A new invariant of 4-manifolds.

We define an integer invariant [Formula: see text] of a smooth, compact, closed 4-manifold X by minimizing a certain complexity of a trisection of X over all trisections. The good feature of [Formula: see text] is that when [Formula: see text] and X is a homology 4-sphere, then X is diffeomorphic to the 4-sphere. Naturally, L is hard to compute.

Good practices for the design, analysis, and interpretation of observational studies on birth spacing and perinatal health outcomes.

Background: Meta-analyses of observational studies have shown that women with a shorter interpregnancy interval (the time from delivery to start of a subsequent pregnancy) are more likely to experience adverse pregnancy outcomes, such as preterm delivery or small for gestational age birth, than women who space their births further apart. However, the studies used to inform these estimates have methodological shortcomings.

Methods: In this commentary, we summarise the discussions of an expert workgroup describing good practices for the design, analysis, and interpretation of observational studies of interpregnancy interval and adverse perinatal health outcomes.

Report of the Office of Population Affairs' expert work group meeting on short birth spacing and adverse pregnancy outcomes: Methodological quality of existing studies and future directions for research.

Background: The World Health Organization (WHO) recommends that women wait at least 24 months after a livebirth before attempting a subsequent pregnancy to reduce the risk of adverse maternal, perinatal, and infant health outcomes. However, the applicability of the WHO recommendations for women in the United States is unclear, as breast feeding, nutrition, maternal age at first birth, and total fertility rate differs substantially between the United States and the low- and middle-resource countries upon which most of the evidence is based.

Methods: To inform guideline development for birth spacing specific to women in the United States, the Office of Population Affairs (OPA) convened an expert work group meeting in Washington, DC, on 14-15 September 2017 among reproductive, perinatal, paediatric, social, and public health epidemiologists; obstetrician-gynaecologists; biostatisticians; and experts in evidence synthesis related to women's health.

A nonalcoholic fatty liver disease model in human induced pluripotent stem cell-derived hepatocytes, created by endoplasmic reticulum stress-induced steatosis.

Hepatic steatosis, a reversible state of metabolic dysregulation, can promote the onset of nonalcoholic steatohepatitis (NASH), and its transition is thought to be critical in disease evolution. The association between endoplasmic reticulum (ER) stress response and hepatocyte metabolism disorders prompted us to characterize ER stress-induced hepatic metabolic dysfunction in human induced pluripotent stem cell-derived hepatocytes (hiPSC-Hep), to explore regulatory pathways and validate a phenotypic model for progression of liver steatosis. We treated hiPSC-Hep with a ratio of unsaturated and saturated fatty acids in the presence of an inducer of ER stress to synergistically promote triglyceride accumulation and dysregulate lipid metabolism.

Survival and healthcare utilization of infants diagnosed with lethal congenital malformations.

Objective: We assessed survival, hospital length of stay (LOS), and costs of medical care for infants with lethal congenital malformations, and also examined the relationship between medical and surgical therapies and survival.

Study Design: Retrospective cohort study including infants born 1998-2009 with lethal congenital malformations, identified using a longitudinally linked maternal/infant database.

Results: The cohort included 786 infants: trisomy 18 (T18, n = 350), trisomy 13 (T13, n = 206), anencephaly (n = 125), bilateral renal agenesis (n = 53), thanatophoric dysplasia/achondrogenesis/lethal osteogenesis imperfecta (n = 38), and infants > 1 of the birth defects (n = 14).

Status of population-based birth defects surveillance programs before and after the Zika public health response in the United States.

Background: The 2016 Zika public health response in the United States highlighted the need for birth defect surveillance (BDS) programs to collect population-based data on birth defects potentially related to Zika as rapidly as possible through enhanced case ascertainment and reporting. The National Birth Defects Prevention Network (NBDPN) assessed BDS program activities in the United States before and after the Zika response.

Methods: The NBDPN surveyed 54 BDS programs regarding activities before and after the Zika response, lessons learned, and programmatic needs.

Relationship between wheelchair skills scores and peak aerobic exercise capacity of manual wheelchair users with spinal cord injury: a cross-sectional study.

Although both wheelchair skills and fitness are important and probably inter-related, the extent and nature of the relationship between them are not well understood. The objective of this study was to test the hypothesis that there are significant relationships between wheelchair skills scores and the peak exercise capacity of community-dwelling manual wheelchair users with spinal cord injury. We studied 26 participants, recording Wheelchair Skills Test Questionnaire scores and peak power output from graded aerobic wheelchair exercise testing on a motorized treadmill.

Evaluating the impact of expanding the number of diagnosis codes reported in inpatient discharge databases on the counts and rates of birth defects.

Objective: Public health surveillance programs worldwide implement a variety of case-finding strategies, and many rely at least in part on International Classification of Diseases (ICD)-based diagnostic codes in administrative and clinical databases. Over time, state- and national-level hospital discharge databases have been expanding the number of reported diagnosis code fields. This study aimed to evaluate the impact of these expansions on frequencies and rates of major birth defects, and the classification of birth defects as isolated vs multiple.

Trends, correlates, and survival of infants with congenital diaphragmatic hernia and its subtypes.

Objective: To identify the live-birth prevalence, trends, correlates, and neonatal and 1-year survival rates of congenital diaphragmatic hernia.

Methods: Using a population-based, retrospective cohort study design, we examined 1,025 cases of congenital diaphragmatic hernia from the 1998-2012 Florida Birth Defects Registry. We used Poisson and joinpoint regression models to compute prevalence ratios and temporal trends, respectively.

Relationship Between Advanced Maternal Age and Timing of First Developmental Evaluation in Children with Autism.

Objective: Mothers of advanced maternal age (AMA) at childbirth (age ≥35 years) may have different perceptions of autism spectrum disorder (ASD) risk, independent of sociodemographic factors, that may affect ASD identification. We aimed to estimate associations between AMA and both age of a child's first evaluation noting developmental concerns and time from first evaluation to first ASD diagnosis.

Methods: We used data for 8-year-olds identified with ASD in the 2008 to 2012 Autism and Developmental Disabilities Monitoring Network.

Visualization in Meteorology-A Survey of Techniques and Tools for Data Analysis Tasks.

This article surveys the history and current state of the art of visualization in meteorology, focusing on visualization techniques and tools used for meteorological data analysis. We examine characteristics of meteorological data and analysis tasks, describe the development of computer graphics methods for visualization in meteorology from the 1960s to today, and visit the state of the art of visualization techniques and tools in operational weather forecasting and atmospheric research. We approach the topic from both the visualization and the meteorological side, showing visualization techniques commonly used in meteorological practice, and surveying recent studies in visualization research aimed at meteorological applications.

Manual wheelchair tilt-rest skill: a cross-sectional survey of awareness and capacity among wheelchair users.

The tilt-rest skill consists of tipping the wheelchair back and allowing it to rest against a solid object with the wheel locks applied (e.g., for pressure redistribution, neck comfort or hands-free activities).

In vitro fertilization, interpregnancy interval, and risk of adverse perinatal outcomes.

Objective: To compare associations between interpregnancy intervals (IPIs) and adverse perinatal outcomes in deliveries following IVF with deliveries following spontaneous conception or other (non-IVF) fertility treatments.

Design: Cohort using linked birth certificate and assisted reproductive technology surveillance data from Massachusetts and Michigan.

Setting: Not applicable.

Identifying Algorithms to Improve the Accuracy of Unverified Diagnosis Codes for Birth Defects.

Objectives: We identified algorithms to improve the accuracy of passive surveillance programs for birth defects that rely on administrative diagnosis codes for case ascertainment and in situations where case confirmation via medical record review is not possible or is resource prohibitive.

Methods: We linked data from the 2009-2011 Florida Birth Defects Registry, a statewide, multisource, passive surveillance program, to an enhanced surveillance database with selected cases confirmed through medical record review. For each of 13 birth defects, we calculated the positive predictive value (PPV) to compare the accuracy of 4 algorithms that varied case definitions based on the number of diagnoses, medical encounters, and data sources in which the birth defect was identified.

Effectiveness of the Wheelchair Skills Training Program: a systematic review and meta-analysis.

Objective: To conduct a systematic review synthesizing the evidence for the effectiveness of the Wheelchair Skills Training Program (WSTP).

Data Sources: We searched PubMed, the Cochrane Library, CINAHL and Embase databases, as well as grey literature, up to 10 October 2017.

Study Selection: Randomized controlled trials (RCTs) assessing the effectiveness of the WSTP.

Marine biodiversity and the chessboard of life.

Species richness is greater in places where the number of potential niches is high. Consequently, the niche may be fundamental for understanding the arrangement of life and especially, the establishment and maintenance of the well-known Latitudinal Biodiversity Gradient (LBG). However, not all potential niches may be occupied fully in a habitat, as measured by niche vacancy/saturation.

A Position Statement on Population Data Science: The Science of Data about People.

Information is increasingly digital, creating opportunities to respond to pressing issues about human populations using linked datasets that are large, complex, and diverse. The potential social and individual benefits that can come from data-intensive science are large, but raise challenges of balancing individual privacy and the public good, building appropriate socio-technical systems to support data-intensive science, and determining whether defining a new field of inquiry might help move those collective interests and activities forward. A combination of expert engagement, literature review, and iterative conversations led to our conclusion that defining the field of Population Data Science (challenge 3) will help address the other two challenges as well.

Reliability and responsiveness of the Self-Efficacy in Assessing, Training and Spotting wheelchair skills (SEATS) outcome measure.

Objectives: The aim of this study was to evaluate the internal consistency, test-retest reliability and responsiveness of the Self-Efficacy in Assessing, Training and Spotting manual wheelchair skills (SEATS-M) and Self-Efficacy in Assessing, Training and Spotting power wheelchair skills (SEATS-P).

Methods: A 2-week test-retest design was used with a convenience sample of occupational and physical therapists who worked at a provincial rehabilitation centre (inpatient and outpatient services). Sixteen participants completed the SEATS-M and 18 participants completed the SEATS-P.

Isolated metachronous breast metastasis from renal cell carcinoma: A report of two cases.

Metastases to the breast are very uncommon as compared to primary tumours. Breast is an unusual site for metastasis from renal cell carcinoma. Only occasional cases are reported in the literature.

Zero-inflated multiscale models for aggregated small area health data.

It is our primary focus to study the spatial distribution of disease incidence at different geographical levels. Often, spatial data are available in the form of aggregation at multiple scale levels such as census tract, county, state, and so on. When data are aggregated from a fine (e.

Extent to Which Caregivers Enhance the Wheelchair Skills Capacity and Confidence of Power Wheelchair Users: A Cross-Sectional Study.

Objective: To test the hypothesis that caregivers enhance the wheelchair skills capacity and confidence of the power wheelchair users to whom they provide assistance, and to describe the nature of that assistance.

Design: Multicenter cross-sectional study.

Setting: Rehabilitation centers and communities.

How Do Marine Pelagic Species Respond to Climate Change? Theories and Observations.

In this review, we show how climate affects species, communities, and ecosystems, and why many responses from the species to the biome level originate from the interaction between the species' ecological niche and changes in the environmental regime in both space and time. We describe a theory that allows us to understand and predict how marine species react to climate-induced changes in ecological conditions, how communities form and are reconfigured, and so how biodiversity is arranged and may respond to climate change. Our study shows that the responses of species to climate change are therefore intelligible-that is, they have a strong deterministic component and can be predicted.