, no known study has examined the prevalence, risk and protective factors of psychiatric conditions among US military veterans who survived COVID-19. METHODS: Data were analysed from the 2019 to 2020 National Health and Resilience in Veterans Study, which surveyed a nationally representative, prospective cohort of 3078 US veterans. Prepandemic and 1-year peripandemic risk and protective factors associated with positive screens for peripandemic internalising (major depressive, generalised anxiety and/or posttraumatic stress disorders) and externalising psychiatric disorders (alcohol and/or drug use disorders) and suicidal ideation were examined using bivariate and multivariate logistic regression analyses. RESULTS: A total of 233 veterans (8.6%) reported having been infected with COVID-19. Relative to veterans who were not infected, veterans who were infected were more likely to screen positive for internalising disorders (20.5% vs 13.9%, p=0.005), externalising disorders (23.2% vs 14.8%, p=0.001) and current suicidal ideation (12.0% vs 7.6%, p=0.015) at peripandemic. Multivariable analyses revealed that greater prepandemic psychiatric symptom severity and COVID-related stressors were the strongest independent predictors of peripandemic internalising disorders, while prepandemic trauma burden was protective. Prepandemic suicidal ideation, greater loneliness and lower household income were the strongest independent predictors of peripandemic suicidal ideation, whereas prepandemic community integration was protective. CONCLUSION: Psychiatric symptoms and suicidal ideation are prevalent in veterans who have survived COVID-19. Veterans with greater prepandemic psychiatric and substance use problems, COVID-related stressors and fewer psychosocial resources may be at increased risk of these outcomes.

Changing demography of homeless adult populations.

As the demographic characteristics of the US population have changed over the past decade, the characteristics of different homeless populations have changed as well. This study tracked changes in demographic characteristics of homeless adult, veteran, and healthcare service user populations against general adult and veteran populations from 2007-2017. The results showed that changing demographics of homeless populations largely reflected broader trends in the general population, and attention is needed on the clinical needs of aging homeless populations. There may be some unique changes in the demography of some homeless populations, such as younger homeless veterans seeking healthcare services.

Soft granular particles sheared at a controlled volume: rate-dependent dynamics and the solid-fluid transition.

We study the responses of fluid-immersed soft hydrogel spheres that are sheared under controlled volume fractions. Slippery, deformable particles along with the density-matched interstitial fluid are sandwiched between two opposing rough cones, allowing studies for a wide range of volume fraction φ both above and below the jamming of granular suspension. We utilize sudden cessations of shearing, accompanied by refraction-matched internal imaging, to supplement the conventional flow-curve measurements. At sufficiently high volume fractions, the settling of particles after the cessations exhibits a continuous yet distinct transition over the change of the shear rate. Such changes back out the qualitative difference in the state of flowing prior to the cessations: the quasi-static yielding of a tightly packed network, as opposed to the rapid sliding of particles mediated by the interstitial fluid whose dynamics depends on the driving rate. In addition, we determine the solid-fluid transition using two independent methods: the extrapolation of stress residues and the estimated yield stress from high values of φ, and the settling of particles upon shear cessations as φ goes across the transition. We also verify the power law on values of characteristic stress with respect to the distance from jamming φ - φc, with an exponent close to 2. These results demonstrate a multitude of relaxation timescales behind the dynamics of soft particles, and raise questions on how we extend the existing paradigms of the flow of a densely packed system when the softness is actively involved.

Nationwide study of the impact of D2 lymphadenectomy on survival after gastric cancer surgery.

BACKGROUND: Gastrectomy including D2 lymphadenectomy is regarded as the standard curative treatment for advanced gastric cancer in Asia. This procedure has also been adopted gradually in the West, despite lack of support from RCTs. This study sought to investigate any advantage for long-term survival following D2 lymphadenectomy in routine gastric cancer surgery in a Western nationwide population-based cohort. METHODS: All patients who had a gastrectomy for cancer in Sweden in 2006-2017 were included in the study. Prospectively determined data items were retrieved from the National Register of Oesophageal and Gastric Cancer. Extent of lymphadenectomy was categorized as D1+/D2 or the less extensive D0/D1 according to the Japanese Gastric Cancer Association classification. Overall survival was analysed and, in addition, a variety of possible confounders were introduced into the Cox proportional hazards regression model. RESULTS: A total of 1677 patients underwent gastrectomy, of whom 471 (28·1 per cent) were classified as having a D1+/D2 and 1206 (71·9 per cent) a D0/D1 procedure. D1+/D2 lymphadenectomy was not associated with higher 30- or 90-day postoperative mortality. Median overall survival for D1+/D2 lymphadenectomy was 41·5 months with a 5-year survival rate of 43·7 per cent, compared with 38·5 months and 38·5 per cent respectively for D0/D1 (P = 0·116). After adjustment for confounders, in multivariable analysis survival was significantly higher after D1+/D2 than following D0/D1 lymphadenectomy (hazard ratio 0·81, 95 per cent c.i. 0·68 to 0·95; P = 0·012). CONCLUSION: This national registry study showed that long-term survival after gastric cancer surgery was improved after gastrectomy involving D1+/D2 lymphadenectomy compared with D0/D1 dissection.

ANTECEDENTES: En Asia, la gastrectomía con linfadenectomía D2 asociada se considera el tratamiento curativo estándar para el cáncer gástrico avanzado. Este procedimiento se ha adoptado gradualmente también en el mundo occidental a pesar de la falta de apoyo de los ensayos clínicos aleatorizados. En este estudio hemos tratado de investigar cualquier ventaja sobre la supervivencia a largo plazo tras la linfadenectomía D2 de rutina en una cohorte de base poblacional de cirugía del cáncer gástrico en un país occidental. MÉTODOS: Se incluyeron todos los pacientes que fueron sometidos a gastrectomía por cáncer en Suecia desde 2006-2017. Se recuperaron datos registrados prospectivamente del Registro Nacional de Cáncer de Esófago y Estómago. La extensión de la linfadenectomía se categorizó en D1+/D2 o cuando fue menos amplia en D0/D1 de acuerdo con la clasificación de la Japanese Gastric Cancer Association. Se analizó la supervivencia global y, además, se introdujeron diversos factores de confusión en un modelo de regresión de riesgos proporcional de Cox. RESULTADOS: Un total de 1.677 pacientes fueron sometidos a gastrectomía, de los cuales 471 (28%) fueron clasificados como D1+/D2 y 1.206 (72%) como D0/D1. La linfadenectomía D1+/D2 no se asoció con una mayor mortalidad postoperatoria a los 30 y 90 días. La mediana de la supervivencia global para la linfadenectomía D1+/D2 fue de 41,5 meses con una tasa de supervivencia a los 5 años de 44% comparado con 38,5 meses y 39%, respectivamente, para D0/D1 (P = 0,116). Después de ajustar por los factores de confusión en el análisis multivariable, la supervivencia fue significativamente más alta en la linfadenectomía D1+/D2 comparada con D0/D1 (cociente de riesgos instantáneos, hazard ratio, HR 0,81 (i.c. del 95% 0,68-0,95), P = 0,012)). CONCLUSIÓN: Este estudio del registro nacional mostró que la supervivencia a largo plazo tras cirugía del cáncer gástrico mejoró después de una gastrectomía que incluya linfadenectomía D1+/D2 en comparación con la disección D0/D1.

The Making of a Flight Feather: Bio-architectural Principles and Adaptation.

The evolution of flight in feathered dinosaurs and early birds over millions of years required flight feathers whose architecture features hierarchical branches. While barb-based feather forms were investigated, feather shafts and vanes are understudied. Here, we take a multi-disciplinary approach to study their molecular control and bio-architectural organizations. In rachidial ridges, epidermal progenitors generate cortex and medullary keratinocytes, guided by Bmp and transforming growth factor ß (TGF-ß) signaling that convert rachides into adaptable bilayer composite beams. In barb ridges, epidermal progenitors generate cylindrical, plate-, or hooklet-shaped barbule cells that form fluffy branches or pennaceous vanes, mediated by asymmetric cell junction and keratin expression. Transcriptome analyses and functional studies show anterior-posterior Wnt2b signaling within the dermal papilla controls barbule cell fates with spatiotemporal collinearity. Quantitative bio-physical analyses of feathers from birds with different flight characteristics and feathers in Burmese amber reveal how multi-dimensional functionality can be achieved and may inspire future composite material designs. VIDEO ABSTRACT.

Homelessness among immigrants in the United States: rates, correlates, and differences compared with native-born adults.

OBJECTIVES: This study examines rates of lifetime adult homelessness among foreign-born adults in the United States and how they differ from native-born adults. STUDY DESIGN: Cross-sectional data from a nationally representative US sample were analyzed. METHODS: A sample of 29,896 native-born (weighted 84.1%) and 6404 foreign-born (weighted 16.0%) US adults participating in the National Epidemiologic Survey on Alcohol and Related Conditions-III were compared on rates of homelessness, controlling for sociodemographic characteristics, mental and substance-use disorders, health insurance, and use of welfare. RESULTS: There was no significant difference in rates of lifetime adult homelessness between foreign-born adults and native-born adults (1.0% vs 1.7%). Foreign-born participants were less likely to have various mental and substance-use disorders, less likely to receive welfare, and less likely to have any lifetime incarceration. The number of years foreign-born adults lived in the United States was significantly associated with risk for homelessness. CONCLUSIONS: These findings suggest the 'healthy immigrant effect' applies to the mental health and social functioning of US immigrants but may not necessarily apply to homelessness. Long-standing immigration procedures requiring mental health and psychosocial evaluations may contribute to selection effects.

Spreading Waves in a Farmers and Hunter-Gatherers Model of the Neolithic Transition in Europe.

The Neolithic transition began the spread of early agriculture throughout Europe through interactions between farmers and hunter-gatherers about 10,000 years ago. Archeological evidence produced by radiocarbon dating indicates that the expanding velocity of farming is roughly constant all over Europe. Theoretical understanding of such evidence has been performed from mathematical modeling viewpoint. However, the expanding velocity determined by existing modeling approaches is faster than the observed velocity. For understanding this difference, we propose a three-component reaction-diffusion system which consists of two different types of farmers (sedentary and migratory) and hunter-gatherers from the viewpoint of the influence of farming technology. Our purpose is to study the relation between the expanding velocity of farmers and the farming technology parameter (say, [Formula: see text]). In this paper, we mainly focus on the one-dimensional traveling wave solution with minimal velocity and show that the minimal velocity decreases, as [Formula: see text] increases. This can be compatible with the observed velocity when farming technology is developed. Our results suggest that the reason for the slowdown of the Neolithic transition might be related to the increase in the development of farming technology.

Hybrid rf SQUID qubit based on high kinetic inductance.

We report development and microwave characterization of rf SQUID (Superconducting QUantum Interference Device) qubits, consisting of an aluminium-based Josephson junction embedded in a superconducting loop patterned from a thin film of TiN with high kinetic inductance. Here we demonstrate that the systems can offer small physical size, high anharmonicity, and small scatter of device parameters. The work constitutes a non-tunable prototype realization of an rf SQUID qubit built on the kinetic inductance of a superconducting nanowire, proposed in Phys. Rev. Lett. 104, 027002 (2010). The hybrid devices can be utilized as tools to shed further light onto the origin of film dissipation and decoherence in phase-slip nanowire qubits, patterned entirely from disordered superconducting films.

Perampanel, an AMPA receptor antagonist: From clinical research to practice in clinical settings.

Epileptic seizures are refractory to treatment in approximately one-third of patients despite the recent introduction of many newer antiepileptic drugs (AEDs). Development of novel AEDs therefore remains a high priority. Perampanel is a first-in-class non-competitive selective AMPA receptor antagonist with a unique mechanism of action. Clinical efficacy and safety of perampanel as adjunctive treatment for focal seizures with/without secondary generalization (±SG) and primary generalized tonic-clonic (PGTC) seizures have been established in five phase 3 randomized controlled trials (RCTs), and a long-term extension study, and perampanel is approved as monotherapy for focal seizures ±SG in the USA. In patients with focal seizures ±SG, add-on perampanel resulted in median percent reduction in seizure frequency 23.3%-34.5% and ≥50% responder rate 28.5%-37.6%; in PGTC seizures, these results were 76.5% and 64.2%, respectively. Efficacy among adolescents (reduction in seizure frequency 34.8%-35.6%; ≥50% responder rate 40.9%-45.0%) and elderly people (reduction in seizure frequency 12.5%-16.9%; ≥50% responder rate 22.2%-42.9%) is similar to those in adults, and results remain comparable between Asian (reduction in seizure frequency 17.3%-38.0%) and global populations. Perampanel has been extensively studied in real-world clinical practice, with similar efficacy and safety results to the RCTs (≥50% responder rate 12.8%-75.0%; adverse events of somnolence/sedation, dizziness, ataxia, and behavioral changes). Real-world observational studies suggest that perampanel tolerability can be improved by slow titration (2 mg every 2-4 weeks), and bedtime administration can mitigate somnolence and dizziness. Counseling about the potential for behavioral changes and close monitoring are recommended.

Trajectories of posttraumatic growth among US military veterans: a 4-year nationally representative, prospective cohort study.

OBJECTIVE: This study examined the nature and determinants of predominant trajectories of posttraumatic growth (PTG) over time. METHOD: Using data from a prospective, nationally representative survey of 2718 US veterans assessed in 2011, 2013, and 2015, we used latent growth mixture modeling to identify PTG trajectories, and to examine key determinants of PTG trajectories from a comprehensive set of sociodemographic, military, health, and psychosocial variables. RESULTS: Three PTG trajectories were identified, labeled as Low and Decreasing PTG (74.0%), Consistently Moderate PTG (12.0%), and High and Increasing PTG (14.0%). Greater severity of posttraumatic stress disorder symptoms, specifically re-experiencing and avoidance symptoms, at baseline predicted Consistently Moderate and High and Increasing PTG trajectories. Compared to the Low and Decreasing PTG trajectory, the High and Increasing PTG trajectory scored higher on baseline measures of gratitude, purpose in life, Spirituality, and social support. CONCLUSION: Posttraumatic growth is a dynamic process with divergent trajectories. Developing interventions that target certain psychosocial factors may help trauma survivors maintain PTG over time.

The ability of Group A streptococcus to adhere to immortalized human skin versus throat cell lines does not reflect their predicted tissue tropism.

OBJECTIVES: To determine if emm pattern-inferred tissue tropisms of Group A streptococcus strains is reflected in their ability to adhere to immortalized human HaCat (keratinocyte) and Detroit 562 (pharyngeal) cell lines. METHODS: Human epithelial cell line monolayers were inoculated with Group A streptococcus, and the percentage of adhered bacteria after a 1-h incubation period was calculated. RESULTS: Of the 21/69 inferred-skin-tropic, and the 25/69 inferred-throat-tropic isolates no preferential adherence was observed to a particular cell line. The 23/69 strains classified as 'generalists', however, showed an overall greater ability to adhere to both cell lines. CONCLUSIONS: Predicted tissue-tropism based on emm patterns is not reflected by preferential adherence to a specific cell line, suggesting that early adhesion events may not be as important in establishing infection at a particular ecological niche than originally expected.

Relationship between bone turnover and density with teriparatide, denosumab or both in women in the DATA study.

BACKGROUND: While changes in biochemical markers of bone turnover (BTM) have been reported to predict changes in bone mineral density (BMD), the relationship between changes in BMD and BTMs with combined antiresorptive/anabolic therapy is unknown. METHODS: In the DATA study, 94 postmenopausal osteoporotic women (ages 51-91) received either teriparatide 20-mcg SC daily, denosumab 60-mg SC every 6months, or both for 2years. Pearson's correlation coefficients (R) were calculated to determine the relationship between baseline and early changes in BTMs (as well as serum sclerostin) and 2-year changes in BMD. RESULTS: In women receiving teriparatide, baseline BTMs did not correlate with 2-year BMD changes though 12-month increases in osteocalcin and P1NP were associated with 2-year increases in spine BMD. In women receiving denosumab, spine and hip BMD gains correlated with both baseline and changes in P1NP and C-telopeptide. In women receiving combined teriparatide/denosumab, while both baseline and decreases in P1NP were associated with spine BMD gains, distal radius increases were associated with less CTX suppression. Neither baseline nor changes in serum sclerostin correlated with BMD in any treatment group. SUMMARY AND CONCLUSIONS: In women treated with teriparatide or denosumab, early BTM changes (increases and decreases, respectively) predict 2-year BMD gains, especially at the spine. In women treated with combined teriparatide/denosumab therapy, BMD increases at the distal radius were associated with less suppression of bone turnover. These results suggest that efficacy of combination therapy at cortical sites such as the radius may depend on residual bone remodeling despite RANKL inhibition.