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Aims Excessive alcohol consumption is a major global health concern, contributing to millions of deaths annually and a significant proportion of cirrhosis cases; however, standardized protocols for early identification of alcohol-associated liver disease are lacking. In this retrospective cohort study, we aimed to understand the prevalence and risk factors associated with elevated liver stiffness measurement (LSM) in high-risk patients with alcohol use disorder (AUD) and identify variables associated with longitudinal abstinence and outcomes. Methods Veterans with severe AUD without known liver disease admitted to a 35-day residential substance use treatment program were offered liver health screening, including Fibroscan evaluation. Assessment of AUD severity and liver health outcomes were evaluated longitudinally by chart review. Results and Conclusions In a cohort of 257 veterans with severe AUD admitted to residential treatment, 185 underwent Fibroscan evaluation, and 22 were identified to have elevated LSM concerning for compensated advanced chronic liver disease. Patients with elevated LSM were more likely to remain abstinent after 1 year. About 41% of patients with LSM ≥ 10 kPa (5% of all screened patients) were confirmed to have cirrhosis on follow-up and incorporated into routine hepatology care. Screening of liver disease in high-risk populations with non-invasive imaging modalities provides an opportunity to identify patients at risk for compensated advanced chronic liver disease before decompensation. Identification of increased risk for advanced chronic liver disease may promote abstinence in patients with severe AUD. Collaboration between mental health professionals and hepatologists is critical for the integration of care for patients with AUD and liver disease. [ABSTRACT FROM AUTHOR]

Objective: Although the population of patients with systemic lupus erythematosus (SLE) is racially and ethnically diverse, many study populations are homogeneous. Further, data are often lacking on critical factors, such as antiphospholipid antibodies (aPLs). We investigated live birth rates in patients with SLE at Kaiser Permanente Northern California, including race and ethnicity and aPL data. Methods: Electronic health records of pregnancies with outcomes observed from 2011 to 2020 were identified among patients with SLE. Prevalent SLE was defined as two or more International Classification of Diseases–coded visits seven or more days apart before the last menstrual period. We summarized patient characteristics, medication orders, health care use, and medication use. Pregnancy outcomes (live birth, stillbirth, spontaneous abortion, ectopic pregnancy, and molar pregnancy) were presented overall and stratified by race and ethnicity, aPL status, and nephritis history. Results: We identified 657 pregnancies among 453 patients with SLE. The cohort was diverse, reflecting the Northern California population (27% Asian, 26% Hispanic, 26% Non‐Hispanic White, 13% Non‐Hispanic Black, 5% multiracial, and approximately 2% Pacific Islander and Native American). Approximately 74% of observed pregnancies ended in live birth, 23% resulted in spontaneous abortion, 2% were ectopic or molar pregnancies, and <1% were stillbirths. There was limited variability in live births by race and ethnic group (72%–79%), aPL status (69.5%–77%), and nephritis history (71%–75%). Conclusion: Our findings are consistent with previous studies; however, some methodologic differences may yield a range of live birth rates. We found that approximately 74% of pregnancies in patients with SLE ended in live birth, with modest variability in spontaneous abortion by race and ethnicity, nephritis history, and aPL status. [ABSTRACT FROM AUTHOR]

Strength-based assessment of behaviors in preschool children provides evidence of emotional and behavioral skills in children, rather than focusing primarily on weaknesses identified by deficit-based assessments. The Preschool Behavioral and Emotional Rating Scales (PreBERS) is a normative assessment of emotional and behavioral strengths in preschool children. The PreBERS has well-established reliability and validity for typically developing children as well as children with identified special education needs, but this has not yet been established for children in Head Start programs, who tend to be at high risk for development of emotional and behavioral concerns. This study explores the factorial validity of the PreBERS scores for a large sample of children participating in Head Start programs around the United States. Results not only confirm the fit of the four-factor model of the PreBERS for this population, but also demonstrate the application of a bifactor model to the structure of the PreBERS which, in turn, allows for the computation of model-based reliability estimates for the four subscales (Emotional Regulation, School Readiness, Social Confidence, Family Involvement) and overall strength index score. The implications suggest that the PreBERS items are reliable scores that can be used to identify behavioral strengths in preschool children in Head Start, and support planning of interventions to selectively address component skills to promote child social and academic success.

This article provides leaders and educational developers of Centers for Teaching and Learning (CTL) with innovative and practical strategies on how to increase their centers' capacity and impact by focusing on quality, efficiency, and cost. This "good, fast, cheap" model represents a promising way that CTL can continue to grow, scale, and innovate in the midst of limited resources. By leveraging existing campus resources, external vendor products, and low-cost technologies, CTL are able to remain effective and impactful, without compromising quality or requiring abundant resources. This article will include real use-case examples from a CTL at a mid-size, private, nonprofit university in Southern California and its use of the "good, fast, cheap" model in its planning and implementation with the aim of generalizing these creative solutions to be applied elsewhere.

A collaborative effort between a junior high school and a nearby university allowed 40 eighth-grade honors students to engage in a scientific investigation within a university laboratory. These students, with their science teachers and university researchers, gathered data on egg cannibalism in a beach-spawning fish and thereby contributed to an ongoing research project. Our objectives were to provide a scientific learning experience for the students and introduce them to a college setting. A survey, given 2.5 years after the investigation, found that most of the students had increased their interest in studying science in college.

Joint Commission National Patient Safety Goal 15 calls for organizations "to identify patients at risk for suicide." Overt suicidal behavior accounts for 0.6% of emergency department (ED) visits, but incidental suicidal ideation is found in 3%-11.6%. This is the first multicenter study of suicide screening in EDs. Of 2,243 patients in six diverse emergency settings, 1,068 (47.7%) were screened with a brief instrument. Depression was endorsed by 369 (34.5%); passive suicidal ideation by 79 (7.3%); and active suicidal ideation by 24 (2.3%). One hundred thirty-seven (12.8%) reported prior attempts, including 35 (3.3%) with current suicidal ideation. Almost half of those with current ideation had a prior attempt (43.8%) versus those without current ideation, 10.3%, chi[superscript 2] (1) = 75.59, "p" less than 0.001. Twenty cases (25%) were admitted to medical services, but only 10 (12.5%) received mental health assessment; none were admitted directly to a psychiatry service. The prevalence of suicidal ideation here is similar to previous studies but the frequency of prior attempts has not been reported. The 35 cases with current ideation and prior attempt are at risk. As they did not present psychiatrically, they would likely have gone undetected. Despite reporting these cases to clinical staff, few received risk assessment. (Contains 3 tables.)

In the article, the author presents their study which assessed the reduction of poly-central nervous system (CNS) medications in older people in an integrated healthcare system in the U.S. in 2018-2020. Also cited are the association between multiple CNS medications and the risks of falls and delirium, and the efforts by the Kaiser Permanente Southern California (KPSC) healthcare system to limit the use of poly-CNS drugs in older adults.

We evaluated diet and diet assessment methods for the California Least Tern (Sternula antillarum browni) at two nesting sites in California over 12 years (2001–2012). California Least Tern diets at Alameda Point (37° 47′ 14″ N, 122° 19′ 12″ W), an estuarine site, and Purisima Point (34° 46′ 39″ N, 120° 37′ 35″ W), an open coast site, were compared using dropped fish and hard parts (otoliths and scales) from regurgitated pellets and fecal samples. SIMPER analyses, Kendall's tau, Kruskal-Wallis, Dunn's test, rank-sum tests, and Welch's t-test determined any differences in assessment methods, chick and adult diets, and sizes of prey items. Diet composition differed between sites for both dropped fish (25% similar) and fecal samples (26%). Assessment methods showed similar results at Alameda Point (79%) for dropped fish and fecal samples but not at Purisima Point when comparing dropped fish to fecal samples (12%) and fecal samples to regurgitated pellets (19%). There was no difference in diet composition at either site or between any method using adult-only samples. All differences in diet composition appeared during the rearing/fledging stage. Fish species dropped at both sites were deeper-bodied (17 mm) than those consumed (11.9 mm), with terns at Purisima Point dropping deep-bodied species typically not consumed and those at Alameda Point dropping larger individuals of usually-consumed species. When comparing adult and chick diets at Alameda Point using fecal samples, composition was similar, and chicks ate larger prey. Our results suggest that more than one assessment method is necessary to provide a complete dietary picture. [ABSTRACT FROM AUTHOR]

Background: A substantial number of patients who do not meet treatment criteria for chronic hepatitis B (CHB) later develop adverse outcomes such as cirrhosis and hepatocellular carcinoma (HCC). Our aim was to determine whether current practice guidelines adequately identify CHB patients who will benefit from antiviral therapy. Methods: We performed a retrospective cohort study comparing the incidence of adverse liver outcomes (cirrhosis and/or HCC) in untreated treatment-ineligible (at baseline and throughout follow-up) versus treated treatment-eligible patients according to standard American Association for the Study of Liver Diseases (AASLD) 2018 guidance (alanine aminotransferase [ALT] >70/50 U/L for men/women plus hepatitis B virus [HBV] DNA >20,000/2,000 IU/mL for HBeAg+/−) and with a sensitivity analyses using a lower threshold (ALT >40 U/L and HBV DNA >2,000 IU/mL). Results: We reviewed records of 5,840 patients from 5 clinics in California and identified 2,987 treatment-naive non-HCC CHB patients. Of those, 271 patients remained untreated treatment-ineligible, 514 patients were treatment-eligible and initiated treatment, with 5-year cumulative adverse liver incidences of 12.5% versus 7.2%, p = 0.074. On multivariable analysis adjusting for age, sex, diabetes, albumin, platelet count, and HBV DNA, compared to treated treatment-eligible patients, untreated treatment-ineligible patients had a significantly higher risk of adverse liver outcomes (adjusted hazard ratio: 2.38, 95% confidence interval 1.03–5.48, p = 0.04) in main analysis by AASLD 2018 criteria but not in sensitivity analysis using the lower treatment threshold (p = 0.09). Conclusion: Patients never meeting standard AASLD 2018 criteria for antiviral therapy and never treated had twice the risk of developing cirrhosis and/or HCC when compared to eligible and treated patients. [ABSTRACT FROM AUTHOR]

Compared to linear analysis approaches, nonlinear analysis of bridge models under large seismic demands has enabled more realistic prediction of global and local responses. However, the sensitivity to modeling assumptions, element and material formulations, software-dependent implementations, and parameter selection may lead to variable results between nonlinear analysis software packages. While previous work has led to a better understanding of how to model nonlinear static response of bridge components and systems, seismic loads and the corresponding material hysteresis introduce additional sources of variability in the nonlinear response. Two ordinary standard bridges in California were analyzed using simplified steel and concrete constitutive models in concentrated plasticity elements for the columns and nonlinear gap-link springs for the abutments. The models were implemented in SAP2000 and OpenSees and calibrated to achieve common material, section, and element-level nonlinear static responses. Subsequently, the models were extended to seismic excitation with common unloading-reloading rules for the material models as well as common definitions for damping and mass. Analysis results showed consistent drift, base shear, and moment-curvature response histories between the software packages. However, the nonlinear seismic response sensitivity for alternative column hinge formulations and abutment models should be investigated in future studies. [ABSTRACT FROM AUTHOR]

Background: Methamphetamine-associated cardiomyopathy/heart failure (MethHF) is an increasingly recognized disease entity in the context of a rising methamphetamine (meth) epidemic that most severely impacts the western United States. Using heart failure (HF) hospitalization data from the Office of Statewide Health Planning and Development, this study aimed to assess trend and disease burden of MethHF in California.Methods: Adult patients (≥18 years old) with HF as primary hospitalization diagnosis between 2008 and 2018 were included in this study. The association with Meth (MethHF) and those without (non-MethHF) were determined by meth-related International Classification of Diseases-based secondary diagnoses. Statistical significance of trends in age-adjusted rates of hospitalization per 100 000 adults were evaluated using nonparametric analysis.Results: Between 2008 and 2018, 1 033 076 HF hospitalizations were identified: 42 565 were MethHF (4.12%) and 990 511 (95.88%) were non-MethHF. Age-adjusted MethHF hospitalizations per 100 000 increased by 585% from 4.1 in 2008 to 28.1 in 2018, while non-MethHF hospitalizations decreased by 6.0% from 342.3 in 2008 to 321.6 in 2018. The rate of MethHF hospitalization increase more than doubled that of a negative control group with urinary tract infection and meth-related secondary diagnoses (7.82-fold versus 3.48-fold, P<0.001). Annual inflation-adjusted hospitalization charges because of MethHF increased by 840% from $41.5 million in 2008 to $390.2 million in 2018, as compared with an 82% increase for all HF hospitalization from $3.503 billion to $6.376 billion. Patients with MethHF were significantly younger (49.64±10.06 versus 72.20±14.97 years old, P<0.001), predominantly male (79.1% versus 52.4%, P<0.001), with lower Charlson Comorbidity Index, yet they had longer length of stay, more hospitalizations per patient, and more procedures performed during their stays.Conclusions: MethHF hospitalizations increased sharply during the study period and contributed significantly to the HF hospitalization burden in California. This emerging HF phenotype, which engenders considerable financial and societal costs, calls for an urgent and concerted public health response to contain its spread. [ABSTRACT FROM AUTHOR]

Background: Falls and hip fractures among older people are associated with high morbidity and mortality. Hyponatraemia may be a risk for falls/hip fractures, but the effect of hyponatraemia duration is not well understood. Aims: To evaluate individuals with periods of sub‐acute and chronic hyponatraemia on subsequent risk for serious falls and/or hip fractures. Methods: Retrospective cohort study in the period 1 January 1998 to 14 June 2016 within an integrated health system of individuals aged ≥55 years with ≥2 outpatient serum sodium measurements. Hyponatraemia was defined as sodium <135 mEq/L with sub‐acute (<30 days) and chronic (≥30 days) analysed as a time‐dependent exposure. Multivariable Cox proportional‐hazards modelling was used to estimate hazard ratios (HR) for serious falls/hip fractures based on sodium category. Results: Among 1 062 647 individuals totalling 9 762 305 sodium measurements, 96 096 serious falls/hip fracture events occurred. Incidence (per‐1000‐person‐years) of serious falls/hip fractures were 11.5, 27.9 and 19.8 for normonatraemia, sub‐acute and chronic hyponatraemia. Any hyponatraemia duration compared to normonatraemia had a serious falls/hip fractures HR (95%CI) of 1.18 (1.15, 1.22), with sub‐acute and chronic hyponatraemia having HR of 1.38 (1.33, 1.42) and 0.91 (0.87, 0.95), respectively. Examined separately, the serious falls HR was 1.37 (1.32, 1.42) and 0.92 (0.88, 0.96) in sub‐acute and chronic hyponatraemia, respectively. Hip fracture HR were 1.52 (1.42, 1.62) and 1.00 (0.92, 1.08) for sub‐acute and chronic hyponatraemia, respectively, compared to normonatraemia. Conclusions: Our findings suggest that early/sub‐acute hyponatraemia appears more vulnerable and associated with serious falls/hip fractures. Whether hyponatraemia is a marker of frailty or a modifiable risk factor for falls remains to be determined. [ABSTRACT FROM AUTHOR]

The ability to distinguish between different migratory behaviours (e.g., anadromy and potamodromy) in fish can provide important insights into the ecology, evolution, and conservation of many aquatic species. We present a simple stable carbon isotope (δ13C) approach for distinguishing between sockeye (anadromous ocean migrants) and kokanee (potamodromous freshwater residents), two migratory ecotypes of Oncorhynchus nerka (Salmonidae) that is applicable throughout most of their range across coastal regions of the North Pacific Ocean. Analyses of kokanee (n = 239) and sockeye (n = 417) from 87 sites spanning the North Pacific (Russia to California) show that anadromous and potamodromous ecotypes are broadly distinguishable on the basis of the δ13C values of their scale and bone collagen. We present three case studies demonstrating how this approach can address questions in archaeology, archival, and conservation research. Relative to conventional methods for determining migratory status, which typically apply chemical analyses to otoliths or involve genetic analyses of tissues, the δ13C approach outlined here has the benefit of being non-lethal (when applied to scales), cost-effective, widely available commercially, and should be much more broadly accessible for addressing archaeological questions since the recovery of otoliths at archaeological sites is rare. [ABSTRACT FROM AUTHOR]

Agricultural activity, urban development and habitat alteration have caused the disappearance of the western spadefoot (Spea hammondii) from 80% of its geographic range in southern California. Despite the western spadefoot’s continuing decline, little research has been conducted on its natural history. The home range of adult spadefoots is unknown, and their use of upland habitat is poorly understood. Both factors are important for the long-term conservation of the species because adult spadefoots spend the majority of their lives away from breeding pools in self-excavated burrows. Between January 2012 and January 2013, we surgically implanted radio transmitters in 15 spadefoots at two locations and recorded their movements and habitat use. The mean distance moved between burrow locations was 18 m (SD ± 24.1 m, range1–204 m). The mean distance of burrows from the breeding pools was 40 m (SD ± 37.42 m, range 1–262 m). Rain was a significant predictor of spadefoot movement, with more rain predicting higher probability of movement and larger distances moved. At remote sensing scale (1 m) spadefoots selected grassland habitat for their burrow locations. At the microsite scale (< 1 m) spadefoots strongly selected duff over grass or shrub cover. Spadefoots burrowed in friable, sandy/loam soil with significantly less clay than random pseudoabsence points. This research enhances our understanding of a little-studied species and will contribute to the development of effective management plans for the western spadefoot. [ABSTRACT FROM AUTHOR]

Objective: Reproductive events have been linked with increased cardiovascular risk in women, but whether they are associated with pre-clinical peripheral arterial disease (PAD) has been understudied. We evaluated associations between reproductive factors and later-life ankle-brachial index (ABI), femoral artery intima-media thickness (fIMT), and femoral plaques. Methods: Cross-sectional analysis of 707 multiethnic women who participated in a follow-up exam of the San Diego Population Study in 2007–2011. To assess associations between reproductive factors (age at menarche, parity, age at menopause, surgical menopause, hormone therapy) with ABI, and Doppler ultrasound measurements of common and superficial fIMT, linear regression was used; for femoral plaque presence, logistic regression was used. Models were adjusted for age, race/ethnicity, and cardiometabolic factors. We tested interactions of reproductive factors with menopause type (natural vs. surgical). Results: Women were on average 71 years old, and 56% were non-Hispanic White. Reproductive factors were not associated with fIMT, femoral plaque presence, or ABI. There were significant interactions between menopause type (surgical vs. natural) and oral contraceptive use (−β: 0.04, p = 0.03) for ABI, as well as between menopause type and parity (β: 0.11, p = 0.05) and age at menopause (β: 0.001, p = 0.05) for fIMT. Among women with natural menopause, oral contraceptive use was associated with higher ABI (β: 0.03, p = 0.007) and older age at natural menopause was related to greater fIMT (β: 0.009, p = 0.06). Among women with surgical menopause, nulliparity was marginally associated with greater fIMT (β: 0.33, p = 0.07). Conclusions: Reproductive history may not be independently associated with later-life lower extremity atherosclerosis in women. Studies are necessary to confirm findings and examine pregnancy-related exposures in relation to pre-clinical PAD. [ABSTRACT FROM AUTHOR]

Effectiveness of rehabilitating wildlife following oil spills has been controversial. Impacts include mortality or changes in behavior affecting health or reproduction. Immediately following a bunker fuel oil spill on San Francisco Bay, California, USA, a unique experiment was conducted to examine the movement and foraging behavior of Surf Scoters (Melanitta perspicillata) that had been oiled, captured, cleaned, rehabilitated, and radio-marked. Unoiled Surf Scoters were similarly cleaned, rehabilitated, and radio-marked while other unoiled Surf Scoters were radio-marked as controls. Surf Scoters in the control group had larger home-ranges (46.29 ± 3.23 km2) than either the oiled/rehabilitated (32.58 ± 5.48 km2) or rehabilitated only groups (31.06 ± 3.05 km2); the control group also was more likely to use unsheltered, shallow areas of the bay (66.9 ± 4.3% of locations) than either the oiled/rehabilitated (50.3 ± 5.2%) or rehabilitated only groups (58.2 ± 6.5%). The oiled/rehabilitated group was closer to shore (986 ± 149 m) than rehabilitated (1,894 ± 295 m) or control groups (2,113 ± 227 m). Differences in habitat use, movement patterns, and home range sizes indicated that Surf Scoters held in captivity were more restricted in their movements; therefore, captivity and rehabilitation practices may also influence success of the rehabilitation. [ABSTRACT FROM AUTHOR]

Rationale, aims, and objectives The United States is in the midst of a public health epidemic with more than 40 people dying each day from prescription opioid overdoses. Health care systems are taking steps to address the opioid overdose epidemic by implementing policy and practice interventions to mitigate the risks of long-term opioid therapy. Kaiser Permanente Southern California launched a comprehensive initiative to transform the way that chronic pain is viewed and treated. Kaiser Permanente Southern California created prescribing and dispensing policies, monitoring and follow-up processes, and clinical coordination through electronic health record integration. The purpose of this paper is to describe the implementation of these interventions and assess the impact of this set of interventions on opioid prescribing. Method The study used a retrospective pre-post evaluation design to track outcomes before and after the intervention. Kaiser Permanente Southern California members age 18 and older excluding cancer, hospice, and palliative care patients and this sub-population of 3 203 880 was approximately 75% of all Kaiser Permanente Southern California members. All data are from Kaiser Permanente's pharmacy data systems and electronic health record collected on a rolling basis as interventions were implemented from January 2010 to December 2015. Results There were reductions in all tracked outcomes: a 30% reduction in prescribing opioids at high doses; a 98% reduction in the number of prescriptions with quantities greater than 200 pills; a 90% decrease in the combination of an opioid prescription with benzodiazepines and carisoprodol; a 72% reduction in the prescribing of Long Acting/Extended Release opioids; and a 95% reduction in prescriptions of brand name opioid-acetaminophen products. In addition, methadone prescribing did not increase during this period. Conclusions This study adds promising results that a comprehensive system-level strategy has the ability to positively affect opioid prescribing. The basic components of the intervention are generalizable and applicable to other health care settings. [ABSTRACT FROM AUTHOR]

Simazine, a member of the triazine group, is registered in California for weed control in soils where a wide range of crops will be (or are) planted. The health risks from simazine use in California were recently assessed by the California Department of Pesticide Regulation (CDPR) for all potential (acute and long-term) exposure scenarios relevant to Californian residents and workers. The results of the CDPR risk assessment indicate that current exposure levels in many of the scenarios under consideration are not health protective for the people in California. The main objective of the present summary report (i.e., case study) was two-fold, both for offering a forum to advance further scientific discussion: (1) to highlight the toxicity and exposure data as well as the assumptions used in the CDPR simazine risk assessment and then (2) to systematically requalify the uncertainties and complexities involved in terms of the toxicity and exposure appraisals given in that risk assessment. In both attempts, the focus was more on residential exposures for young children and women of child-bearing age in that simazine was reportedly seen to exhibit neuroendocrine effects across a variety of species. [ABSTRACT FROM PUBLISHER]

The article discusses the evolution of California's approach to choice of law, and it mentions several decisions by the state's appellate courts and the Supreme Court of California which deal with the application, or lack thereof, of territorial jurisdiction rules to decide what law applies in cases involving conflicts of laws. It states that California courts adopted an "interest analysis methodology for resolving false conflicts cases" during the 1960s. State laws are also examined.

Highlights: [•] Seabirds in California are affected by chronic petroleum oiling. [•] Natural petroleum seeps are the primary source of chronic oiling. [•] The majority of birds affected are diving birds. [•] A seasonal trend in oiling may be related to wave energy from large storms. [ABSTRACT FROM AUTHOR]

Objective An increased frequency of atherosclerosis (ATH) in systemic lupus erythematosus (SLE) is well-documented but not fully explained by the presence of traditional cardiac risk factors. Several nontraditional biomarkers, including proinflammatory high-density lipoprotein (piHDL) and leptin, have been individually associated with subclinical ATH in SLE. The aim of this study was to examine whether these and other biomarkers can be combined into a risk profile, the Predictors of Risk for Elevated Flares, Damage Progression, and Increased Cardiovascular Disease in Patients with SLE (PREDICTS), that could be used to better predict future progression of ATH. Methods In total, 210 patients with SLE and 100 age-matched healthy control subjects (all women) participated in this prospective cohort study. The longitudinal presence of carotid plaque and intima-media thickness (IMT) were measured at baseline and followup (mean ± SD 29.6 ± 9.7 months). Results At followup, carotid plaque was present in 29% of SLE patients. Factors significantly associated with plaque, determined using Salford Predictive Modeling and multivariate analysis, included age ≥48 years (odds ratio [OR] 4.1, P = 0.002), high piHDL function (OR 9.1, P < 0.001), leptin levels ≥34 ng/dl (OR 7.3, P = 0.001), plasma soluble TWEAK levels ≥373 pg/ml (OR 28.8, P = 0.004), and history of diabetes (OR 61.8, P < 0.001). Homocysteine levels ≥12 μmoles/liter were also a predictor. However, no single variable demonstrated an ideal combination of good negative predictive values (NPVs), positive predictive values (PPVs), sensitivity, and specificity. A high-risk PREDICTS profile was defined as ≥3 positive biomarkers or ≥1 positive biomarker plus a history of diabetes; for high-risk SLE patients, the PPV was 64%, NPV was 94%, sensitivity was 89%, and specificity was 79%. In multivariate analysis, SLE patients with the high-risk profile had 28-fold increased odds for the longitudinal presence of plaque ( P < 0.001) and increased progression of IMT ( P < 0.001). Conclusion A high-risk PREDICTS score confers 28-fold increased odds of the presence of any current, progressive, or acquired carotid plaque, both in patients with SLE and in control subjects, and is significantly associated with higher rates of IMT progression. [ABSTRACT FROM AUTHOR]

Late Cenozoic tectonic reconstructions of southern California (United States) have been hindered for decades by disagreement over the total displacement on the southern San Andreas fault; disparate estimates of dextral offset range from 160 km to 240 km. Prior estimates were based on purely translational models that neglect the effects of transrotational strain on the orientation and distribution of key geologic markers. We present a new reconstruction that integrates published lithologic, structural, and paleocurrent data with the effects of clockwise rotation in the eastern Transverse Ranges (ETR). This model yields 200 ± 14 km of cumulative offset on the southern San Andreas fault system in the Salton Trough. The disparity between our estimate and a lower estimate of 160 km for the Mojave segment can be explained by a combination of transtensional elongation along the southwest boundary of the ETR, transfer of strain to the eastern California shear zone, and diffuse crustal shortening in the Big Bend region. This reconstruction reconciles previously incompatible and long-debated models, and places an important new constraint on the tectonic evolution of the Pacific-North America plate boundary in southern California. [ABSTRACT FROM AUTHOR]

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Surface behavior and concurrent underwater vocalizations were recorded for Pacific white-sided dolphins in the Southern California Bight (SCB) over multiple field seasons spanning 3 years. Clicks, click trains, and pulsed calls were counted and classified based on acoustic measurements, leading to the identification of 19 key call features used for analysis. Kruskal-Wallis tests indicated that call features differ significantly across behavioral categories. Previous work had discovered two distinctive click Types (A and B), which may correspond to known subpopulations of Pacific white-side dolphins in the Southern California Bight; this study revealed that animals producing these different click types also differ in both their behavior and vocalization patterns. Click Type A groups were predominantly observed slow traveling and milling, with little daytime foraging, while click Type B groups were observed traveling and foraging. These behavioral differences may be characteristic of niche partitioning by overlapping populations; coupled with differences in vocalization patterns, they may signify that these subpopulations are cryptic species. Finally, random forest decision trees were used to classify behavior based on vocalization data, with rates of correct classification up to 86%, demonstrating the potential for the use of vocalization patterns to predict behavior. [ABSTRACT FROM AUTHOR]

The article examines ways in which the U.S. Immigration Reform Act of 1965 has had an impact on the demographic makeup of several U.S. metropolitan areas. It argues that this immigration legislation, signed by then President Lyndon B. Johnson, is often overlooked by urban scholars as a cause of metropolitan expansion and that research is often focused on topics such as deindustrialization, air conditioning, or racial discrimination. It highlights urban expansion by focusing on several individuals in particular locations including urban scholar William H. Whyte in Princeton, New Jersey, Mayor Margaret Price of Naperville, Illinois, and sociology professor Mark Baldassare in Irvine, California.

Abstract: Two dendrochronological properties – ring width and ring chemistry – were investigated in trees near Cinder Cone in Lassen Volcanic National Park, northeastern California, for the purpose of re-evaluating the date of its eruption. Cinder Cone is thought to have erupted in AD 1666 based on ring-width evidence, but interpreting ring-width changes alone is not straightforward because many forest disturbances can cause changes in ring width. Old Jeffrey pines growing in Cinder Cone tephra and elsewhere for control comparison were sampled. Trees growing in tephra show synchronous ring-width changes at AD 1666, but this ring-width signal could be considered ambiguous for dating the eruption because changes in ring width can be caused by other events. Trees growing in tephra also show changes in ring phosphorus, sulfur, and sodium during the late 1660s, but inter-tree variability in dendrochemical signals makes dating the eruption from ring chemistry alone difficult. The combination of dendrochemistry and ring-width signals improves confidence in dating the eruption of Cinder Cone over the analysis of just one ring-growth property. These results are similar to another case study using dendrochronology of ring width and ring chemistry at Parícutin, Michoacán, Mexico, a cinder cone that erupted beginning in 1943. In both cases, combining analysis with ring width and ring chemistry improved confidence in the dendro-dating of the eruptions. [Copyright &y& Elsevier]

A novel Babesia species is described from blood collected from 3 common murres (also known as common guillemots) (Uria aalge) from California. This is the first report of a Babesia species from the Alcidae and the second from the Charadriiformes. Babesia uriae n. sp. is morphologically similar to several other avian Babesia species but can be differentiated from Babesia bennetti, the only other species from a host in the Charadriiformes, by size of round and amoeboid forms. Phylogenetic analysis of near-full length 18S rRNA, ITS-1, 5.8S rRNA, and ITS-2 sequences indicated that the Babesia sp. from the common murre is closely related to Babesia poelea, a parasite of brown boobies (Sula leucogaster). [ABSTRACT FROM AUTHOR]

Purpose: Given that the prevalence of childhood obesity is increasing in the United States, we tested the timely hypothesis that obesity hinders physical examination based localization of the cryptorchid testis. Materials and Methods: Body mass index and percentiles of weight for height and body mass index for age were calculated for boys undergoing surgery for cryptorchidism at the University of California San Francisco Children''s Hospital and Children''s Hospital of Oakland. Two definitions of obesity were examined, ie greater than 85% or greater than 95% for either percentile. Patients were examined in the office and under general anesthesia before the skin incision. Intraoperative testicular location was recorded for each patient. The numbers of correct and incorrect preoperative determinations of testicular location were stratified by weight classification. Results were analyzed using contingency tables and Fisher''s exact test. Results: A total of 161 boys were recruited, accounting for 171 testes. The predictive value of palpating a suspected testis preoperatively with patients under anesthesia was greater than 95% for all weight classifications (p <0.0001). The predictive value of not palpating a testis preoperatively under anesthesia was greater than 56% for obese boys and greater than 42% for nonobese boys (p <0.0001). The concordance rates between examinations in the office and those performed under anesthesia were 90.9% and 82.7% for obese and nonobese boys, respectively (p = 0.51). The predictive value of not palpating a suspected cryptorchid testis in the office was higher in nonobese boys than in obese boys (81% vs 22%, p <0.0001). Conclusions: In our series childhood obesity did not make preoperative testicular examinations under anesthesia less accurate. However, office examinations may be more accurate in nonobese boys. [Copyright &y& Elsevier]

Objectives: The purpose of this study was to examine the association of progressive versus stable peripheral arterial disease (PAD) with the risk of future cardiovascular disease (CVD) events. Background: An independent association between PAD, defined by low values of the ankle-brachial index (ABI), and future CVD risk has been demonstrated. However, the prognostic significance of declining versus stable ABI has not been studied. Methods: We recruited 508 subjects (59 women, 449 men) from 2 hospital vascular laboratories in San Diego, California. ABI and CVD risk factors were measured at Visit 2 (1990 to 1994). ABI values from each subject''s earliest vascular laboratory examination (Visit 1) were abstracted from medical records. Mortality and morbidity were tracked for 6 years after Visit 2 using vital statistics and hospitalization data. Results: In multivariate models adjusted for CVD risk factors, very low (<0.70) and, in some cases, low (0.70 ≤ ABI <0.90) Visit 2 ABIs were associated with significantly elevated all-cause mortality, CVD mortality, and combined CVD morbidity/mortality at 3 and 6 years. Decreases in ABI of more than 0.15 between Visit 1 and Visit 2 were significantly associated with an increased risk of all-cause mortality (risk ratio [RR]: 2.4) and CVD mortality (RR: 2.8) at 3 years, and CVD morbidity/mortality (RR: 1.9) at 6 years, independent of Visit 2 ABI and other risk factors. Conclusions: Progressive PAD (ABI decline >0.15) was significantly and independently associated with increased CVD risk. Patients with decreasing ABI may be candidates for more intensive cardiovascular risk factor management. [Copyright &y& Elsevier]

Drifting Macrocystis pyrifera (L.) C. Agardh sporophytes have long been viewed as the primary long-distance dispersal vector; yet, few data exist that support the ability of reproductive viable sporophytes to actually travel the presumed hundreds to thousands of kilometers. This study addressed the reproductive longevity of experimental and naturally occurring M. pyrifera drifters. Temporal variability in sporophyte size and reproduction was estimated for experimental drifting sporophytes that were tethered to surface buoys and compared with attached plants (controls). Reproductive viability was also studied for beach-cast drifters (BCD), and naturally drifting sporophytes observed during field surveys in Monterey Bay. Detached drifting sporophytes were tracked with radio transmitters to follow drifter trajectories and to measure drifting speed. Experimental drifters (ED) experienced a 74% reduction in frond length after 35 days, a 76% reduction in average frond number after 70 days, and a reduction in average sorus area by 83% after 28 days. Although zoospore production was reduced following detachment, sporophytes remained fertile with high zoospore germination success as long as sori were present (125 days). Zoospore production and germination success for natural and BCD was similar to ED. The average displacement of radio-tagged drifters was 7.12 km·day−1, suggesting that a sporophyte adrift for 125 days disperses viable propagules (zoospores) over 890 km (±363). Dispersal of propagules is important for population restoration, distribution, and genetic diversity. Such dispersal distances are long enough to connect potentially all Northern Hemisphere Macrocystis populations across a generational timescale and may facilitate inter-hemispheric gene flow. [ABSTRACT FROM AUTHOR]

Background The associations between symptoms and venous disease of the lower extremities are poorly characterized. Methods We conducted a cross-sectional study to evaluate relationships between symptoms associated with venous disease and prevalent disease in 2408 men and women aged 29 to 91 years who were employees, retirees, or spouses at a large state university. Index participants were randomly selected within strata by age, sex, and ethnicity. A structured interview assessed the prevalence of aching, itching, heaviness, tired legs, cramping, swelling, and nighttime restless legs. A comprehensive standardized examination determined the prevalence of visible disease (normal, telangiectasias, varicose veins, and trophic changes) and functional disease (normal, superficial, and deep disease). We related symptoms to disease with attention to modification by sex, ethnicity, and age. Results Aching, itching, heaviness, tired legs, cramping, and swelling were related to both superficial and deep functional disease. The same symptoms were related to varicose veins and trophic changes. Swelling and heaviness were related to telangiectatic disease. Except for restless legs and trophic changes, the prevalence of symptoms across each category was greater in women than men. Aching was the most common symptom but was relatively nonspecific. Swelling was the most specific marker for prevalent visible and functional disease. Heaviness and itching also helped to distinguish prevalent disease. Conclusions Venous symptoms were more prevalent in study participants with both visible and functional disease and in women. Swelling was the most specific predictor; heaviness, itching, and aching also helped to distinguish cases. [ABSTRACT FROM AUTHOR]

Laboratory and field experiments were done in Stillwater Cove, Carmel bay, California, and Montery Harbor, California, to determine the effect of photosynthetically active radiation (PAR) on the shallow (upper) limit of giant kelp, Macrocytis pyrifera (L.) C. Agardh. At shallow depths, M. pyrifera did not recruit or grow to macroscopic size from gametophytes or embryonic sporophytes transplanted to vertical buoy lines; sharp decreases in PAR with depth coincided with observed recruitment and sporophyte distributions. Shade manipulations indicated that settlement of M. pyrifera to zoospores was decreased, but not prohibited, by high PAR. Post settlement stages (gametophytes and embryonic sporophytes), however, survived only under shade. These results suggest that high PAR can inhibit the recruitment of M. pyrifera to shallow water by killing its postsettlement stages; whether or not ultraviolet (UV) radiation also inhibits recruitment was not tested. In either case, however, it appears that high irradiance (PAR and / or UV) regulates the shallow limit of M. pyfera prior to temperature and desiccation stresses inherent to intertidal regions. In an additional experiment, recruitment or growth of transplanted gametophytes or embryonic sporophytes of Macrocystits integrifolia Bory also did not occur at shallow depths, suggesting that this shallow water species accesses high irradiance regions via a method other than sexual reproduction. [ABSTRACT FROM AUTHOR]

Objectives. The purpose of the study was to determine whether breast-feeding is associated with increased longevity or cause-specific survival. Methods. Teacher throughout California identified intellectually gifted children as pat of a prospective study begun in the 1920s by Lewis Terman. Information on breast-feeding was available on 1170 subjects, who have been followed for more than 65 years. Results. Survival analysis (Cox proportional hazards model) indicated that breast-feeding was associated with increased longevity, even after adjustment for age at baseline, birthweight, infant health, and childhood socioeconomics status, but only among men, and the association was not significant (p = .15). Neither cardiovascular disease nor cancer survival was significantly associated with duration of breast-feeding for either sex. Survival fro deaths due to injuries was positively associated with breast-feeding after adjustment (p = .03) and demonstrated a clear gradient with duration, but only among men. Conclusions. Overall, the present study does not provide strong evidence that breast-feeding is associated with adult longevity. The reduced risk of death from injury may reflect chance, in that the association was significant only for men, or it may reflect psychosocial correlates of breast-feeding practices. [ABSTRACT FROM AUTHOR]

From the evening of March 12, till dinner on March 13, 2017, the 1st International Ustilago/Smut Convergence took place as a workshop prior to the start of the 29th Fungal Genetics Conference, in Asilomar, California. The overall goals of the meeting were to expand the smut model systems being used and to expand participation by the next generations of scientists with these fungi. These goals were implemented through a combination of emphasis on student and post-doc presentations, mentoring of such individuals, and active recruitment of participation by groups under-represented at such meetings in recent years in the US, especially those from Latin America and other Spanish-speaking countries. Work was presented at the first workshop on U. maydis , Sporosorium reilianum , Microbotryum violaceum , U. esculenta , and Thecaphora thlaspeos. Students and post-doctoral researchers were encouraged to present their "just-in-time," as-yet-unpublished data, in a safe environment, with the understanding of those attending the meeting that this early access was a privilege not to be taken advantage of. The result was lively and constructive discussion, including a variety of presentations by these young scientists on putative and characterized smut effector proteins, clearly at the forefront of such research, even considering the advances presented later that week at the Fungal Genetics Conference. This review also briefly compares the first meeting with the events of the recent 2nd International Ustilago/Smut Convergence (March 11–12, 2019), which ended with a tribute to Prof. Dr. Regine Kahmann, in honor of her career, and especially for her contributions to the field of smut genetics. [ABSTRACT FROM AUTHOR]

Reports on an end of strike of three northern California area grocery chains. Includes Safeway, Lucky Stores and Save Mart; Employees' rollover of contract; Proposals of cost-cutting measures; Retention of health insurance package; Wage increase proposal.

Advises that a 9-day work stoppage at the Los Angeles Metropolitan Transit Authority was ended when employees represented by the Amalgamated Transit Union ratified a 3-year agreement. Details of the contract.

Deals with a four-year contract covering 3,500 workers in Fremont, California that was agreed on by New United Motor Manufacturing Inc. (NUMMI), a joint venture between General Motors Corp. and Toyota Corp., and the United Auto Workers (UAW). Major issues, including retiree health care benefit program and wage increases.

Provides information on a 39-month contract between GTE of California, Inc. and Communications Workers of America affecting about 12,000 utility workers employed throughout California. Details of the agreement.

Upscaled soil hydraulic properties are needed for many large-scale hydrologic applications such as regional and global climate studies and investigations of land-atmosphere interactions. Many larger scale subsurface flow and contaminant transport studies also require upscaled hydraulic property estimates. The objectives of this study were to develop a methodology for upscaling hydraulic property functions using a p-norm approach, to examine how p-norm values differ for two commonly used soil hydraulic property models (the Gardner and van Genuchten functions), and to investigate the relative sensitivities of p-norms and the effective hydraulic parameters to the degree of soil heterogeneity (expressed in terms of variances and auto-correlation lengths of the hydraulic parameters) and other environmental conditions. The p-norm approach expresses upscaling schemes such that it reduces their sensitivity to uncertainties (heterogeneities) in site conditions. The upscaling schemes are obtained as the result of two new criteria proposed to upscale soil hydraulic properties in this study--one preserving the ensemble vertical moisture flux across the land-atmosphere boundary, and a second preserving the ensemble soil surface moisture content. The effective soil hydraulic parameters of a heterogeneous soil formation are then derived by conceptualizing the formation as an equivalent homogeneous medium that satisfies the upscaling criteria. Upscaling relationships between the Gardner and van Genuchten models can then also be established for steady-state vertical flow using the statistical structures of the hydraulic parameters of these two models as estimated from field measurements. The upscaling scheme is demonstrated using hydraulic property data collected at 84 locations across a site in the Mojave Desert. Our results show that the p-norms generally vary less in magnitude than the effective parameters when the variances of the hydraulic parameters increase. We also show that, in general, p-norm values are better defined for the van Genuchten model than the Gardner model. Hydraulic parameter auto correlations, as defined by correlation lengths, were found to have little impact in relating the upscaling schemes (p-norm values) for the two hydraulic property models, but correlation between the hydraulic parameters within the hydraulic property models can significantly affect p-norm relationships. [ABSTRACT FROM AUTHOR]