States Population Research Articles

Nonadiabatic Field with Triangle Window Functions on Quantum Phase Space.

Recent progress on the constraint coordinate-momentum phase space (CPS) formulation of finite-state quantum systems has revealed that the triangle window function approach is an isomorphic representation of the exact population-population correlation function of the two-state system. We use the triangle window (TW) function and the CPS mapping kernel element to formulate a novel useful representation of discrete electronic degrees of freedom (DOFs). When it is employed with nonadiabatic field (NaF) dynamics, a new variant of the NaF approach (i.e., NaF-TW) is proposed. The NaF-TW expression of the population of any adiabatic state is always positive semidefinite. Extensive benchmark tests of model systems in both the condensed phase and gas phase demonstrate that the NaF-TW approach is able to faithfully capture the dynamical interplay between electronic and nuclear DOFs in a broad region, including where the states remain coupled all the time, as well as where the bifurcation characteristic of nuclear motion is important.

Quantitative analysis of social influence and digital piracy contagion with differential equations on networks

Illegal file sharing of copyrighted contents through popular file sharing networks poses an enormous threat to providers of digital contents, such as, games, softwares, music and movies. Though empirical studies of network effects on piracy is a well-studied domain, the dynamics of peer effect in the context of evolving social contagion has not been enough explored using dynamical models. In this research, we methodically study the trends of online piracy with a continuous ODE approach and differential equations on graphs to have a clear comparative view. We first formulate a compartmental model to study bifurcations and thresholds mathematically. We later move on with a network-based analysis to illustrate the proliferation of online piracy dynamics with an epidemiological approach over a social network. We figure out a solution for this online piracy problem by developing awareness among individuals and introducing media campaigns, which could be a valuable factor in eradicating and controlling online piracy. Next, using degree-block approximation, network analysis has been performed to investigate the phenomena from a heterogeneous approach and to derive the threshold condition for the persistence of piracy in the population in a steady state. Considering the dual control of positive peer influence and media-driven awareness, we examine the system through realistic parameter selection to better understand the complexity of the dynamics and suggest policy implications.

Association between dietary consumption of fatty acids and age-related macular degeneration in the National Health and Nutrition Examination Survey

The aim of this study is to assess the relationship between dietary intake of fatty acids and the age-related macular degeneration (AMD) in the United States population. Adult participants of the 2005–2008 National Health and Nutrition Examination Survey (NHANES) were included in this nationwide cross-sectional study. Dietary fatty acid intake was obtained from two 24-h dietary recall interviews. The intake of dietary fatty acids was analyzed as a continuous and categorical variable. AMD status was assessed using nonmydriatic fundus photographs. Univariate and multivariate logistic regression analyses were used to assess the association between dietary fatty acid intake and AMD. The unweighted population included 4702 individuals of whom 374 had AMD. After adjusting for relevant variables, each 1 unit increase (1 mg/1000 kcal) intake of EPA (OR: 0.996, 95% CI: 0.993–0.996, P = 0.018), DPA (OR: 0.976, 95% CI: 0.962–0.990, P = 0.002), and DHA (OR: 0.996, 95% CI: 0.994–0.999, P = 0.003) were significantly decreased odds of any AMD. The highest versus lowest quartile of EPA (OR: 0.476, P for trend < 0.001), DPA (OR: 0.467, P for trend = 0.005) and DHA (OR: 0.586, P for trend = 0.008) were negatively associated with the odds of any AMD. Subgroup analysis showed that higher quartiles of EPA (OR: 0.461, P for trend < 0.002), DPA (OR: 0.467, P for trend = 0.006) and DHA (OR: 0.578, P for trend = 0.007) exhibited a negative association with early AMD. The study found no significant association between the intake of dietary fatty acids, including n-3 PUFA, and the odds of late AMD. In the 2005–2008 NHANES population, higher dietary DHA, DPA and EPA intake associated with decreased odds of early AMD. However, no clear association was found between specific types of FAs and late AMD.

Genetic differentiation of wild boar populations in a region affected by African swine fever

In the European Union, African swine fever (ASF) affects wild boar (Sus scrofa) populations in several Member States. Knowledge of population connectivity is important for the implementation of control measures, in particular the establishment of effective barriers. Population genetic comparisons of neighbouring populations can be very helpful in this respect. The present study investigated the genetic differentiation of wild boar in eastern Germany. This region has been affected by ASF since September 2020. A total of 1,262 wild boars from 31 hunting grounds (populations) in ASF-affected and ASF-free districts were sampled over a total area of almost 100,000 km². The study area encompassed a network of geographical factors that promote (roads, rivers, cities) or inhibit (natural areas, habitat corridors) genetic differentiation between wild boar populations. The genetic differentiation of the areas was based on 12 microsatellite markers. Three different Bayesian algorithms were used to analyse the data. The results were combined into a common approach with 9 clusters. Based on the cluster distribution in each population, the connectivity between the areas was quantified. The strongest differentiation was found along an imaginary line along the lower Elbe valley through Berlin and the A11 freeway to the Szczecin Lagoon. In contrast, the Mecklenburg Lake District and the south-east of the study area showed strong connectivity between areas. The special features of the landscapes along the lower Elbe valley, which was assessed as highly connective, and the high barrier effect of the A11 freeway in contrast to the other freeways in the study area show that barrier effects cannot be generalised in principle, but are actually determined by the circumstances of individual structures. The results of the connectivity analysis were compared with the distribution of viral lineages and variants. The genotypes of the wild boar populations and the ASFV lineages and variants showed a good explanatory approach for the observed disease dynamics in the study area. The newly gained knowledge on barriers and regionally different connectivity between wild boar populations can support considerations and measures for the containment of ASF in the affected areas by improving the understanding of wild boar dispersal dynamics.

Characterization of Deformational Isomerization Potential and Interconversion Dynamics with Ultrafast X-ray Solution Scattering.

Dimeric complexes composed of d8 square planar metal centers and rigid bridging ligands provide model systems to understand the interplay between attractive dispersion forces and steric strain in order to assist the development of reliable methods to model metal dimer complexes more broadly. [Ir2 (dimen)4]2+ (dimen = para-diisocyanomenthane) presents a unique case study for such phenomena, as distortions of the optimal structure of a ligand with limited conformational flexibility counteract the attractive dispersive forces from the metal and ligand to yield a complex with two ground state deformational isomers. Here, we use ultrafast X-ray solution scattering (XSS) and optical transient absorption spectroscopy (OTAS) to reveal the nature of the equilibrium distribution and the exchange rate between the deformational isomers. The two ground state isomers have spectrally distinct electronic excitations that enable the selective excitation of one isomer or the other using a femtosecond duration pulse of visible light. We then track the dynamics of the nonequilibrium depletion of the electronic ground state population─often termed the ground state hole─with ultrafast XSS and OTAS, revealing a restoration of the ground state equilibrium in 2.3 ps. This combined experimental and theoretical study provides a critical test of various density functional approximations in the description of bridged d8-d8 metal complexes. The results show that density functional theory calculations can reproduce the primary experimental observations if dispersion interactions are added, and a hybrid functional, which includes exact exchange, is used.

A bioinformatic analysis of T-cell epitope diversity in SARS-CoV-2 variants: association with COVID-19 clinical severity in the United States population

Long-term immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) requires the identification of T-cell epitopes affecting host immunogenicity. In this computational study, we explored the CD8+ epitope diversity estimated in 27 of the most common HLA-A and HLA-B alleles, representing most of the United States population. Analysis of 16 SARS-CoV-2 variants [B.1, Alpha (B.1.1.7), five Delta (AY.100, AY.25, AY.3, AY.3.1, AY.44), and nine Omicron (BA.1, BA.1.1, BA.2, BA.4, BA.5, BQ.1, BQ.1.1, XBB.1, XBB.1.5)] in analyzed MHC class I alleles revealed that SARS-CoV-2 CD8+ epitope conservation was estimated at 87.6%–96.5% in spike (S), 92.5%–99.6% in membrane (M), and 94.6%–99% in nucleocapsid (N). As the virus mutated, an increasing proportion of S epitopes experienced reduced predicted binding affinity: 70% of Omicron BQ.1-XBB.1.5 S epitopes experienced decreased predicted binding, as compared with ~3% and ~15% in the earlier strains Delta AY.100–AY.44 and Omicron BA.1–BA.5, respectively. Additionally, we identified several novel candidate HLA alleles that may be more susceptible to severe disease, notably HLA-A*32:01, HLA-A*26:01, and HLA-B*53:01, and relatively protected from disease, such as HLA-A*31:01, HLA-B*40:01, HLA-B*44:03, and HLA-B*57:01. Our findings support the hypothesis that viral genetic variation affecting CD8 T-cell epitope immunogenicity contributes to determining the clinical severity of acute COVID-19. Achieving long-term COVID-19 immunity will require an understanding of the relationship between T cells, SARS-CoV-2 variants, and host MHC class I genetics. This project is one of the first to explore the SARS-CoV-2 CD8+ epitope diversity that putatively impacts much of the United States population.

Herpes zoster in older adults: Impact on carbon footprint in the United States

ABSTRACT We provide estimates for (I) annual herpes zoster (HZ) cases, (II) carbon costs related to healthcare utilization, and (III) annual carbon emissions due to HZ among ≥50 years of age (YOA) United States (US) population. We estimated the annual number of HZ cases in the US based on available incidence data and demographic data of individuals ≥50 YOA. Both the healthcare resource utilization (HCRU) associated with HZ cases and the unit carbon dioxide equivalent (i.e. CO2e) costs associated with each type of HCRU in the US were estimated based on literature and studies available online. The carbon footprint associated with HZ annually among US adults ≥50 YOA was estimated by multiplying the unit carbon estimates by the HCRU. In the US population aged ≥50 YOA in 2020 (i.e. approximately 118 million), approximately 1.1 million cases of HZ occur annually assuming no vaccination. Based on 2 sources of HCRU the average kgCO2e per HZ patient ranged from 61.0 to 97.6 kgCO2e, with values by age group ranging from 40.9 kgCO2e in patients aged 50–59 to 195.9 kgCO2e in patients ≥80 YOA. The total annual HZ associated carbon ranged between 67,000 and 107,000 tons of CO2e in the US population aged ≥50 YOA. The impact of HZ on carbon footprint in the US results in considerable greenhouse gas (GHG)emissions. Assuming no vaccination, the burden of HZ is projected to rise over the coming years with the aging populations consequently worsening its impact on GHG emissions. (Figure 1)

Abstract PO2-25-11: Incidence of Breast Cancer in Louisiana Compared to the United States

Abstract Aside from skin cancer, breast cancer is the most common cancer in American women. More specifically, one in eight women will develop breast cancer during their lifetime. Breast cancer is classified into subtypes defined by immunohistochemistry (IHC) expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). ER+/PR+/HER2- tumors are the most common form of breast cancer and are typically associated with risk factors including older age, nulliparity, obesity following menopause, alcohol and tobacco use, sedentary lifestyle, and hormone therapy. ER-/PR-/HER2+ tumors comprise approximately 15-20% of breast cancers and are caused by overexpression of the HER2 gene. These tumors have similar risk factors to ER+/PR+/HER2- tumors, except for age. Women with HER2+ breast cancer are likely to be younger compared to ER+PR+/HER2-. Tumors lacking hormone receptors are classified as ER-/PR-/HER2-, otherwise known as triple-negative breast cancer (TNBC). TNBC represents 10%-20% of breast cancers and carries a poorer prognosis, shorter survival, and unresponsiveness to hormone therapy compared to other forms of breast cancer. TNBC has been associated with African American race, socioeconomically deprived population, younger age at diagnosis (most frequently in women ages 40-50), more advanced disease stage, higher grade, high mitotic indices, family history of breast cancer and BRCA1 mutations. The primary aim of this study is to compare incidence of ER+/PR+/HER2-, ER-/PR-/HER2+, and ER-/PR-/HER2- (TNBC) in Louisiana to the national population. The Louisiana Tumor Registry (LTR) was utilized to obtain state and national level data. The LTR is a participant of the National Cancer Institute’s Surveillance, Epidemiology and End Results Program, and the Centers for Disease Control and Prevention’s National Program of Cancer Registries. Our study evaluated women in Louisiana diagnosed with ER+/PR+/HER2-, ER-/PR-/HER2+, and ER-/PR-/HER2- from 2010-2019. The populations were subdivided by age at time of diagnosis. Data was subdivided into ages 0-49, and &amp;gt;50. Rates were calculated per 100,00 and age-adjusted to the 2000 United States Standard Population (19 age groups - Census P25-1130). A p-value of &amp;lt; 0.05 indicates a significantly different rate in Louisiana comparative to the United States (SEER). Our results are as follows. Unexpectedly, Louisiana has a significantly lower rate of ER+/PR+/HER2- cancer in women ages 0-49 and ages &amp;gt;50 compared to the United States. Based on epidemiological risk factors, Louisiana should have a much higher rate of ER+/PR+/HER2- comparative to the United States population. Louisiana has a significantly higher rate of ER-/PR-/HER2+ cancer in women ages &amp;gt;50 and ER-/PR-/HER2- (TNBC) in women ages 0-49 and ages &amp;gt;50 compared to the United States. These findings are discordant with traditional epidemiologic studies regarding breast cancer and require further investigation. Breast Cancer Incidence Rates1 by Age from 2010-2019 in Louisiana and the United States Table 1: Breast Cancer Incidence Rates in women ages 0-49 and ages &amp;gt;50 from 2010-2019 in Louisiana Compared to the United States. Citation Format: Avery Daily, Julie Cupp, Krystle Trosclair. Incidence of Breast Cancer in Louisiana Compared to the United States [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-25-11.

Charge separation control in organic photosensitizers for photocatalytic water splitting without sacrificial electron donors

Photocatalytic hydrogen evolution reaction (photoHER) is one of the most promising approaches towards production of “green” hydrogen. Currently, the state-of-the-art photoHER systems require the use of sacrificial electron donors (SED), because of inefficient charge separation in photosensitizers and thermodynamically challenging water oxidation by the same catalyst. Here, we present a molecular design approach for all-organic photosensitizers with effective intramolecular charge separation, microsecond lifetime of excited states, controllable direction of electron transfer, and ability to oxidize water for recovery of the photocatalytic system to its initial state. Such photosensitizers comprise weakly conjugated strong electron donor and acceptor what enables charge transfer during the light absorption. The excitation energy is stored in long-living triplet states, whose lifetime can be monitored by the thermally activated delayed fluorescence. Additionally, application of heavy-atom effect helps not only to increase the population of triplet state but also to increase its stability and lifetime. When such photosensitizers are attached to the platinized TiO2, efficient photoHER catalysts are obtained which produce H2 under irradiation with sunlight. In the presence of SED, the highest turnover number after 24 h (TON24h) of such systems exceed 3500, whilst in pure water without any SED, TON24h reaches 2000. Our best system performs photocatalytic SED-free water-splitting for 48 h keeping 100 % of its activity and constant turnover frequency of 26 h−1. The described here investigations reveal that water splitting can be performed by a simple three component system “photosensitizer|TiO2|Pt” under specific control of 1) the charge separation and its direction, 2) intersystem crossing rate and triplet state lifetime, and 3) favorable water oxidation thermodynamics within a photosensitizer together with 4) appropriate alignment of energy levels to the catalyst.

Increasing Diversity, Equity, and Inclusion in Urology Residency Recruitment: Recommendations from the Society of Women in Urology

ObjectiveTo provide a framework for diversifying the urologic workforce through residency recruitment by integrating principles of diversity, equity, and inclusion (DEI) into program mission and values, application review, and interview process. Materials and MethodsFor this narrative review, the Society of Women in Urology Advancing DEI in Urology Residency Recruitment Task Force identified four areas for incorporating DEI into residency recruitment: defining a residency program’s mission and values, holistic application review, an objective interview process, and implementing DEI principles into a program. Using PubMed and Google Scholar, we performed a non-systematic literature search of articles from January 2014 through January 2024. Search terms included combinations of “diversity”, “equity”, “inclusion”, “residency”, “holistic review”, “applications”, “interviews”, and “initiatives”. Additional resources were identified through citations of selected articles. Based on findings from these articles, Task Force members made recommendations for best practices. ResultsThe diversity of practicing urologists is disproportionate to that of the United States population. Emerging evidence demonstrates that DEI efforts in healthcare are associated with better outcomes and reduction in healthcare inequities. We offer strategies for residency programs to integrate DEI initiatives into their recruitment, application review, and interview process. Furthermore, we address extending DEI principles into a program’s mission and culture to create an inclusive environment conducive to training and supporting individuals from unique backgrounds. ConclusionIt is critical to recruit and retain diverse talent into urology to improve patient care. We urge residency programs and their supporting institutions to adopt DEI principles into their recruitment efforts.

A Case-Control Study of Racial Differences in Melasma Risk Factors and Incidence in a Diverse National United States Population

A Case-Control Study of Racial Differences in Melasma Risk Factors and Incidence in a Diverse National United States Population

Demographic Correlates of Endometriosis Diagnosis Among United States Women Aged 15-50

To compare demographic characteristics for women with and without a diagnosis of endometriosis. Data were collected from the National Survey of Family Growth - a publicly available survey designed and administered by the Centers for Disease Control, which uses a nationally-representative sample of the United States population. Univariate data were reported as survey-weighted percentages and means, and were analyzed using chi-square, t-tests, and logistic regression. Analyses accounted for complex survey design. United States PARTICIPANTS: Interviews were conducted with 6,141 female respondents, aged 15-50, between 2017 and 2019. Data were collected through in-person interviews. Nationally, 5.7% reported a diagnosis of endometriosis (95% CI 4.6-6.9%). Those with endometriosis were older, with a mean age of 39 (95% CI 38.1-39.9), compared to 31.7 (95% CI 31.2-32.2) among those without (p < 0.0005). Endometriosis diagnosis was significantly associated with race. Compared to non-Hispanic White women, Hispanic women had an adjusted odds ratio (aOR) of 0.37 (95% CI 0.21-0.65) for diagnosis of endometriosis, and non-Hispanic Black women had an aOR of 0.54 (95% CI 0.35-0.84). We also observed a difference in diagnosis by health insurance: compared to those with private insurance or Medi-Gap coverage, those with Medicare or military insurance had an aOR for endometriosis diagnosis of 2.49 (95% CI 1.36-4.55). Finally, compared to those with less than a high school education, those who had completed high school or greater had an aOR for endometriosis diagnosis of 2.84 (95% CI 1.15-6.99). These disparities in endometriosis diagnosis suggest that intersecting barriers may preclude certain groups from accessing timely endometriosis diagnosis and management. Further studies are warranted to explore these hypothesis-generating data, and to identify and address specific barriers to equitable endometriosis diagnosis and management.

Mental Health and Traumatic Occupational Exposure in Wildland Fire Dispatchers

Wildland fire dispatchers play a key role in wildland fire management and response organization; however, to date, wildland fire studies have largely focused on the physical hazards and, to a lesser extent, mental health hazards of wildland firefighting operational personnel, and dispatcher studies have primarily focused on 911 and police dispatchers. Studies of other dispatchers have provided some limited insight into potential strains impacting this workforce, including work-related fatigue, burnout, and traumatic exposure. However, the specific job hazards that are faced by wildland fire dispatchers are poorly understood. In 2023, we conducted a cross-sectional survey of 510 wildland fire dispatchers with questions about their occupational health, general health, and well-being. We used validated screening instruments to measure the rates of anxiety, depression, PTSD, and suicidal thoughts and ideation. Here, we also present the results of mental health and trauma exposure questions that were asked as part of a larger survey. We found that demographic factors were significant indicators of anxiety, depression, and binge/restrictive eating. Our data indicate that rates of anxiety, depression, PTSD, and suicidal thoughts and ideation are significantly higher for both the wildland fire dispatching workforce and other emergency responder populations than those of the general United States population.

The Economic Impact of Poor Road System on Agricultural Value Chain in Rivers State, Nigeria

The purpose of this research was to examine the economic impact of poor road system on agricultural value chain in Rivers State. This study utilized a survey methodology to collect data from the whole population of Rivers state. A total of 355 people from the three senatorial districts filled out the survey, and the researcher used the Taro Yamane formula to determine that a sample size of 400 was appropriate. With a mean criteria of 3.0, the Statistical Package for the Social Sciences (SPSS) were used to analyze the study's research topics. Reviewing the results of the economic impact of poor road network on agricultural value chain in Rivers State are; damage of perishable goods as a result of long hours spent in transporting the goods from farm to market, etc. The study concluded that good road system is one of the factors to achieve food sufficiency in the Rivers State and recommended that government of the state should assists farmers in conveying their farm produce to urban market where they are sold for better price by providing vehicles for them, create good road network that connect farmlands to modern market in urban areas of the state among others.

The Gould’s Toucanet Selenidera gouldii (Natterer, 1837) (Aves: Ramphastidae) as a monotypic species

The Gould’s Toucanet Selenidera gouldii (Natterer, 1837) occurs mainly in eastern Amazonia, with a geographically isolated population in the northeast Brazilian state of Ceará. Based on two male specimens from the latter population that appeared to have a smaller body and bill with a relatively large black patch, Pinto &amp; Camargo (1961) described the subspecies S. g. baturitensis. This taxon has long been known in museum collections only by the two male specimens mentioned in its description, but recently obtained specimens have now permitted a test of its validity with larger sample sizes. Here, I examined the largest sample of S. g. baturitensis studied to date to show that S. g. gouldii and S. g. baturitensis are just the east and west ends of a broad geographic pattern of smoothly clinal differences in morphometrics that were categorized as subspecies taxa.

Morbidity pattern among tribal farmers in a selected district of Tripura, India

Background: Tribal communities in Tripura comprise 31.76% of the state's total population. The tribal people of Tripura are primarily farmers, and in spite of concerns about their poor health and unfulfilled requirements, they continue to get healthcare in isolated locations where there are obstacles such as undernourishment, a lack of medical facilities, and a labor scarcity. The study's objective is to ascertain the morbidity pattern among tribal farmers in Tripura. Methods: In 2021 after receiving approval from IIPS, Mumbai, selected farmers from Dhalai district were surveyed. We utilised cross-tabulation, chi2, PCA and straightforward logistic regression. Results: Only 5.17% of the sample population had higher education, 54.1% overall was male, and 23.1% were smokers. Jhum (Hill) cultivation was used by 15.5%, while regular (plain) farming was used by 84.5%. Tribal farmers in Tripura were suffered by both acute and chronic diseases. Diarrhoea and fever amongst acute diseases seemed to have the highest prevalence rates (1.82% each), whereas jaundice and reproductive tract infections have the lowest levels (0.30 each). Asthma had the highest prevalence (3.65%) among the chronic diseases, followed by hypertension (2.74%). The morbidity rate decreased as education levels rose. Normal cultivators and the cultivators who worked more times were more likely to have both acute and chronic diseases than jhum cultivators. Conclusions: It is possible to draw the conclusion that farmers didn't lead a healthy lifestyle and suffered from diseases. The study's findings could serve as a foundation for developing economic, educational, and medical plans for tribal farmers to safeguard them from health risks and workplace dangers.

Burden of gallstone disease in the United States population: Prepandemic rates and trends.

Gallstone disease is one of the most common digestive disorders in the United States and leads to significant morbidity, mortality, and health care utilization. To expand on earlier findings and investigate prepandemic rates and trends in the gallstone disease burden in the United States using national survey and claims databases. The National Ambulatory Medical Care Survey, National Inpatient Sample, Nationwide Emergency Department Sample, Nationwide Ambulatory Surgery Sample, Vital Statistics of the United States, Optum Clinformatics® Data Mart, and Centers for Medicare and Medicaid Services Medicare 5% Sample and Medicaid files were used to estimate claims-based prevalence, medical care including cholecystectomy, and mortality with a primary or other gallstone diagnosis. Rates were age-adjusted (for national databases) and shown per 100000 population. Gallstone disease prevalence (claims-based, 2019) was 0.70% among commercial insurance enrollees, 1.03% among Medicaid beneficiaries, and 2.09% among Medicare beneficiaries and rose over the previous decade. Recently, in the United States population, gallstone disease contributed to approximately 2.2 million ambulatory care visits, 1.2 million emergency department visits, 625000 hospital discharges, and 2000 deaths annually. Women had higher medical care rates with a gallstone disease diagnosis, but mortality rates were higher among men. Hispanics had higher ambulatory care visit and hospital discharge rates compared with Whites, but not mortality rates. Blacks had lower ambulatory care visit and mortality rates, but similar hospital discharge rates compared with whites. During the study period, ambulatory care and emergency department visit rates with a gallstone disease diagnosis rose, while hospital discharge and mortality rates declined. Among commercial insurance enrollees, rates were higher compared with national data for ambulatory care visits and hospitalizations, but lower for emergency department visits. Cholecystectomies performed in the United States included 605000 ambulatory laparoscopic, 280000 inpatient laparoscopic, and 49000 inpatient open procedures annually. Among commercial insurance enrollees, rates were higher compared with national data for laparoscopic procedures. The gallstone disease burden in the United States is substantial and increasing, particularly among women, Hispanics, and older adults with laparoscopic cholecystectomy as the mainstay treatment. Current practice patterns should be monitored for better health care access.

Photodissociation dynamics of SO2 via the G̃1B1 state: The O(1D2) and O(1S0) product channels.

Produced by both nature and human activities, sulfur dioxide (SO2) is an important species in the earth's atmosphere. SO2 has also been found in the atmospheres of other planets and satellites in the solar system. The photoabsorption cross sections and photodissociation of SO2 have been studied for several decades. In this paper, we reported the experimental results for photodissociation dynamics of SO2 via the G̃1B1 state. By analyzing the images from the time-sliced velocity map ion imaging method, the vibrational state population distributions and anisotropy parameters were obtained for the O(1D2) + SO(X3Σ-, a1Δ, b1Σ+) and O(1S0) + SO(X3Σ-) channels, and the branching ratios for the channels O(1D2) + SO(X3Σ-), O(1D2) + SO(a1Δ), and O(1D2) + SO(b1Σ+) were determined to be ∼0.3, ∼0.6, and ∼0.1, respectively. The SO products were dominant in electronically and rovibrationally excited states, which may have yet unrecognized roles in the upper planetary atmosphere.

Reducing Voltage Losses in Organic Photovoltaics Requires Interfacial Disorder Management

AbstractThanks to the introduction of non‐fullerene acceptors, efficiencies of organic photovoltaics are now approaching 20%. Closing the gap with inorganic photovoltaics requires minimizing voltage losses without penalizing charge extraction, for which microstructure control is crucial. However, the complex interplay between microstructure and charge generation, recombination, and extraction has so far not been unraveled. Here, a systematic study linking device performance to distinct microstructural features via machine learning is presented. Building bi‐layer devices allows to separately study the influence of aggregation and disorder on the energies and lifetimes of bulk and interfacial states. Unambiguous assignments of specific structural motifs to the device photophysics are thus possible. It is found that the control of aggregation‐caused quenching is decisive for the exciton splitting efficiency and thus the carrier generation. Furthermore, the static disorder at the donor–acceptor interface controls the nonradiative recombination by shifting the excited state population from the bulk toward the interface. Finally, the amount of disorder in the bulk is found decisive for charge extraction. The finding that charge generation, recombination, and extraction are controlled by distinct structural features, is the key to optimizing these motifs independently, which will pave the way for organic photovoltaics toward the detailed balance limit.

Estimated Clinician-Patient Ratios in US Orthotic and Prosthetic Care: State-Level Trends and Discrepancies

ABSTRACT Introduction For the past 20 years, speculative studies have forewarned of a clinician shortage in the field of orthotics and prosthetics (O&amp;P). Such predictions should emphasize the importance of monitoring potential patient and clinician populations to identify trends and intranational disparities. However, there have been no recent population-based examinations of these previously predicted shortages. Objectives This study estimated geographical differences and evaluated national and state-level trends in O&amp;P care within the United States. The study used data on certified O&amp;P clinicians, state populations, and rates of lower-limb amputation secondary to diabetes in Medicare populations. Study Design The original research article is a retrospective data analysis. Methods Clinician data from the American Board for Certification in Prosthetics Orthotics and Pedorthics, population data from the US Census Bureau, and Medicare data from the Centers for Disease Control and Prevention and the Center for Medicare and Medicaid Services were uploaded into ArcGIS mapping software and geographically weighted for examination across spatial and temporal parameters. Results The data show national and state-level trends and disparities. The findings reveal large differences in care environments between states. Conclusions Speculation on the ability for current supply to meet perceived demand is complicated, but these data update and elaborate upon previous estimations for predicted clinician scarcity in the near future. Further analysis of state-level distance-to-care discrepancies and an examination of which states would benefit most from expansion of O&amp;P services will be necessary. Clinical Relevance Statement This research provides a rudimentary foundation for continued investigation into geographical trends and discrepancies in O&amp;P supply and demand. The successful understanding of these metrics could inform policy and education initiatives, optimize clinical intervention for regional needs, and foster professional expansion into undertreated patient populations.