Factors Associated with Influenza & Tdap Vaccine Uptake in Pregnant Patients at the UT Family Medicine Clinic in Memphis

INTRODUCTION: Given the increased risk for infections among pregnant patients and newborns, vaccination against influenza (\u3e50,000,000 annual US cases affecting all ages) and pertussis (\u3e15,000 annual US cases disproportionately affecting newborns) are recommended among pregnant patients in order to protect them and their babies via passive immunity to cover a newborn’s window of vaccine ineligibility. Though flu and Tdap vaccination rates among pregnant patients have been trending upwards nationally, there is still room for improvement to achieve optimal rates. OBJECTIVES: The primary objectives were to study factors that affect the vaccination rates at the University of Tennessee Family Medicine Clinic at Memphis (UTFMC-M), compare those rates with national pregnancy flu/Tdap vaccination rates, and to generate recommendations based off observed factors associated with vaccine uptake to improve flu/Tdap vaccination rates in UTFMC-M pregnant patients. METHODS: This was a retrospective chart review of UTFMC-M patients who were pregnant from September 1, 2019-April 24, 2020 (included 2019-2020 flu season) (n=465). Variables studied included demographic data (race, age, insurance), immunization history (vaccine status, history of physician encouragement), and prenatal history (parity, number of prenatal visits, trimester at first visit, high risk clinic (HRC) admittance status). Vaccination status was based on ACIP recommendations (Flu shot eligible = any gestational age; Tdap eligible = ≥27 weeks). Positive HRC admittance was noted for patients with ≥2 visits to the UTFMC-M HRC, a clinic that specializes in high risk pregnant patient care. RESULTS: The patient sample was predominantly black (84.3%) and insured by Medicaid programs (88%). Among eligible UTFMC-M pregnant patients, 50.1% were flu-vaccinated (n=465); 73.8% were Tdap-vaccinated (n=317); and 52.1% were Flu+Tdap-vaccinated (n=317). No significant associations were found between vaccine uptake and HRC status, parity, and age. However, statistically significant relationships were found between vaccine uptake and physician encouragement (positive relationship with flu shot: X2(1, N = 465) =131, p \u3c 0.001, Tdap: X2 (6, N = 465) =476, p \u3c 0.001), number of prenatal visits (flu shot group median 8 visits, Tdap group median 9 visits vs. unvaccinated group median 4 visits; p \u3c 0.001), and early trimester age at first prenatal visit (X2(6, N = 465) =47.635 , p CONCLUSION: 2019-2020 UTFMC-M vaccination rates were on par with 2018-2019 US flu vaccine rates and higher than 2018-2019 US Tdap and Flu+Tdap rates. There were statistically significant relationships between vaccine uptake at UTFMC-M and physician encouragement, number of prenatal visits, and early trimester age at first prenatal visit but no significant relationships with UTFMC-M HRC admittance, parity, or age. Recommendations following from our observations to address further vaccine rate improvement include: continue vaccine encouragement, continue booking multiple visits (8 for flu, 9 for Tdap), prioritize Tdap vaccine higher for late trimester intake patients, and focus on flu vaccine encouragement and education

Improving GPT-2 Throughput for Lossless Text Compression

Compression helps with handling the enormous amount (in the hundreds of millions of terabytes) of data generated daily. We can compress data with redundancies at higher rates with better models of data. Knowing large language models' (LLM) impressive performance at modeling text data, they seem well suited for lossless text compression. We implement a lossless text compressor that uses arithmetic coding with GPT-2. A naive GPT-2-based compressor is slow---it compresses 200-500 bytes per second with a GPU compared to almost two million bytes per second by 7-Zip (a general-purpose compressor). Though such a compressor's outputs are about 30% smaller than 7-Zip's, the poor compression speed limits its practicality. Hence, we investigate how various LLM optimizations impact our compressor's performance and speed. We achieve a 1.5x speedup without significant performance degradation. We achieve further speedup (over 2x) if we accept sacrificing performance. Additionally, we find that increasing model size improves compression performance more than increasing context size and that distilled models compress better than pruned models.No embargoAcademic Major: Computer Science and Engineerin

Efficiency of first-trimester uterine artery Doppler, A-disintegrin and metalloprotease 12, pregnancy-associated plasma protein A, and maternal characteristics in the prediction of preeclampsia

OBJECTIVE: To estimate the efficiency of first-trimester uterine artery Doppler, A-disintegrin and metalloprotease 12 (ADAM12), pregnancy-associated plasma protein A (PAPP-A) and maternal characteristics in the prediction of pre-eclampsia. METHODS: This is a prospective cohort study of patients presenting for first-trimester aneuploidy screening between 11-14 weeks’ gestation. Maternal serum ADAM12 and PAPP-A levels were measured by immunoassay, and mean uterine artery Doppler pulsatility indices (PI) were calculated. Outcomes of interest included pre-eclampsia, early pre-eclampsia, defined as requiring delivery at <34 weeks’ gestation, and gestational hypertension. Logistic regression analysis was used to model the prediction of pre-eclampsia using ADAM12 multiples of the median (MoM), PAPP-A MoM, and uterine artery Doppler PI MoM, either individually or in combination. Sensitivity, specificity, and area under the receiver-operating characteristic curves (AUC) were used to compare the screening efficiency of the models using non-parametric U-statistics. RESULTS: Of 578 patients with complete outcome data, there were 54 (9.3%) cases of preeclampsia and 13 (2.2%) cases of early pre-eclampsia. Median ADAM12 levels were significantly lower in patients who developed pre-eclampsia compared to those who did not. (0.81 v. 1.01 MoMs; p<0.04) For a fixed false positive rate (FPR) of 10%, ADAM12, PAPP-A, and uterine artery Doppler in combination with maternal characteristics identified 50%, 48%, and 52% of patients who developed pre-eclampsia, respectively. Combining these first-trimester parameters did not improve the predictive efficiency of the models. CONCLUSION: First-trimester ADAM12, PAPP-A, and uterine artery Doppler are not sufficiently predictive of pre-eclampsia. Combinations of these parameters do not further improve their screening efficiency

SMA Imaging of CO(3-2) Line and 860 micron Continuum of Arp 220 : Tracing the Spatial Distribution of Luminosity

We used the Submillimeter Array (SMA) to image 860 micron continuum and CO(3-2) line emission in the ultraluminous merging galaxy Arp 220, achieving a resolution of 0.23" (80 pc) for the continuum and 0.33" (120 pc) for the line. The CO emission peaks around the two merger nuclei with a velocity signature of gas rotation around each nucleus, and is also detected in a kpc-size disk encompassing the binary nucleus. The dust continuum, in contrast, is mostly from the two nuclei. The beam-averaged brightness temperature of both line and continuum emission exceeds 50 K at and around the nuclei, revealing the presence of warm molecular gas and dust. The dust emission morphologically agrees with the distribution of radio supernova features in the east nucleus, as expected when a starburst heats the nucleus. In the brighter west nucleus, however, the submillimeter dust emission is more compact than the supernova distribution. The 860 micron core, after deconvolution, has a size of 50-80 pc, consistent with recent 1.3 mm observations, and a peak brightness temperature of (0.9-1.6)x10^2 K. Its bolometric luminosity is at least 2x10^{11} Lsun and could be ~10^{12} Lsun depending on source structure and 860 micron opacity, which we estimate to be of the order of tau_{860} ~ 1 (i.e., N_{H_2} ~ 10^{25} cm^{-2}). The starbursting west nuclear disk must have in its center a dust enshrouded AGN or a very young starburst equivalent to hundreds of super star clusters. Further spatial mapping of bolometric luminosity through submillimeter imaging is a promising way to identify the heavily obscured heating sources in Arp 220 and other luminous infrared galaxies.Comment: ApJ. in press. 26 pages, 10 figure

Resilience of infaunal ecosystems during the Early Triassic greenhouse Earth

The Permian-Triassic mass extinction severely depleted biodiversity, primarily observed in the body fossil of well-skeletonized animals. Understanding how whole ecosystems were affected and rebuilt following the crisis requires evidence from both skeletonized and soft-bodied animals; the best comprehensive information on soft-bodied animals comes from ichnofossils. We analyzed abundant trace fossils from 26 sections across the Permian-Triassic boundary in China and report key metrics of ichnodiversity, ichnodisparity, ecospace utilization, and ecosystem engineering. We find that infaunal ecologic structure was well established in the early Smithian. Decoupling of diversity between deposit feeders and suspension feeders in carbonate ramp-platform settings implies that an effect of trophic group amensalism could have delayed the recovery of nonmotile, suspension-feeding epifauna in the Early Triassic. This differential reaction of infaunal ecosystems to variable environmental controls thus played a substantial but heretofore little appreciated evolutionary and ecologic role in the overall recovery in the hot Early Triassic ocean

Cell-free circulating mitochondrial DNA content and risk of hepatocellular carcinoma in patients with chronic HBV infection.

Recent studies have demonstrated a potential link between circulating cell-free mitochondrial DNA (mtDNA) content and cancers. However, there is no study evaluating the association between circulating mtDNA as a non-invasive marker of hepatocellular carcinoma (HCC) risk. We conducted a nested case-control study to determine circulating mtDNA content in serum samples from 116 HBV-related HCC cases and 232 frequency-matched cancer-free HBV controls, and evaluate the retrospective association between mtDNA content and HCC risk using logistic regression and their temporal relationship using a mixed effects model. HCC cases had significantly lower circulating mtDNA content than controls (1.06 versus 2.47, P = 1.7 × 10(-5)). Compared to HBV patients with higher mtDNA content, those with lower mtDNA content had a significantly increased risk of HCC with an odds ratio (OR) of 2.19 (95% confidence interval [CI] 1.28-3.72, P = 0.004). Quartile analyses revealed a significant dose-dependent effect (Ptrend = 0.001) for this association. In a pilot longitudinal sub-cohort of 14 matched cases-control pairs, we observed a trend of dramatically decreased mtDNA content in cases and slightly decreased mtDNA content in controls, with a significant interaction of case-control status with time (Pinteraction = 0.049). Our findings suggest that circulating mtDNA is a potential novel non-invasive biomarker of HCC risk in HBV patients

Genomic, Pathway Network, and Immunologic Features Distinguishing Squamous Carcinomas

This integrated, multiplatform PanCancer Atlas study co-mapped and identified distinguishing molecular features of squamous cell carcinomas (SCCs) from five sites associated with smokin

Unveiling the physical properties and kinematics of molecular gas in the Antennae Galaxies (NGC 4038/9) through high resolution CO (J = 3-2) observations

We present a ~ 1" (100 pc) resolution 12CO (3-2) map of the nearby intermediate stage interacting galaxy pair NGC 4038/9 (the Antennae galaxies) obtained with the Submillimeter Array. We find that half the CO (3-2) emission originates in the overlap region where most of the tidally induced star formation had been previously found in shorter wavelength images, with the rest being centered on each of the nuclei. The gross distribution is consistent with lower resolution single dish images, but we show for the first time the detailed distribution of the warm and dense molecular gas across this galaxy pair at resolutions comparable to the size of a typical giant molecular complex. While we find that 58% (33/57) of the spatially resolved Giant Molecular Associations (GMAs; a few x 100 pc) are located in the overlap region, only \leqq 30% spatially coincides with the optically detected star clusters, suggesting that the bulk of the CO (3-2) emission traces the regions with very recent or near future star formation activity. The spatial distribution of the CO (3-2)/CO (1-0) integrated brightness temperature ratios mainly range between 0.3 and 0.8, which suggests that on average the CO (3-2) line in the Antennae is not completely thermalized and similar to the average values of nearby spirals. A higher ratio is seen in both nuclei and the southern complexes in the overlap region. Higher radiation field associated with intense star formation can account for the nucleus of NGC 4038 and the overlap region, but the nuclear region of NGC 4039 show relatively little star formation or AGN activities and cannot be easily explained. We show kinematical evidence that the high line ratio in NGC 4039 is possibly caused by gas inflow into the counter-rotating central disk.Comment: 20 pages, 12 figures, 4 tables, accepted for publication in Astrophysical Journa

Jet energy measurement with the ATLAS detector in proton-proton collisions at root s=7 TeV

The jet energy scale and its systematic uncertainty are determined for jets measured with the ATLAS detector at the LHC in proton-proton collision data at a centre-of-mass energy of √s = 7TeV corresponding to an integrated luminosity of 38 pb-1. Jets are reconstructed with the anti-kt algorithm with distance parameters R=0. 4 or R=0. 6. Jet energy and angle corrections are determined from Monte Carlo simulations to calibrate jets with transverse momenta pT≥20 GeV and pseudorapidities {pipe}η{pipe}<4. 5. The jet energy systematic uncertainty is estimated using the single isolated hadron response measured in situ and in test-beams, exploiting the transverse momentum balance between central and forward jets in events with dijet topologies and studying systematic variations in Monte Carlo simulations. The jet energy uncertainty is less than 2. 5 % in the central calorimeter region ({pipe}η{pipe}<0. 8) for jets with 60≤pT<800 GeV, and is maximally 14 % for pT<30 GeV in the most forward region 3. 2≤{pipe}η{pipe}<4. 5. The jet energy is validated for jet transverse momenta up to 1 TeV to the level of a few percent using several in situ techniques by comparing a well-known reference such as the recoiling photon pT, the sum of the transverse momenta of tracks associated to the jet, or a system of low-pT jets recoiling against a high-pT jet. More sophisticated jet calibration schemes are presented based on calorimeter cell energy density weighting or hadronic properties of jets, aiming for an improved jet energy resolution and a reduced flavour dependence of the jet response. The systematic uncertainty of the jet energy determined from a combination of in situ techniques is consistent with the one derived from single hadron response measurements over a wide kinematic range. The nominal corrections and uncertainties are derived for isolated jets in an inclusive sample of high-pT jets. Special cases such as event topologies with close-by jets, or selections of samples with an enhanced content of jets originating from light quarks, heavy quarks or gluons are also discussed and the corresponding uncertainties are determined. © 2013 CERN for the benefit of the ATLAS collaboration