Magnitude of income-related disparities in adverse perinatal outcomes

BACKGROUND: To assess and compare multiple measurements of socioeconomic position (SEP) in order to determine the relationship with adverse perinatal outcomes across various contexts. METHODS: A birth registry, the Nova Scotia Atlee Perinatal Database, was confidentially linked to income tax and related information for the year in which delivery occurred. Multiple logistic regression was used to examine odds ratios between multiple indicators of SEP and multiple adverse perinatal outcomes in 117734 singleton births between 1988 and 2003. Models for after tax family income were also adjusted for neighborhood deprivation to gauge the relative magnitude of effects related to SEP at both levels. Effects of SEP were stratified by single- versus multiple-parent family composition, and by urban versus rural location of residence. RESULTS: The risk of small for gestational age and spontaneous preterm birth was higher across all the indicators of lower SEP, while risk for large for gestational age was lower across indicators of lower SEP. Higher risk of postneonatal death was demonstrated for several measures of lower SEP. Higher material deprivation in the neighborhood of residence was associated with increased risk for perinatal death, small for gestational age birth, and iatrogenic and spontaneous preterm birth. Family composition and urbanicity were shown to modify the association between income and some perinatal outcomes. CONCLUSIONS: This study highlights the importance of understanding the definitions of SEP and the mechanisms that lead to the association between income and poor perinatal outcomes, and broadening the types of SEP measures used in some cases

Effects of Invasive Winter Moth Defoliation on Tree Radial Growth in Eastern Massachusetts, USA

Winter moth, Operophtera brumata L. (Lepidoptera: Geometridae), has been defoliating hardwood trees in eastern Massachusetts since the 1990s. Native to Europe, winter moth has also been detected in Rhode Island, Connecticut, eastern Long Island (NY), New Hampshire, and Maine. Individual tree impacts of winter moth defoliation in New England are currently unknown. Using dendroecological techniques, this study related annual radial growth of individual host (Quercus spp. and Acer spp.) trees to detailed defoliation estimates. Winter moth defoliation was associated with up to a 47% reduction in annual radial growth of Quercus trees. Latewood production of Quercus was reduced by up to 67% in the same year as defoliation, while earlywood production was reduced by up to 24% in the year following defoliation. Winter moth defoliation was not a strong predictor of radial growth in Acer species. This study is the first to document impacts of novel invasions of winter moth into New England

The role of salt bridges, charge density, and subunit flexibility in determining disassembly routes of protein complexes

Mass spectrometry can be used to characterize multiprotein complexes, defining their subunit stoichiometry and composition following solution disruption and collision-induced dissociation (CID). While CID of protein complexes in the gas phase typically results in the dissociation of unfolded subunits, a second atypical route is possible wherein compact subunits or subcomplexes are ejected without unfolding. Because tertiary structure and subunit interactions may be retained, this is the preferred route for structural investigations. How can we influence which pathway is adopted? By studying properties of a series of homomeric and heteromeric protein complexes and varying their overall charge in solution, we found that low subunit flexibility, higher charge densities, fewer salt bridges, and smaller interfaces are likely to be involved in promoting dissociation routes without unfolding. Manipulating the charge on a protein complex therefore enables us to direct dissociation through structurally informative pathways that mimic those followed in solution

Supply Chain Logistics and Business Ecosystems Needed for the Development of Natural Vaccines with Novel, Safer, and Noninvasive Delivery Mechanisms

The success of natural, non-invasive vaccines is dependent not only on their efficacy and safety but also on the logistics and business ecosystems required to develop and distribute them. This chapter discusses the challenges and opportunities associated with developing and implementing a supply chain for such vaccines as well as different scenarios that a similar new business could encounter on its path to the market. We examine options for vertical coordination within the value chain in areas such as product manufacturing, packaging, and distribution. Market and stakeholder analysis is also provided, which focuses on contracting strategies, while keeping in mind the importance of an efficient and equitable distribution of vaccines. Lastly, we will explain our most probable road map, how we arrived at that decision, and how this information can be used by natural vaccine producers to develop supply chains

The Role of Maternal Smoking in Effect of Fetal Growth Restriction on Poor Scholastic Achievement in Elementary School

Fetal growth restriction and maternal smoking during pregnancy are independently implicated in lowering intellectual attainment in children. We hypothesized that only reduction of fetal growth that is attributable to extrinsic causes (e.g., maternal smoking) affects intellectual development of a child. Cross-sectional survey of 3,739 students in Nova Scotia (Canada) in 2003 was linked with the perinatal database, parental interviews on socio-demographic factors and the performance on standardized tests when primarily 11–12 years of age, thereby forming a retrospective cohort. Data was analyzed using hierarchical logistic regression with correction for clustering of children within schools. The risk of poor test result among children born small-for-gestational-age (SGA) to mothers who smoked was 29.4%, higher than in any other strata of maternal smoking and fetal growth. The adjusted odds ratio among SGA children born to mothers who smoked was the only one elevated compared to children who were not growth restricted and born to mothers who did not smoke (17.0%, OR = 1.46, 95% CI 1.02, 2.09). Other perinatal, maternal and socio-demographic factors did not alter this pattern of effect modification. Heterogeneity of etiology of fetal growth restriction should be consider in studies that address examine its impact on health over life course

Customized birth weight for gestational age standards: Perinatal mortality patterns are consistent with separate standards for males and females but not for blacks and whites

BACKGROUND: Some currently available birth weight for gestational age standards are customized but others are not. We carried out a study to provide empirical justification for customizing such standards by sex and for whites and blacks in the United States. METHODS: We studied all male and female singleton live births and stillbirths (22 or more weeks of gestation; 500 g birth weight or over) in the United States in 1997 and 1998. White and black singleton live births and stillbirths were also examined. Qualitative congruence between gestational age-specific growth restriction and perinatal mortality rates was used as the criterion for identifying the preferred standard. RESULTS: The fetuses at risk approach showed that males had higher perinatal mortality rates at all gestational ages compared with females. Gestational age-specific growth restriction rates based on a sex-specific standard were qualitatively consistent with gestational age-specific perinatal mortality rates among males and females. However, growth restriction patterns among males and females based on a unisex standard could not be reconciled with perinatal mortality patterns. Use of a single standard for whites and blacks resulted in gestational age-specific growth restriction rates that were qualitatively congruent with patterns of perinatal mortality, while use of separate race-specific standards led to growth restriction patterns that were incompatible with patterns of perinatal mortality. CONCLUSION: Qualitative congruence between growth restriction and perinatal mortality patterns provides an outcome-based justification for sex-specific birth weight for gestational age standards but not for the available race-specific standards for blacks and whites in the United States

Question Decomposition Improves the Faithfulness of Model-Generated Reasoning

As large language models (LLMs) perform more difficult tasks, it becomes harder to verify the correctness and safety of their behavior. One approach to help with this issue is to prompt LLMs to externalize their reasoning, e.g., by having them generate step-by-step reasoning as they answer a question (Chain-of-Thought; CoT). The reasoning may enable us to check the process that models use to perform tasks. However, this approach relies on the stated reasoning faithfully reflecting the model's actual reasoning, which is not always the case. To improve over the faithfulness of CoT reasoning, we have models generate reasoning by decomposing questions into subquestions. Decomposition-based methods achieve strong performance on question-answering tasks, sometimes approaching that of CoT while improving the faithfulness of the model's stated reasoning on several recently-proposed metrics. By forcing the model to answer simpler subquestions in separate contexts, we greatly increase the faithfulness of model-generated reasoning over CoT, while still achieving some of the performance gains of CoT. Our results show it is possible to improve the faithfulness of model-generated reasoning; continued improvements may lead to reasoning that enables us to verify the correctness and safety of LLM behavior.Comment: For few-shot examples and prompts, see https://github.com/anthropics/DecompositionFaithfulnessPape

Pupil dilation reveals top–down attentional load during spatial monitoring

It has long been known that the diameter of human pupil enlarges with increasing effort during the execution of a task. This has been observed not only for purely mechanical effort but also for mental effort, as for example the computation of arithmetic problems with different levels of difficulty. Here we show that pupil dilation reflects changes in visuospatial awareness induced by attentional load during multi-tasking. In the single-task condition, participants had to report the position of lateralized, briefly presented, masked visual targets ("right", "left", or "both" sides). In the multitasking conditions, participants also performed additional tasks, either visual or auditory, to increase the attentional load. Sensory stimulation was kept constant across all conditions to rule out the influence of low-level factors. Results show that event-related pupil dilation strikingly increased with task demands, mirroring a concurrent decrease in visuospatial awareness. Importantly, pupil dilation significantly differed between two dual-task conditions that required to process the same number of stimuli but yielded differed levels of accuracy (difficulty). In contrast, pupil dilation did not differ between two conditions which were equally challenging but differed both in the modality of the dual task (auditory vs. visual) and in the number of stimuli to be attended. We conclude that pupil dilation genuinely reflects the top-down allocation of supramodal attentional resources