Community-level characteristics of high infant mortality: A tool to identify at-risk communities

Infant mortality (IM) rate is a key indicator of population health and has been gradually improving in the United States. However, it is still a public health problem among minority and low-income communities. Maternal factors explain some of the variation, but community-level factors may also be a contributor. This study examines measures to identify a set of indicators that explain variations in IM at the community-level. Data for 77 communities in a city were obtained from local health databases. We used multivariable linear regression models to examine the strength of the association between IM and maternal, population, community wealth, and social capital characteristics. Community-level IM rates ranged from 2.1 – 25.6 deaths per 1,000 live births in 2000-2002. The final model explained 75% of the variation in IM rates at the community-level (R2=0.75). The model included a high percentage of low birth weight babies, a decline in mothers who began prenatal care in the second trimester, an increase in the percentage of Hispanics, increased unemployment rates, an increase in the percentage of veterans, an increased rate of foreign-born residents, and smaller average family sizes. Social capital variables, homicide rate and vacant housing, were also significant in the final model. Identifying communities at risk for high IM rates is imperative to improve maternal and child health outcomes because of shortages in public health resources. The development of a parsimonious set of community-level indicators can assist public health practitioners in targeting their resources to prevent infant mortality in high-risk communities

Evidence for the Bypass of the Response-Selection Bottleneck in Tasks with Reflexive Responses in Younger and Older Adults

This study investigated dual-task processing in younger and older adults using a psychological refractory period procedure. The first task was to name the color framing a picture; the second task was to either press a button or tilt their body in the direction of the tilt of the picture. In the body-tilt condition, electromyography was used to determine the reaction time. The stimulus-onset asynchrony (SOA) between the onset of the color and tilting of the picture varied from 50 to 1000 ms. In contrast with the response selection bottleneck model, which claims that processing of a second task cannot be completed until the first task is finished, the mode of response for the two tasks directly impacted the ability to avoid the bottleneck. In the body-tilt condition the increase in reaction time to the second task with decreasing SOA was less than in the button press condition, suggesting that processing of the second task could begin before processing of the first task was completed. This was true for both younger and older adults. Contrary to previous findings that older adults cannot engage in simultaneous processing of two tasks, evidence was found that older adults, like younger adults, could bypass the cognitive bottleneck if the second task has a reflexive component

Is Methotrexate (MTX) an Effective Treatment in Partially Or Totally Reducing the Symptoms of Myasthenia Gravis (MG) Patients?

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Methotrexate (MTX) is an effective treatment in partially or totally reducing the symptoms of Myasthenia Gravis (MG) patients. STUDY DESIGN: Review of three English language studies; one Case Series Study following 3 patients with concomitant MG and Rheumatoid Arthritis treated with MTX published in 2014, one Single-Blind Randomized Control Trial (RCT) comparing MTX and AZA (Azathioprine) published in 2011, and one Double-blind, placebo-controlled Randomized Control Trial published in 2016. DATA SOURCES: Three primary research studies published in peer reviewed journals; found on the PubMed database. Each study’s results included patient oriented outcomes that were relevant to this selective EBM review. OUTCOMES MEASURED: Each study assessed the MG outcomes and quality of life measures after treatment with Methotrexate. The two RCTs used the following assessment tools to quantify their outcomes: Quantitative MG (QMG) Score, Manual Muscle Testing (MMT), MG Quality of Life (MGQOL), MG-Activities of Daily Living (MG-ADL), Minimum Manifestations Status (MMS), and MG Composite Change. RESULTS: The Case Series Study showed an association between MTX and improved MG symptoms; however it did not show cause and effect. The Single-Blind RCT compared MTX and AZA (enrollment: AZA n = 15; MTX n = 16). Similarities between both groups were found in regards to MMS after 24 months (AZA n = 7; MTX n = 9; p = 0.83; ABI = .03; NNT = 34), and safety; giving promise to MTX’s efficacy. The Double-blind, placebo-controlled RCT (enrollment: MTX n = 25; Placebo n = 25) found MTX did not improve QMG, MMT, MGQOL, MG-ADL, or MG Composite Change over 12 months. Withdrawals: Placebo n = 7; MTX n = 1; no serious MTX-related adverse events were encountered. Both RCT’s data was determined to be not statistically significant due to small enrollment size. P-values were \u3e0.05 and 95% CI were too wide to be precise. CONCLUSION: Based on the Case Series Study and two RCTs, MTX is not an effective treatment in partially or totally reducing the symptoms of MG patients

Chaos in one-dimensional lattices under intense laser fields

A model is investigated where a monochromatic, spatially homogeneous laser field interacts with an electron in a one-dimensional periodic lattice. The classical Hamiltonian is presented and the technique of stroboscopic maps is used to study the dynamical behavior of the model. The electron motion is found to be completely regular only for small field amplitudes, developing a larger chaotic region as the amplitude increases. The quantum counterpart of the classical Hamiltonian is derived. Exact numerical diagonalizations show the existence of universal, random-matrix fluctuations in the electronic energy bands dressed by the laser field. A detailed analysis of the classical phase space is compatible with the statistical spectral analysis of the quantum model. The application of this model to describe transport and optical absorption in semiconductor superlattices submitted to intense infrared laser radiation is proposed.Comment: 9 pages, RevTex 3.0, EPSF (6 figures), to appear in Europhys. J.

A new 3,4-dihydroxypyrrolidine-based material for molecular recognition

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