High quality implementation of 4Rs + MTP increases classroom emotional support and reduces absenteeism.

School-based social and emotional learning (SEL) programs are associated with improvements in children's SEL and academic outcomes, and the quality of classroom interactions. The magnitude of these effects increases at high levels of program implementation quality. This study aimed to (1) identify teachers' profiles of quality of implementation, (2) explore teachers and classroom characteristics contributing to their propensity to comply with high quality of implementation, and (3) examine the relations between school assignment to an SEL program, quality of classroom interactions, and child SEL and academic outcomes at different levels of teachers' compliance propensity. This study drew upon data from a cluster-randomized controlled trial evaluating the efficacy of 4Rs + MTP, a literacy-based SEL program, on third and fourth grade teachers (n = 330) and their students (n = 5,081) across 60 New York City public elementary schools. Latent profile analysis indicated that measures of teacher responsiveness and amount of exposure to implementation supports contributed to the differentiation of profiles of high and low quality of implementation. Random forest analysis showed that more experienced teachers with low levels of professional burnout had high propensity to comply with high quality of implementation. Multilevel moderated mediation analysis indicated that 4Rs + MTP teachers with high compliance propensity were associated with higher classroom emotional support and lower children's school absences than their counterparts in the control group. These findings may inform debates in policy research about the importance of providing the supports teachers need to implement SEL school programs with high quality.

Management of hospitalized patients with mild to moderate diabetic ketoacidosis using a continuous insulin infusion protocol on a medical surgical ward and observation level of care: A retrospective cohort study.

Although the practice of using rapid-acting subcutaneous insulin for the management of mild-to-moderate diabetic ketoacidosis is becoming increasingly popular, the continuous insulin infusion remains widely utilized, and its real-world applicability and safety on a medical surgical unit (Med Surg) and observation level of care are unclear. We assessed whether a continuous insulin infusion protocol for mild-to-moderate diabetic ketoacidosis on Med Surg/observation level of care over a 6.5-year period was associated with adverse outcomes. A retrospective cohort study of adults hospitalized with mild-to-moderate diabetic ketoacidosis was conducted at 2 community hospitals in Northern California, USA, from January 2014 to May 2020. Demographic and clinical variables were collected using an electronic health record. Admission to Med Surg/observation was compared to intensive care unit admission for the outcomes of 30-day readmission, presence of hypoglycemia, rate of hypoglycemic episodes, in-hospital and 30-day mortality, and length of stay using bivariate analysis. Among 227 hospital encounters (mean age 41 years, 52.9% women, 79.3% type 1 diabetes, 97.4% utilization of continuous insulin infusion), 19.4% were readmitted within 30 days, and 20.7% developed hypoglycemia. For Med Surg/observation encounters compared to the intensive care unit, there were no statistically significant differences in the risk of readmission (RR 1.48, 95% CI, 0.86-2.52), hypoglycemia (RR 1.17, 95% CI, 0.70-1.95), or increased length of stay (RR 0.71, 95% CI, 0.55-1.02); there was a lower risk of hypoglycemic events during hospitalization (RR 0.69, 95% CI, 0.54-0.96). Continuous insulin infusion utilization may be a safe option for treatment of mild-to-moderate diabetic ketoacidosis on Med Surg/observation level of care. Further investigation is needed.

A State-of-the-Art Survey of Tasks for Tree Design and Evaluation With a Curated Task Dataset.

In the field of information visualization, the concept of "tasks" is an essential component of theories and methodologies for how a visualization researcher or a practitioner understands what tasks a user needs to perform and how to approach the creation of a new design. In this article, we focus on the collection of tasks for tree visualizations, a common visual encoding in many domains ranging from biology to computer science to geography. In spite of their commonality, no prior efforts exist to collect and abstractly define tree visualization tasks. We present a literature review of tree visualization articles and generate a curated dataset of over 200 tasks. To enable effective task abstraction for trees, we also contribute a novel extension of the Multi-Level Task Typology to include more specificity to support tree-specific tasks as well as a systematic procedure to conduct task abstractions for tree visualizations. All tasks in the dataset were abstracted with the novel typology extension and analyzed to gain a better understanding of the state of tree visualizations. These abstracted tasks can benefit visualization researchers and practitioners as they design evaluation studies or compare their analytical tasks with ones previously studied in the literature to make informed decisions about their design. We also reflect on our novel methodology and advocate more broadly for the creation of task-based knowledge repositories for different types of visualizations. The Supplemental Material, which can be found on the Computer Society Digital Library at http://doi.ieeecomputersociety.org/10.1109/TVCG.2021.3064037, will be maintained on OSF: https://osf.io/u5ehs/.

Built environment profiles for Latin American urban settings: The SALURBAL study.

The built environment of cities is complex and influences social and environmental determinants of health. In this study we, 1) identified city profiles based on the built landscape and street design characteristics of cities in Latin America and 2) evaluated the associations of city profiles with social determinants of health and air pollution. Landscape and street design profiles of 370 cities were identified using finite mixture modeling. For landscape, we measured fragmentation, isolation, and shape. For street design, we measured street connectivity, street length, and directness. We fitted a two-level linear mixed model to assess the association of social and environmental determinants of health with the profiles. We identified four profiles for landscape and four for the street design domain. The most common landscape profile was the "proximate stones" characterized by moderate fragmentation, isolation and patch size, and irregular shape. The most common street design profile was the "semi-hyperbolic grid" characterized by moderate connectivity, street length, and directness. The "semi-hyperbolic grid", "spiderweb" and "hyperbolic grid" profiles were positively associated with higher access to piped water and less overcrowding. The "semi-hyperbolic grid" and "spiderweb" profiles were associated with higher air pollution. The "proximate stones" and "proximate inkblots" profiles were associated with higher congestion. In conclusion, there is substantial heterogeneity in the urban landscape and street design profiles of Latin American cities. While we did not find a specific built environment profile that was consistently associated with lower air pollution and better social conditions, the different configurations of the built environments of cities should be considered when planning healthy and sustainable cities in Latin America.

Multimorbidity patterns among COVID-19 deaths: proposal for the construction of etiological models

[ABSTRACT]. Objectives. To describe patterns of multimorbidity among fatal cases of COVID-19, and to propose a classification of patients based on age and multimorbidity patterns to begin the construction of etiological models. Methods. Data of Colombian confirmed deaths of COVID-19 until June 11, 2020, were included in this analysis (n=1488 deaths). Relationships between COVID-19, combinations of health conditions and age were explored using locally weighted polynomial regressions. Results. The most frequent health conditions were high blood pressure, respiratory disease, diabetes, cardiovascular disease, and kidney disease. Dyads more frequents were high blood pressure with diabetes, cardiovascular disease or respiratory disease. Some multimorbidity patterns increase probability of death among older individuals, whereas other patterns are not age-related, or decrease the probability of death among older people. Not all multimorbidity increases with age, as is commonly thought. Obesity, alone or with other diseases, was associated with a higher risk of severity among young people, while the risk of the high blood pressure/diabetes dyad tends to have an inverted U distribution in relation with age. Conclusions. Classification of individuals according to multimorbidity in the medical management of COVID-19 patients is important to determine the possible etiological models and to define patient triage for hospitalization. Moreover, identification of non-infected individuals with high-risk ages and multimorbidity patterns serves to define possible interventions of selective confinement or special management.

[RESUMEN]. Objetivos. Describir los patrones de multimorbilidad entre los casos fatales de COVID-19, y proponer una clasificación de los pacientes basada en la edad y los patrones de multimorbilidad para iniciar la construcción de modelos etiológicos. Métodos. Se incluyeron los datos de las muertes confirmadas por COVID-19 en Colombia hasta el 11 de junio de 2020 (n=1 488 muertes). Se exploraron las relaciones entre la COVID-19, las combinaciones de enfermedades y la edad utilizando regresiones polinómicas con ponderación local. Resultados. Las enfermedades más frecuentes fueron la hipertensión arterial, las enfermedades respiratorias, la diabetes, las enfermedades cardiovasculares y las enfermedades renales. Las díadas más frecuentes fueron la hipertensión arterial combinada con diabetes, enfermedades cardiovasculares o enfermedades respiratorias. Algunos patrones de multimorbilidad aumentan la probabilidad de morir en las personas mayores, mientras que otros no están relacionados con la edad o disminuyen la probabilidad de morir en las personas mayores. A diferencia de lo que con frecuencia se considera, no toda la multimorbilidad aumenta con la edad. La obesidad, aislada o combinada con otras enfermedades, se asocia con un mayor riesgo de enfermedad grave en los jóvenes, mientras que el riesgo de la díada hipertensión arterial/diabetes tiende a tener una distribución en U invertida en relación con la edad. Conclusiones. La clasificación de los individuos según la multimorbilidad en el manejo médico de los pacientes con COVID-19 es importante para determinar los posibles modelos etiológicos y definir el triaje de los pacientes para su hospitalización. Además, la identificación de los individuos no infectados con edades y patrones de multimorbilidad de alto riesgo sirve para definir posibles intervenciones de confinamiento selectivo o manejo especial.

Multimorbidity patterns among COVID-19 deaths: proposal for the construction of etiological models.

OBJECTIVES: To describe patterns of multimorbidity among fatal cases of COVID-19, and to propose a classification of patients based on age and multimorbidity patterns to begin the construction of etiological models. METHODS: Data of Colombian confirmed deaths of COVID-19 until June 11, 2020, were included in this analysis (n=1488 deaths). Relationships between COVID-19, combinations of health conditions and age were explored using locally weighted polynomial regressions. RESULTS: The most frequent health conditions were high blood pressure, respiratory disease, diabetes, cardiovascular disease, and kidney disease. Dyads more frequents were high blood pressure with diabetes, cardiovascular disease or respiratory disease. Some multimorbidity patterns increase probability of death among older individuals, whereas other patterns are not age-related, or decrease the probability of death among older people. Not all multimorbidity increases with age, as is commonly thought. Obesity, alone or with other diseases, was associated with a higher risk of severity among young people, while the risk of the high blood pressure/diabetes dyad tends to have an inverted U distribution in relation with age. CONCLUSIONS: Classification of individuals according to multimorbidity in the medical management of COVID-19 patients is important to determine the possible etiological models and to define patient triage for hospitalization. Moreover, identification of non-infected individuals with high-risk ages and multimorbidity patterns serves to define possible interventions of selective confinement or special management.

OBJETIVOS: Describir los patrones de multimorbilidad entre los casos fatales de COVID-19, y proponer una clasificación de los pacientes basada en la edad y los patrones de multimorbilidad para iniciar la construcción de modelos etiológicos. MÉTODOS: Se incluyeron los datos de las muertes confirmadas por COVID-19 en Colombia hasta el 11 de junio de 2020 (n=1 488 muertes). Se exploraron las relaciones entre la COVID-19, las combinaciones de enfermedades y la edad utilizando regresiones polinómicas con ponderación local. RESULTADOS: Las enfermedades más frecuentes fueron la hipertensión arterial, las enfermedades respiratorias, la diabetes, las enfermedades cardiovasculares y las enfermedades renales. Las díadas más frecuentes fueron la hipertensión arterial combinada con diabetes, enfermedades cardiovasculares o enfermedades respiratorias. Algunos patrones de multimorbilidad aumentan la probabilidad de morir en las personas mayores, mientras que otros no están relacionados con la edad o disminuyen la probabilidad de morir en las personas mayores. A diferencia de lo que con frecuencia se considera, no toda la multimorbilidad aumenta con la edad. La obesidad, aislada o combinada con otras enfermedades, se asocia con un mayor riesgo de enfermedad grave en los jóvenes, mientras que el riesgo de la díada hipertensión arterial/diabetes tiende a tener una distribución en U invertida en relación con la edad. CONCLUSIONES: La clasificación de los individuos según la multimorbilidad en el manejo médico de los pacientes con COVID-19 es importante para determinar los posibles modelos etiológicos y definir el triaje de los pacientes para su hospitalización. Además, la identificación de los individuos no infectados con edades y patrones de multimorbilidad de alto riesgo sirve para definir posibles intervenciones de confinamiento selectivo o manejo especial.

Polynomial-product states: A symmetry-projection-based factorization of the full coupled cluster wavefunction in terms of polynomials of double excitations.

Our goal is to remedy the failure of symmetry-adapted coupled-cluster theory in the presence of strong correlation. Previous work along these lines has taken us from a diagram-level analysis of the coupled-cluster equations to an understanding of the collective modes which can occur in various channels of the coupled-cluster equations to the exploration of non-exponential wavefunctions in efforts to combine coupled-cluster theory with symmetry projection. In this manuscript, we extend these efforts by introducing a new, polynomial product wavefunction ansatz that incorporates information from symmetry projection into standard coupled-cluster theory in a way that attempts to mitigate the effects of the lack of size extensivity and size consistency characteristic of symmetry-projected methods. We describe the new approach in detail within the context of our previous efforts, explore some illustrative calculations, and consider one route for reducing the computational cost of the new method.

Spin polynomial similarity transformation for repulsive Hamiltonians: interpolating between coupled cluster and spin-projected unrestricted Hartree-Fock.

Our overarching goal is to be able to describe both weak and strong correlation with a single, computationally affordable method without sacrificing important qualities of the wavefunction, e.g. symmetries of the Hamiltonian. We know that coupled cluster theory with low-order excitations is excellent at describing weakly-correlated systems near equilibrium, but breaks down as systems become more strongly correlated. Projected Hartree-Fock on the other hand is inherently capable of describing multireference character, but misses weak correlation. We are thus exploring how best to combine coupled cluster and projected Hartree-Fock in our search for a computationally feasible method that is applicable across a wide range of correlation strengths. In this manuscript, we adapt our earlier work on the pairing Hamiltonian to repulsive Hamiltonians, resulting in the spin polynomial similarity transformation (SpinPoST) interpolation. SpinPoST parameterizes the wavefunction in order to interpolate between the coupled cluster and spin-projected unrestricted Hartree-Fock ansätze self consistently, and is a spin-symmetry adapted model which involves only single and double excitations. We employ a unique approach of optimizing the wavefunction by minimizing the effect of connected quadruple excitations, resulting in a method which is spin-symmetry adapted and is comparable energetically to coupled cluster with singles and doubles for weak correlation and spin-projected Hartree-Fock for strong correlation.

Recoupling the singlet- and triplet-pairing channels in single-reference coupled cluster theory.

It is well known that single-reference coupled cluster theory truncated to low orders of excitations gives the right answer for the right reason when systems are dominated by dynamical or weak correlation. Static or strong correlation is more problematic, causing often catastrophic breakdown of restricted coupled cluster. This failure can be remedied, e.g., by allowing symmetry breaking in the reference or taking a multi-reference approach, but poses an interesting theoretical problem, especially since many groups have found that simplifying the T2 operator or the doubles amplitude equations gives better results. In singlet-paired coupled cluster, eliminating the triplet-pairing channel recovers reasonable qualitative behavior for strong correlation at the cost of a decreased description of dynamical correlation in weakly correlated situations. This behavior seems to hold for both closed- and open-shell systems. In this work, we explore the coupling of the singlet- and triplet-pairing channels of T2 and attempt to recouple them in order to recover dynamical correlation without reintroducing catastrophic failure due to strong correlation. In the weakly correlated regime, these pairing channels are only weakly coupled, and a simple recoupling gives good results. However, as strong correlation dominates, the coupling strength between the singlet- and triplet-pairing channels increases, making it difficult to perturbatively recouple the singlet- and triplet-pairing channels in this regime.

Singlet-paired coupled cluster theory for open shells.

Restricted single-reference coupled cluster theory truncated to single and double excitations accurately describes weakly correlated systems, but often breaks down in the presence of static or strong correlation. Good coupled cluster energies in the presence of degeneracies can be obtained by using a symmetry-broken reference, such as unrestricted Hartree-Fock, but at the cost of good quantum numbers. A large body of work has shown that modifying the coupled cluster ansatz allows for the treatment of strong correlation within a single-reference, symmetry-adapted framework. The recently introduced singlet-paired coupled cluster doubles (CCD0) method is one such model, which recovers correct behavior for strong correlation without requiring symmetry breaking in the reference. Here, we extend singlet-paired coupled cluster for application to open shells via restricted open-shell singlet-paired coupled cluster singles and doubles (ROCCSD0). The ROCCSD0 approach retains the benefits of standard coupled cluster theory and recovers correct behavior for strongly correlated, open-shell systems using a spin-preserving ROHF reference.