Annual Summary of Vital Statistics-2000

The birth rate in 2000 (preliminary data)was 14.8 births per 1000 population, an increase of 2% from 1999 (14.5). The fertility rate, births per 1000 women aged 15 to 44 years, increased 3% to 67.6 in 2000, compared with 65.9 in 1999. The 2000 increases in births and the fertility rate were the third consecutive yearly increases, the largest in many years, halting the steady decline in the number of births and fertility rates in the 1990s. Fertility rates for total white, non-Hispanic white, black, and Native American women each increased about 2% in 2000. The fertility rate for black women, which declined 19% from 1990 to 1996, has changed little since 1996. The rate for Hispanic women rose 4% in 2000 to reach the highest level since 1993. Birth rates for women 30 years or older continued to increase. The proportion of births to unmarried women remained about the same at one third, but the number of births rose 3%. The birth rate for teen mothers declined again for the ninth consecutive year. The use of timely prenatal care (83.2%) remained unchanged in 2000, and was essentially unchanged for non-Hispanic white (88.5%), black (74.2%), and Hispanic (74.4%) mothers. The number and rate of multiple births continued their dramatic rise, but all of the increase was confined to twins; for the first time in more than a decade, the number of triplet and higher-order multiple births declined (4%) between 1998 and 1999 (multiple birth information is not available in preliminary 2000 data). The overall increases in multiple births account, in part, for the lack of improvement in the percentage of low birth weight (LBW) births. LBW remained at 7.6% in 2000. The infant mortality rate (IMR) dropped to 6.9 per 1000 live births (preliminary data) in 2000 (the rate was 7.1 in 1999). The ratio of the IMR among black infants to that for white infants was 2.5 in 2000, the same as in 1999. Racial differences in infant mortality remain a major public health concern. The role of low birth weight in infant mortality remains a major issue. Among all of the states, Utah and Maine had the lowest IMRs. State-bystate differences in IMR reflect racial composition, the percentage LBW, and birth weight-specific neonatal mortality rates for each state. The United States continues to rank poorly in international comparisons of infant mortality. Expectation of life at birth reached a record high of 76.9 years for all gender and race groups combined. Death rates in the United States continue to decline. The age-adjusted death rate for suicide declined 4% between 1999 and 2000; homicide declined 7%. Death rates for children 19 years of age or less declined for 3 of the 5 leading causes in 2000; cancer and suicide levels did not change for children as a group. A large proportion of childhood deaths, however, continue to occur as a result of preventable injuries

Earth Through the Eyes of NAPA-1: Commissioning Results and the Next Steps in CubeSat Earth Observation

Disruptive CubeSat technology has brought scientific missions within reach that were previously only achievable through larger spacecraft. Satellite Earth Observation is now the new frontier for governments, private industry, and academia. With the recent launch of the Napa-1 satellite the Royal Thai Airforce (RTAF) has joined the ranks by having its first ever Earth Observation CubeSat in space. Its design, launch, early operations (LEOPS), and commissioning have been carried out by ISISpace, supporting the market’s need for imagery from space. Napa-1, meaning firmament in Thai, is a 6U CubeSat with the Gecko Imager from SCS Space as its primary payload, capable of taking RGB snapshot images with a 39-meter ground sampling distance (GSD) from 500 km altitude. In addition, the TriScape camera from Simera Sense flies onboard as an in-orbit technology demonstrator and is capable of delivering high-quality images with a GSD of 5 meter in the RGB bands. With well over 200 images taken by the primary payload this paper will look back on this exciting first period of Napa-1’s operational life and proudly present the very first images taken by the satellite and the lessons learnt throughout this turnkey mission. With that many images taken and that much data generated, the implemented onboard- and on ground data handling systems have been put to the test. ISISpace has made use of KUBOS’ Major Tom for command and control and having integrated a low-level processing tool, also for image data preview and delivery. Insight is provided into the systems and tools in place for image target planning, image acquisition, satellite command and control, and data delivery to the customer. How is it ensured targets are successfully captured? How is the usefulness of the image data efficiently validated? Subsequently, how is knowledge transfer to the customer accomplished to ensure successful routine operations? ISISpace will share the valuable lessons learnt from the mission planning, data handling, operations, and training points of view and show relevant in-orbit data on, for example, attitude behavior and temperature. In parallel, ISISpace has taken the next step in CubeSat Earth observation by using Napa-1 as a baseline while accommodating larger data streams and leveraging a higher level of automation. Together with the companies Simera Sense and Pinkmatter Solutions, multispectral images with automated on ground data processing (L0 up to L3) are to be delivered by the follow-up mission, Napa-2, to be launched in the summer of 2021. Details on this mission, including a further outlook at how CubeSat imagery and on ground processing will be shaped in the next few years will be provided

Transforming the Healthcare Response to Intimate Partner Violence and Taking Best Practices to Scale

BACKGROUND: Intimate partner violence (IPV) is prevalent among adolescent and adult women, with significant physical, sexual, and mental health consequences. In 2011, the Institute of Medicine\u27s Clinical Preventive Services for Women consensus report recommended universal screening for violence as a component of women\u27s preventive services; this policy has been adopted by the Health Resources and Services Administration (HRSA). These policy developments require that effective clinic-based interventions be identified, easily implemented, and taken to scale. METHODS: To foster dialogue about implementing effective interventions, we convened a symposium entitled Responding to Violence Against Women: Emerging Evidence, Implementation Science, and Innovative Interventions, on May 21, 2012. Drawing on multidisciplinary expertise, the agenda integrated data on the prevalence and health impact of IPV violence, with an overview of the implementation science framework, and a panel of innovative IPV screening interventions. Recommendations were generated for developing, testing, and implementing clinic-based interventions to reduce violence and mitigate its health impact. RESULTS: The strength of evidence supporting specific IPV screening interventions has improved, but the optimal implementation and dissemination strategies are not clear. Implementation science, which seeks to close the evidence to program gap, is a useful framework for improving screening and intervention uptake and ensuring the translation of research findings into routine practice. CONCLUSIONS: Findings have substantial relevance to the broader research, clinical, and practitioner community. Our conference proceedings fill a timely gap in knowledge by informing practitioners as they strive to implement universal IPV screening and guiding researchers as they evaluate the success of implementing IPV interventions to improve women\u27s health and well-being

APOE ϵ4 modifies the relationship between infectious burden and poor cognition

Objective: We investigated whether APOE ϵ4 is an effect modifier of the association between infectious burden (IB) and poor cognition in a multiethnic cohort, the Northern Manhattan Study. Methods: IB was assessed by a quantitative weighted index of exposure to common pathogens associated with vascular risk, infectious burden index (IBI), and by serology for individual infections. Cognition was assessed by completion of the Mini-Mental State Examination at baseline and a full neuropsychological test battery after a median follow-up of approximately 6 years. Adjusted linear and logistic regressions estimated the association between IBI and cognition, with a term included for the interaction between APOE ϵ4 and IBI. Results: Among those with full neuropsychological test results (n = 569), there were interactions between IBI and APOE ϵ4 (p = 0.07) and herpes simplex virus 1 (HSV-1) and APOE ϵ4 (p = 0.02) for processing speed. IBI was associated with slower processing speed among non–ϵ4 carriers (β = −0.08 per SD change in IBI, 95% confidence interval [CI] −0.16 to −0.01), but not among APOE ϵ4 carriers (β = 0.06 per SD change in IBI, 95% CI –0.08 to 0.19). HSV-1 positivity was associated with slower processing speed among non–ϵ4 carriers (β = −0.24, 95% CI −0.45 to −0.03), but not among APOE ϵ4 carriers (β = 0.27, 95% CI −0.09 to 0.64). Conclusions: Potential effect modification by the APOE ϵ4 allele on the relationship of infection, and particularly viral infection, to cognitive processing speed warrants further investigation

The Interplay of Variants Near LEKR and CCNL1 and Social Stress in Relation to Birth Size

Background We previously identified via a genome wide association study variants near LEKR and CCNL1 and in the ADCY5 genes lead to lower birthweight. Here, we study the impact of these variants and social stress during pregnancy, defined as social adversity and neighborhood disparity, on infant birth size. We aimed to determine whether the addition of genetic variance magnified the observed associations. Methodology/Principal Findings We analyzed data from the Northern Finland Birth Cohort 1986 (n = 5369). Social adversity was defined by young maternal age (<20 years), low maternal education (<11 years), and/or single marital status. Neighborhood social disparity was assessed by discrepancy between neighborhoods relative to personal socio-economic status. These variables are indicative of social and socioeconomic stress, but also of biological risk. The adjusted multiple regression analysis showed smaller birth size in both infants of mothers who experienced social adversity (birthweight by −40.4 g, 95%CI −61.4, −19.5; birth length −0.14 cm, 95%CI −0.23, −0.05; head circumference −0.09 cm 95%CI −0.15, −0.02) and neighborhood disparity (birthweight −28.8 g, 95%CI −47.7, −10.0; birth length −0.12 cm, 95%CI −0.20, −0.05). The birthweight-lowering risk allele (SNP rs900400 near LEKR and CCNL1) magnified this association in an additive manner. However, likely due to sample size restriction, this association was not significant for the SNP rs9883204 in ADCY5. Birth size difference due to social stress was greater in the presence of birthweight-lowering alleles. Conclusions/Significance Social adversity, neighborhood disparity, and genetic variants have independent associations with infant birth size in the mutually adjusted analyses. If the newborn carried a risk allele rs900400 near LEKR/CCNL1, the impact of stress on birth size was stronger. These observations give support to the hypothesis that individuals with genetic or other biological risk are more vulnerable to environmental influences. Our study indicates the need for further research to understand the mechanisms by which genes impact individual vulnerability to environmental insults

Integrated management of cogeneration plants and district heating networks

L'articolo tratta dell'utilizzo integrato dei modelli numerici del CHP e della rete e dell'utilizzo delle relative dinamiche per l'ottimizzazione energetica della conduzione del sistema