The Costs of Low Birth Weight

Birth weight has emerged as the leading indicator of infant health and welfare and the central focus of infant health policy. This is because low birth weight (LBW) infants experience severe health and developmental difficulties that can impose enormous costs on society. But would the prevention of LBW generate equally sizable cost savings and health improvements? Estimates of the return to LBW-prevention from cross-sectional associations may be biased by omitted variables that cannot be influenced by policy, such as genetic factors. To address this, we compare the hospital costs, health at birth, and infant mortality rates between heavier and lighter infants from all twin pairs born in the United States. We also examine the effect of maternal smoking during pregnancy the leading risk factor for LBW in the United States on health among singleton births after controlling for detailed background characteristics. Both analyses imply substantially smaller effects of LBW than previously thought, suggesting two possibilities: 1) existing estimates overstate the true costs and consequences of LBW by at least a factor of four and by as much as a factor of 20; or 2) different LBW-preventing interventions have different health and cost consequences, implying that policy efforts that presume a single return to reducing LBW will necessarily be suboptimal.

A Spaceflight Magnetic Bearing Equipped Optical Chopper with Six-Axis Active Control

This paper describes the development of an ETU (Engineering Test Unit) rotary optical chopper with magnetic bearings. An ETU is required to be both flight-like, nearly identical to a flight unit without the need for material certifications, and demonstrate structural and performance integrity. A prototype breadboard design previously demonstrated the feasibility of meeting flight performance requirements using magnetic bearings. The chopper mechanism is a critical component of the High Resolution Dynamics Limb Sounder (HIRDLS) which will be flown on EOS-CHEM (Earth Observing System-Chemistry). Particularly noteworthy are the science requirements which demand high precision positioning and minimal power consumption along with full redundancy of coils and sensors in a miniature, lightweight package. The magnetic bearings are unique in their pole design to minimize parasitic losses and utilize collocated optical sensing. The motor is of an unusual disk-type ironless stator design. The ETU design has evolved from the breadboard design. A number of improvements have been incorporated into the ETU design. Active thrust control has been added along with changes to improve sensor stability, motor efficiency, and touchdown and launch survivability. It was necessary to do all this while simultaneously reducing the mechanism volume. Flight-like electronics utilize a DSP (Digital Signal Processor) and contain all sensor electronics and drivers on a single five inch by nine inch circuit board. Performance test results are reported including magnetic bearing and motor rotational losses

Modular Wideband Active Vibration Absorber

A comparison of space experiments with previous missions shows a common theme. Some of the recent experiments are based on the scientific fundamentals of instruments of prior years. However, the main distinguishing characteristic is the embodiment of advances in engineering and manufacturing in order to extract clearer and sharper images and extend the limits of measurement. One area of importance to future missions is providing vibration free observation platforms at acceptable costs. It has been shown by researchers that vibration problems cannot be eliminated by passive isolation techniques alone. Therefore, various organizations have conducted research in the area of combining active and passive vibration control techniques. The essence of this paper is to present progress in what is believed to be a new concept in this arena. It is based on the notion that if one active element in a vibration transmission path can provide a reasonable vibration attenuation, two active elements in series may provide more control options and better results. The paper presents the functions of a modular split shaft linear actuator developed by NASA's Goddard Space Flight Center and University of Massachusetts Lowell. It discusses some of the control possibilities facilitated by the device. Some preliminary findings and problems are also discussed

Spectrometer Scan Mechanism for Encountering Jovian Orbit Trojan Asteroids

This paper describes the design, testing, and lessons learned during the development of the Lucy Ralph (L'Ralph) Scan Mirror System (SMS), composed of the Scan Mirror Mechanism (SMM), Differential Position Sensor System (DPSS) and Mechanism Control Electronics (MCE). The L'Ralph SMS evolved from the Advanced Topographic Laser Altimeter System (ATLAS) Beam Steering Mechanism (BSM), so design comparisons will be made. Lucy is scheduled to launch in October 2021, embarking upon a 12-year mission to make close range encounters in 2025 and 2033 with seven Trojan asteroids and one main belt asteroid that are within the Jovian orbit. The L'Ralph instrument is based upon the New Horizons Ralph instrument, which is a panchromatic and color visible imager and infrared spectroscopic mapper that slewed the spacecraft for imaging. The L'Ralph SMM is to provide scanning for imaging to eliminate the need to slew the spacecraft. One purpose of this paper is to gain understanding of the reasoning behind some of the design features as compared with the ATLAS BSM. We will identify similarities and differences between the ATLAS BSM and the L'Ralph SMM that resulted from the latter's unique requirements. Another purpose of this paper is to focus upon "Lessons Learned" that came about during the development of the L'Ralph SMM and its MCE, both mechanism engineering issues and solutions as well as Ground Support Equipment (GSE) issues and solutions that came about during the validation of requirements process. At the time of this writing, the L'Ralph SMM has been flight qualified and delivered to the project

EUS-guided portal pressure gradient measurement with a simple novel device: a human pilot study.

Background and aimsPortal hypertension is a serious adverse event of liver cirrhosis. Recently, we developed a simple novel technique for EUS-guided portal pressure gradient (PPG) measurement (PPGM). Our animal studies showed excellent correlation between EUS-PPGM and interventional radiology-acquired PPGM. In this video we demonstrate the results of the first human pilot study of EUS-PPGM in patients with liver disease.MethodsEUS-PPGM was performed by experienced endosonographers using a linear echoendoscope, a 25-gauge FNA needle, and a novel compact manometer. The portal vein and hepatic vein (or inferior vena cava) were targeted by use of a transgastric or transduodenal approach. Feasibility was defined as successful PPGM in each patient. Safety was based on adverse events captured in a postprocedural interview.ResultsTwenty-eight patients underwent EUS-PPGM with 100% technical success and no adverse events. PPG ranged from 1.5 to 19 mm Hg and had excellent correlation with clinical parameters of portal hypertension, including the presence of varices (P = .0002), PH gastropathy (P = .007), and thrombocytopenia (P = .036).ConclusionThis novel technique of EUS-PPGM using a 25-gauge needle and compact manometer is feasible and appears safe. Given the availability of EUS and the simplicity of the manometry setup, EUS-guided PPG may represent a promising breakthrough for procuring indispensable information in the management of patients with liver disease

The metallic resistance of a dilute two-dimensional hole gas in a GaAs quantum well: two-phase separation at finite temperature?

We have studied the magnetotransport properties of a high mobility two-dimensional hole gas (2DHG) system in a 10nm GaAs quantum well (QW) with densities in range of 0.7-1.6*10^10 cm^-2 on the metallic side of the zero-field 'metal-insulator transition' (MIT). In a parallel field well above B_c that suppresses the metallic conductivity, the 2DHG exhibits a conductivity g(T)~0.3(e^2/h)lnT reminiscent of weak localization. The experiments are consistent with the coexistence of two phases in our system: a metallic phase and a weakly insulating Fermi liquid phase having a percolation threshold close to B_c

Molecular basis of FIR-mediated c-myc transcriptional control

The far upstream element (FUSE) regulatory system promotes a peak in the concentration of c-Myc during cell cycle. First, the FBP transcriptional activator binds to the FUSE DNA element upstream of the c-myc promoter. Then, FBP recruits its specific repressor (FIR), which acts as an on/off transcriptional switch. Here we describe the molecular basis of FIR recruitment, showing that the tandem RNA recognition motifs of FIR provide a platform for independent FUSE DNA and FBP protein binding and explaining the structural basis of the reversibility of the FBP-FIR interaction. We also show that the physical coupling between FBP and FIR is modulated by a flexible linker positioned sequentially to the recruiting element. Our data explain how the FUSE system precisely regulates c-myc transcription and suggest that a small change in FBP-FIR affinity leads to a substantial effect on c-Myc concentration.MRC Grant-in-aid U11757455

Pre-vaccination prevalence of anogenital and oral human papillomavirus in young HIV-infected men who have sex with men.

The aims of this study were to: 1) determine prevalence of anogenital and oral HPV, 2) determine concordance between HPV at anal, perianal, scrotal/penile, and oral sites; and 3) describe factors associated with anogenital HPV types targeted by the 9-valent vaccine. Data were collected from 2012 to 2015 among men who have sex with men 18-26 years of age enrolled in a vaccine trial (N = 145). Penile/scrotal, perianal, anal, and oral samples were tested for 61 HPV types. Logistic regression was used to identify factors associated with types in the 9-valent vaccine. Participants' mean age was 23.0 years, 55.2% were African-American, and 26.2% were Hispanic; 93% had anal, 40% penile, and 6% oral HPV. Among those with anogenital infection, 18% had HPV16. Concordance was low between anogenital and oral sites. Factors independently associated with a 9-valent vaccine-type HPV were: race (African-American vs. White, OR=2.67, 95% CI=1.11-6.42), current smoking (yes vs. no, OR=2.37, 95% CI=1.03-5.48), and number of recent receptive anal sex partners (2+ vs. 0, OR=3.47, 95% CI=1.16-10.4). Most MSM were not infected with HPV16 or HPV18, suggesting that they may still benefit from HPV vaccination, but anogenital HPV was very common, highlighting the importance of vaccinating men before sexual initiation. CLINICAL TRIAL NUMBER: NCT01209325