Cultural Context Index: A Geospatial Measure of Social Determinants of Health in the United States

Minority populations will continue to grow in the United States. Such pluralism necessitates iterative, geospatial measurements of cultural contexts. Our objective in this study was to create a measure of social determinants of health in geographic areas with varying ethnic, linguistic, and religious diversity in the United States. We extracted geographic information systems data based on community characteristics that have known associations with population health disparities from 2015 to 2019. We used principal component analysis to construct a Cultural Context Index (CCI). We created the CCI for 73,682 census tracts across 50 states and five inhabited territories. We identified hot and cold spots that are the highest and lowest CCI quintile, respectively. Hot spots census tracts were mostly located in metropolitan areas (84.8%), in the Southern census region (41.5%), and also had larger Black and Hispanic populations. The census tracts with the greatest need for culturally competent health care also had the sickest populations. Census tracts with a CCI rank of 5 (\u27greatest need\u27) had higher prevalences of self-reported poor physical health (17.2%) and poor mental health (17.4%), compared to either the general population (13.9% and 14.5%) or to CCI rank of 1 (\u27lowest need\u27) (11.9% and 10.8%). The CCI can pinpoint census tracts with a need for culturally competent health care and inform supply-side policy planning as healthcare and social service providers will inevitably come in contact with consumers from different backgrounds

Evoluția tuberculozei la pacienţii cu adicții

Background. The association of tuberculosis with addictions such as alcoholism and drug use contribute to severe evolution of the case. Objective of the study. Consisted in the identifying the evolution of tuberculosis in patients with chronic alcoholism and drug addiction. Material and Methods. It was performed a longitudinal, descriptive and retrospective study composed from 141 patients with chronic alcoholism, including 7 patients with a history of intravenous drug use registered during 2018 years. Results. A high rate of late-detected forms with chronic evolution - 20 (14%) diagnosed with fibrocavitary TB and insidious evolution 121 (86%) such as infiltrative TB was established. The high rate of cases undergoing repeated anti-TB treatment 62 (44%) and the rate of new cases -79 (56%) explained the low rate of treatment success rate - 42 (30%), death of 33 (23%) cases, lost to follow-up of 7 (5%) cases and those who evolved with therapeutic failure - 5 (3.5%) patients. In 54 (38%) cases no data about the therapeutic continuity were identified. Conclusion. Evolution of tuberculosis in patients with chronic alcoholism and drug addiction is insidious, which contributed to the detection of chronic previously treated forms and the high rate of death as well as patients lost to follow-up. Introducere. Asocierea tuberculozei cu adicțiile precum: consumul de alcool și droguri conferă o severitate deosebită a cazului. Scopul lucrării. A constatat în identificarea evoluției tuberculozei la pacienții cu alcoolism cronic și narcomanie. Material și Metode. S-a efectuat un studiu longitudinal, descriptiv şi retrospectiv format din 141 de pacienți cu alcoolism cronic, inclusiv 7 pacienți cu istoric de utilizare intravenoasă de droguri înregistrați în perioada anului 2018. Rezultate. S-a constatat o rată înaltă a formelor tardiv depistate cu evoluție cronică - 20 (14%) diagnosticați cu TB fibrocavitară și evoluție insidioasă 121 (86%), precum și TB infiltrativă. Rata înaltă a cazurilor supuse tratamentului anti-TB repetat 62 (44%) și rata cazurilor noi-79 (56%) a explicat rata scăzută a succesului terapeutic- 42 (30%), decesului la 33 (23%) cazuri, pierderii din supraveghere a 7 (5%) cazuri şi a celor care au evoluat cu eșec terapeutic - 5 (3, 5%) pacienți. În 54 (38%) cazuri nu au fost găsite date despre continuitatea terapeutică. Concluzii. Evoluția tuberculozei la pacienții cu alcoolism cronic și narcomanie este insidioasă, fapt care a contribuit atât la depistarea formelor cronice supuse tratamentului repetat și ratei înalte a decesului, cât și a pacienților pierduți din supraveghere

Effective and scalable software compatibility testing

Today’s software systems are typically composed of multiple components, each with different versions. Software compat-ibility testing is a quality assurance task aimed at ensuring that multi-component based systems build and/or execute correctly across all their versions ’ combinations, or config-urations. Because there are complex and changing interde-pendencies between components and their versions, and be-cause there are such a large number of configurations, it is generally infeasible to test all potential configurations. Con-sequently, in practice, compatibility testing examines only a handful of default or popular configurations to detect prob-lems; as a result costly errors can and do escape to the field. This paper presents a new approach to compatibility test-ing, called Rachet. We formally model the entire config-uration space for software systems and use the model to generate test plans to sample a portion of the space. In this paper, we test all direct dependencies between components and execute the test plan efficiently in parallel. We present empirical results obtained by applying our approach to two large-scale scientific middleware systems. The results show that for these systems Rachet scaled well and discovered in-compatibilities between components, and that testing only direct dependences did not compromise test quality

Low leakage-current InAsSb nanowire photodetectors on silicon

Axially doped p–i–n InAs0.93Sb0.07 nanowire arrays have been grown on Si substrates and fabricated into photodetectors for shortwave infrared detection. The devices exhibit a leakage current density around 2 mA/cm2 and a 20% cutoff of 2.3 μm at 300 K. This record low leakage current density for InAsSb based devices demonstrates the suitability of nanowires for the integration of III–V semiconductors with silicon technology

Mortgage design in an equilibrium model of the housing market

How can mortgages be redesigned to reduce macrovolatility and default? We address this question using a quantitative equilibrium life‐cycle model. Designs with countercyclical payments outperform fixed payments. Among those, designs that front‐load payment reductions in recessions outperform those that spread relief over the full term. Front‐loading alleviates liquidity constraints when they bind most, reducing default and stimulating housing demand. To illustrate, a fixed‐rate mortgage (FRM) with an option to convert to adjustable‐rate mortgage, which front‐loads payment reductions relative to an FRM with an option to refinance underwater, reduces price and consumption declines six times as much and default three times as much.Funding Provided by NSF under grant "Mortgage Design in an Equilibrium Model of the Housing Market" (1623801 - National Science Foundation)Accepted manuscrip

An Unbiased Lipid Phenotyping Approach To Study the Genetic Determinants of Lipids and Their Association with Coronary Heart Disease Risk Factors.

Direct infusion high-resolution mass spectrometry (DIHRMS) is a novel, high-throughput approach to rapidly and accurately profile hundreds of lipids in human serum without prior chromatography, facilitating in-depth lipid phenotyping for large epidemiological studies to reveal the detailed associations of individual lipids with coronary heart disease (CHD) risk factors. Intact lipid profiling by DIHRMS was performed on 5662 serum samples from healthy participants in the Pakistan Risk of Myocardial Infarction Study (PROMIS). We developed a novel semi-targeted peak-picking algorithm to detect mass-to-charge ratios in positive and negative ionization modes. We analyzed lipid partial correlations, assessed the association of lipid principal components with established CHD risk factors and genetic variants, and examined differences between lipids for a common genetic polymorphism. The DIHRMS method provided information on 360 lipids (including fatty acyls, glycerolipids, glycerophospholipids, sphingolipids, and sterol lipids), with a median coefficient of variation of 11.6% (range: 5.4-51.9). The lipids were highly correlated and exhibited a range of associations with clinical chemistry biomarkers and lifestyle factors. This platform can provide many novel insights into the effects of physiology and lifestyle on lipid metabolism, genetic determinants of lipids, and the relationship between individual lipids and CHD risk factors