Analysis of Firearm Violence During the COVID-19 Pandemic in the US

Importance In the US, the COVID-19 pandemic intensified some conditions that may contribute to firearm violence, and a recent surge in firearm sales during the pandemic has been reported. However, patterns of change in firearm violence in the first year of the COVID-19 pandemic in the US remain unclear. Objective To quantify the changes in interpersonal firearm violence associated with the pandemic across all 50 US states and the District of Columbia. Design, Setting, and Participants This population-based cross-sectional study examined 50 US states and the District of Columbia from January 1, 2016, to February 28, 2021. The COVID-19 pandemic period was defined as between March 1, 2020, and February 28, 2021. Statistical analysis was performed from April to December 2021. Main Outcomes and Measures A 2-stage interrupted time-series design was used to examine the excess burden of firearm-related incidents, nonfatal injuries, and deaths associated with the pandemic while accounting for long-term trends and seasonality. In the first stage, separate quasi-Poisson regression models were fit to the daily number of firearm events in each state. In the second stage, estimates were pooled using a multivariate meta-analysis. Results In the US (all 50 states and the District of Columbia) during the pandemic period of March 1, 2020, to February 28, 2021, there were 62 485 identified firearm-related incidents, 40 021 firearm-related nonfatal injuries, and 19 818 firearm-related deaths. The pandemic period was associated with 8138 (95% empirical confidence interval [eCI], 2769-12 948) excess incidents (increase of 15.0% [95% eCI, 4.6%-26.1%]), 10 222 (95% eCI, 8284-11 650) excess nonfatal injuries (increase of 34.3% [95% eCI, 26.1%-41.1%]), and 4381 (95% eCI, 2262-6264) excess deaths (increase of 28.4% [95% eCI, 12.9%-46.2%]). The increase in firearm-related violence was more pronounced from June to October 2020 and in Minnesota and New York State. Conclusions and Relevance In the US, the first year of the COVID-19 pandemic was associated with an excess burden of firearm-related incidents, nonfatal injuries, and deaths, with substantial temporal and spatial variations

Q-Switched 2 Micron Solid-State Lasers and Their Applications

In this chapter, we overview the Q-switched 2 μm solid-state laser development achieved in recent years, including flash- and diode-pumped solid-state lasers based on active and passive modulators. In summary, active Q-switching is still the first choice for obtaining large pulse energy at 2 μm currently, while passive Q-switching based on saturable absorbers (SAs), especially the newly emerging broadband low-dimension nanomaterial, is becoming promising approach in generating Q-switched 2 μm lasers specially with high repetition rate, although the output power, pulse duration, and pulse energy needs further enhancement. Besides, some important applications of 2 μm lasers, such as medicine, laser radar, and infrared directional interference, have also been introduced in brief

Salubrinal improves mechanical properties of the femur in osteogenesis imperfecta mic

Salubrinal is an agent that reduces the stress to the endoplasmic reticulum by inhibiting de-phosphorylation of eukaryotic translation initiation factor 2 alpha (eIF2α). We and others have previously shown that the elevated phosphorylation of eIF2α stimulates bone formation and attenuates bone resorption. In this study, we applied salubrinal to a mouse model of osteogenesis imperfecta (Oim), and examined whether it would improve Oim's mechanical property. We conducted in vitro experiments using RAW264.7 pre-osteoclasts and bone marrow derived cells (BMDCs), and performed in vivo administration of salubrinal to Oim (+/−) mice. The animal study included two control groups (wildtype and Oim placebo). The result revealed that salubrinal decreased expression of nuclear factor of activated T cells cytoplasmic 1 (NFATc1) and suppressed osteoclast maturation, and it stimulated mineralization of mesenchymal stem cells from BMDCs. Furthermore, daily injection of salubrinal at 2 mg/kg for 2 months made stiffness (N/mm) and elastic module (GPa) of the femur undistinguishable to those of the wildtype control. Collectively, this study supported salubrinal's beneficial role to Oim's femora. Unlike bisphosphonates, salubrinal stimulates bone formation. For juvenile OI patients who may favor strengthening bone without inactivating bone remodeling, salubrinal may present a novel therapeutic option

Analysis of Vegetation Vulnerability Dynamics and Driving Forces to Multiple Drought Stresses in a Changing Environment

Quantifying changes in the vulnerability of vegetation to various drought stresses in different seasons is important for rational and effective ecological conservation and restoration. However, the vulnerability of vegetation and its dynamics in a changing environment are still unknown, and quantitative attribution analysis of vulnerability changes has been rarely studied. To this end, this study explored the changes of vegetation vulnerability characteristics under various drought stresses in Xinjiang and conducted quantitative attribution analysis using the random forest method. In addition, the effects of ecological water transport and increased irrigation areas on vegetation vulnerability dynamics were examined. The standardized precipitation index (SPI), standardized precipitation-evapotranspiration index (SPEI), and standardized soil moisture index (SSMI) represent atmospheric water supply stress, water and heat supply stress, and soil water supply stress, respectively. The results showed that: (1) different vegetation types responded differently to water stress, with grasslands being more sensitive than forests and croplands in summer; (2) increased vegetation vulnerability under drought stresses dominated in Xinjiang after 2003, with vegetation growth and near-surface temperature being the main drivers, while increased soil moisture in the root zone was the main driver of decreased vegetation vulnerability; (3) vulnerability of cropland to SPI/SPEI/SSMI-related water stress increased due to the rapid expansion of irrigation areas, which led to increasing water demand in autumn that was difficult to meet; and (4) after ecological water transport of the Tarim River Basin, the vulnerability of its downstream vegetation to drought was reduced

A Nationwide Study of Maternal Exposure To Ambient Ozone and Term Birth Weight In the United States

Background: Maternal exposure to ozone (O3) may cause systemic inflammation and oxidative stress and contribute to fetal growth restriction. We sought to estimate the association between maternal exposure to O3 and term birth weight and term small for gestational age (SGA) in the United States (US). Methods: We conducted a nationwide study including 2,179,040 live term singleton births that occurred across 453 populous counties in the contiguous US in 2002. Daily county-level concentrations of O3 data were estimated using a Bayesian fusion model. We used linear regression to estimate the association between O3 exposure and term birth weight and logistic regression to estimate the association between O3 exposure and term SGA during each trimester of the pregnancy and the entire pregnancy after adjusting for maternal characteristics, infant sex, season of conception, ambient temperature, county poverty rate, and census region. We additionally used distributed lag models to identify the critical exposure windows by estimating the monthly and weekly associations. Results: A 10 parts per billion (ppb) increase in O3 over the entire pregnancy was associated with a lower term birth weight (-7.6 g; 95 % CI: −8.8 g, −6.4 g) and increased risk of SGA (odds ratio = 1.030; 95 % CI: 1.020, 1.040). The identified critical exposure windows were the 13th- 25th and 32nd −37th gestational weeks for term birth weight and 13th- 25th for term SGA. We found the association was more pronounced among mothers who were non-Hispanic Black, unmarried, or had lower education level. Conclusions: Among US singleton term births, maternal exposure to O3 was associated with lower rates of fetal growth, and the 13th- 25th gestational weeks were the identified critical exposure windows

Distributed workload and response time management for web applications

Abstract-Managing workload for large scale web applications is a fundamental task for satisfactory quality of service, low management and operation cost. In this paper, we present SCOPS, a system of distributed workload management to achieve service differentiation and overload protection in such large scale deployment. Our system splits the workload management logic into distributed components on each back-end server and frontend proxy. The control solution is designed to protect the backend server from overloading and to achieve both efficient usage of system resource and service differentiation by employing a unique optimization target. The control components are automatically organized based on the flow of workloads, such that management overhead is minimized. SCOPS is extremely flexible because it requires no source code changes to host OS, application servers, or web applications. Additionally, the distributed design makes it scalable and robust for cloud scale server deployment. Experiments with our implementation confirm SCOPS's performance with dynamic heavy workload, incurring neglectable runtime overhead. More importantly, SCOPS also ensures fault-tolerance and fast convergence to system failures

Inhibitory Effects of Dopamine Receptor D1 Agonist on Mammary Tumor and Bone Metastasis

Dopaminergic signaling plays a critical role in the nervous system, but little is known about its potential role in breast cancer and bone metabolism. A screening of ~1,000 biologically active compounds revealed that a selective agonist of dopamine receptor D1 (DRD1), A77636, inhibited proliferation of 4T1.2 mammary tumor cells as well as MDA-MB-231 breast cancer cells. Herein, we examined the effect of A77636 on bone quality using a mouse model of bone metastasis from mammary tumor. A77636 inhibited migration of cancer cells in a DRD1-dependent fashion and suppressed development of bone-resorbing osteoclasts by downregulating NFATc1 through the elevation of phosphorylation of eIF2α. In the mouse model of bone metastasis, A77636 reduced osteolytic lesions and prevented mechanical weakening of the femur and tibia. Collectively, we expect that dopaminergic signaling might provide a novel therapeutic target for breast cancer and bone metastasis

Primary care physicians' views on the factors for enhancing patients' trust in rural areas of Zhejiang province, China: a cross-sectional study

OBJECTIVES: To examine primary care physicians' (PCPs) perception of patients' trust and associated factors for enhancing perceived trust in rural China. DESIGN: A cross-sectional questionnaire study. SETTING: All township health centres (primary care facilities in rural areas of China) in both developed and less developed counties of Zhejiang province, China, were chosen as the study sites. PARTICIPANTS: A total of 849 questionnaires were distributed from December 2019 to January 2020, and 673 PCPs working in township health centres completed the questionnaires. The response rate was 79.3%. OUTCOME MEASURES: PCPs' perceived patients' trust in them, PCPs' practices to meet patients' expectations and PCPs' perceived conflicting patient and employer interests were measured by a self-designed and verified questionnaire. Confirmatory factor analysis was applied to verify the measurement model of PCPs' practices. Multivariable logistic regression analyses were performed to explore the association between clinical practice characteristics, discordant patient and employer interests and perceived patient trust after controlling for social-demographic characteristics. RESULTS: Among all participants, 572 (85.0%) PCPs often/always perceived patients' trust in their clinical competence, and over two-thirds of PCPs reported ever perceived patient worries about overprescriptions. After adjustment for social-demographic characteristics, regression model results indicated that, among PCPs' clinical practices characteristics, emotional support (OR=1.23, 95% CI=1.06 to 1.42) and accurate diagnosis and treatment (OR=1.35, 95% CI=1.17 to 1.55) were positively associated with PCPs' perceived patients' trust in their clinical competence. A strong association was found between accurate diagnosis and treatment (OR=1.20, 95% CI=1.08 to 1.34, p<0.001; OR=1.22, 95% CI=1.10 to 1.35, p<0.001), conflicting patient and employer interests (OR=1.35, 95% CI=1.12 to 1.63, p<0.01; OR=1.29, 95% CI=1.07 to 1.54, p<0.01) and PCPs' perceived patient worries about unnecessary medicine or tests, respectively. CONCLUSIONS: PCPs' emotional support to patients as well as their abilities to make accurate diagnosis and provide appropriate treatment is positively associated with PCPs' self-reported patients' trust. It is recommended that reforms to realign patient and employer's interests be investigated