The role of poverty and racial discrimination in exacerbating the health consequences of COVID-19

There were more than 800,000 confirmed coronavirus disease 2019 (COVID-19) deaths in the United States (U.S) by the end of 2021. The health consequences of COVID-19, however, have not affected all residents equally. In this review, we synthesize recent evidence suggesting that high levels of poverty in the U.S. compared to other high-income countries, as well as historic and ongoing racial/ethnic discrimination, have exacerbated the health consequences of COVID-19, particularly for racial/ethnic minorities. We discuss four mechanisms through which poverty and discrimination affect COVID-19-related health consequences: greater pre-existing health challenges, reduced access to healthcare, lower-quality neighbourhood and housing conditions, and unequal exposure to high-risk occupations. Evidence suggests that economic and policy institutions that contributed to higher pre-pandemic poverty rates in the U.S., particularly among racial/ethnic minorities, have been central determinants of unequal health outcomes during the COVID-19 pandemic

Providing Grid Services With Heat Pumps: A Review

Abstract The integration of variable and intermittent renewable energy generation into the power system is a grand challenge to our efforts to achieve a sustainable future. Flexible demand is one solution to this challenge, where the demand can be controlled to follow energy supply, rather than the conventional way of controlling energy supply to follow demand. Recent research has shown that electric building climate control systems like heat pumps can provide this demand flexibility by effectively storing energy as heat in the thermal mass of the building. While some forms of heat pump demand flexibility have been implemented in the form of peak pricing and utility demand response programs, controlling heat pumps to provide ancillary services like frequency regulation, load following, and reserve have yet to be widely implemented. In this paper, we review the recent advances and remaining challenges in controlling heat pumps to provide these grid services. This analysis includes heat pump and building modeling, control methods both for isolated heat pumps and heat pumps in aggregate, and the potential implications that this concept has on the power system

DISC1–ATF4 transcriptional repression complex: dual regulation of the cAMP-PDE4 cascade by DISC1

Disrupted-In-Schizophrenia 1 (DISC1), a risk factor for major mental illnesses, has been studied extensively in the context of neurodevelopment. However, the role of DISC1 in neuronal signaling, particularly in conjunction with intracellular cascades that occur in response to dopamine, a neurotransmitter implicated in numerous psychiatric disorders, remains elusive. Previous data suggest that DISC1 interacts with numerous proteins that impact neuronal function, including activating transcription factor 4 (ATF4). In this study, we identify a novel DISC1 and ATF4 binding region in the genomic locus of phosphodiesterase 4D (PDE4D), a gene implicated in psychiatric disorders. We found that the loss of function of either DISC1 or ATF4 increases PDE4D9 transcription, and that the association of DISC1 with the PDE4D9 locus requires ATF4. We also show that PDE4D9 is increased by D1-type dopamine receptor dopaminergic stimulation. We demonstrate that the mechanism for this increase is due to DISC1 dissociation from the PDE4D locus in mouse brain. We further characterize the interaction of DISC1 with ATF4 to show that it is regulated via protein kinase A-mediated phosphorylation of DISC1 serine-58. Our results suggest that the release of DISC1-mediated transcriptional repression of PDE4D9 acts as feedback inhibition to regulate dopaminergic signaling. Furthermore, as DISC1 loss-of-function leads to a specific increase in PDE4D9, PDE4D9 itself may represent an attractive target for therapeutic approaches in psychiatric disorders.National Institute of General Medical Sciences (U.S.) (Award T32GM07753)National Institutes of Health (U.S.) (R01 MH091115

AutoGraph: Imperative-style Coding with Graph-based Performance

There is a perceived trade-off between machine learning code that is easy to write, and machine learning code that is scalable or fast to execute. In machine learning, imperative style libraries like Autograd and PyTorch are easy to write, but suffer from high interpretive overhead and are not easily deployable in production or mobile settings. Graph-based libraries like TensorFlow and Theano benefit from whole-program optimization and can be deployed broadly, but make expressing complex models more cumbersome. We describe how the use of staged programming in Python, via source code transformation, offers a midpoint between these two library design patterns, capturing the benefits of both. A key insight is to delay all type-dependent decisions until runtime, via dynamic dispatch. We instantiate these principles in AutoGraph, a software system that improves the programming experience of the TensorFlow library, and demonstrate usability improvements with no loss in performance compared to native TensorFlow graphs. We also show that our system is backend agnostic, and demonstrate targeting an alternate IR with characteristics not found in TensorFlow graphs

Alignment of Optical Backscatter Measurements From the EXPORTS Northeast Pacific Field Deployment

Backscattering of light is commonly measured by ocean observing systems, including ships and autonomous platforms, and is used as a proxy for the concentration of water column constituents such as phytoplankton and particulate carbon. Multiple on-going projects involve large numbers of independent measurements of backscatter, as well as other biologically relevant parameters, to understand how biology is changing in time and space throughout the global ocean. Rarely are there sufficient measurements to test how well these instruments are inter-calibrated in real-world deployment conditions. This paper develops a procedure to align multiple independently calibrated backscatter instruments to each other using nearby profiling casts and applies this method to nine instruments deployed during a recent field campaign in the North Pacific during August–September of 2018. This process revealed several incorrect calibrations; post-alignment, all nine instruments aligned extremely well with each other. We also tested an alignment to a deep-water reference and found that this method is generally sufficient but has significant limitations; this procedure lacks the ability to correct instruments measuring only shallow profiles and can only account for additive offsets, not multiplicative changes. These findings highlight the utility of process studies involving several independent measurements of similar parameters in the same area

Epidemiology and Outcomes of Vertebral Artery Injury in 16 582 Cervical Spine Surgery Patients: An AOSpine North America Multicenter Study.

STUDY DESIGN: A multicenter retrospective case series was compiled involving 21 medical institutions. Inclusion criteria included patients who underwent cervical spine surgery between 2005 and 2011 and who sustained a vertebral artery injury (VAI). OBJECTIVE: To report the frequency, risk factors, outcomes, and management goals of VAI in patients who have undergone cervical spine surgery. METHODS: Patients were evaluated on the basis of condition-specific functional status using the Neck Disability Index (NDI), modified Japanese Orthopaedic Association (mJOA) score, the Nurick scale, and the 36-Item Short-Form Health Survey (SF-36). RESULTS: VAIs were identified in a total of 14 of 16 582 patients screened (8.4 per 10 000). The mean age of patients with VAI was 59 years (±10) with a female predominance (78.6%). Patient diagnoses included myelopathy, radiculopathy, cervical instability, and metastatic disease. VAI was associated with substantial blood loss (770 mL), although only 3 cases required transfusion. Of the 14 cases, 7 occurred with an anterior-only approach, 3 cases with posterior-only approach, and 4 during circumferential approach. Fifty percent of cases of VAI with available preoperative imaging revealed anomalous vessel anatomy during postoperative review. Average length of hospital stay was 10 days (±8). Notably, 13 of the 14 (92.86%) cases resolved without residual deficits. Compared to preoperative baseline NDI, Nurick, mJOA, and SF-36 scores for these patients, there were no observed changes after surgery (P = .20-.94). CONCLUSIONS: Vertebral artery injuries are potentially catastrophic complications that can be sustained from anterior or posterior cervical spine approaches. The data from this study suggest that with proper steps to ensure hemostasis, patients recover function at a high rate and do not exhibit residual deficits

Rare Complications of Cervical Spine Surgery: Pseudomeningocoele.

STUDY DESIGN: This study was a retrospective, multicenter cohort study. OBJECTIVES: Rare complications of cervical spine surgery are inherently difficult to investigate. Pseudomeningocoele (PMC), an abnormal collection of cerebrospinal fluid that communicates with the subarachnoid space, is one such complication. In order to evaluate and better understand the incidence, presentation, treatment, and outcome of PMC following cervical spine surgery, we conducted a multicenter study to pool our collective experience. METHODS: This study was a retrospective, multicenter cohort study of patients who underwent cervical spine surgery at any level(s) from C2 to C7, inclusive; were over 18 years of age; and experienced a postoperative PMC. RESULTS: Thirteen patients (0.08%) developed a postoperative PMC, 6 (46.2%) of whom were female. They had an average age of 48.2 years and stayed in hospital a mean of 11.2 days. Three patients were current smokers, 3 previous smokers, 5 had never smoked, and 2 had unknown smoking status. The majority, 10 (76.9%), were associated with posterior surgery, whereas 3 (23.1%) occurred after an anterior procedure. Myelopathy was the most common indication for operations that were complicated by PMC (46%). Seven patients (53%) required a surgical procedure to address the PMC, whereas the remaining 6 were treated conservatively. All PMCs ultimately resolved or were successfully treated with no residual effects. CONCLUSIONS: PMC is a rare complication of cervical surgery with an incidence of less than 0.1%. They prolong hospital stay. PMCs occurred more frequently in association with posterior approaches. Approximately half of PMCs required surgery and all ultimately resolved without residual neurologic or other long-term effects