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Pregnancy is a condition of broad interest across many medical and health services research domains, but one not easily identified in healthcare claims data. Our objective was to establish an algorithm to identify pregnant women and their pregnancies in claims data. We identified pregnancy-related diagnosis, procedure, and diagnosis-related group codes, accounting for the transition to International Statistical Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) diagnosis and procedure codes, in health encounter reporting on 10/1/2015. We selected women in Merative MarketScan commercial databases aged 15–49 years with pregnancy-related claims, and their infants, during 2008–2019. Pregnancies, pregnancy outcomes, and gestational ages were assigned using the constellation of service dates, code types, pregnancy outcomes, and linkage to infant records. We describe pregnancy outcomes and gestational ages, as well as maternal age, census region, and health plan type. In a sensitivity analysis, we compared our algorithm-assigned date of last menstrual period (LMP) to fertility procedure-based LMP (date of procedure + 14 days) among women with embryo transfer or insemination procedures. Among 5,812,699 identified pregnancies, most (77.9%) were livebirths, followed by spontaneous abortions (16.2%); 3,274,353 (72.2%) livebirths could be linked to infants. Most pregnancies were among women 25–34 years (59.1%), living in the South (39.1%) and Midwest (22.4%), with large employer-sponsored insurance (52.0%). Outcome distributions were similar across ICD-9 and ICD-10 eras, with some variation in gestational age distribution observed. Sensitivity analyses supported our algorithm’s framework; algorithm- and fertility procedure-derived LMP estimates were within a week of each other (mean difference: -4 days [IQR: -13 to 6 days]; n = 107,870). We have developed an algorithm to identify pregnancies, their gestational age, and outcomes, across ICD-9 and ICD-10 eras using administrative data. This algorithm may be useful to reproductive health researchers investigating a broad range of pregnancy and infant outcomes.

Primary care clinicians are an important source of reproductive health care for their patients. Knowledge of contraception methods is essential to informed patient-centered decision-making about contraceptive options

Through their teaching of early Christian history and theology, Elizabeth A. Clark contends, Princeton Theological Seminary, Harvard Divinity School, Yale Divinity School, and Union Theological Seminary functioned as America's closest equivalents to graduate schools in the humanities during the nineteenth century. These four Protestant institutions, founded to train clergy, later became the cradles for the nonsectarian study of religion at secular colleges and universities. Clark, one of the world's most eminent scholars of early Christianity, explores this development in Founding the Fathers: Early Church History and Protestant Professors in Nineteenth-Century America.Based on voluminous archival materials, the book charts how American theologians traveled to Europe to study in Germany and confronted intellectual currents that were invigorating but potentially threatening to their faith. The Union and Yale professors in particular struggled to tame German biblical and philosophical criticism to fit American evangelical convictions. German models that encouraged a positive view of early and medieval Christianity collided with Protestant assumptions that the church had declined grievously between the Apostolic and Reformation eras. Trying to reconcile these views, the Americans came to offer some counterbalance to traditional Protestant hostility both to contemporary Roman Catholicism and to those historical periods that had been perceived as Catholic, especially the patristic era.

Flour from the fruit of breadfruit trees (Artocarpus altilis) holds the potential to serve as a wheat flour replacement in gluten-free product formulations. This study evaluated the impact of breadfruit flour and leavening agent on gluten-free bread quality. Breadfruit flour was first milled and characterized by the researchers prior to being used in this study. Experimental formulas were mixed with varying breadfruit flour inclusion (0%, 20%, 35%, and 50%) and leavening agent (yeast and baking powder). Quality parameters including density, specific volume, pH, water activity, color, and texture were assessed, and proximate analysis was performed to characterize the nutritional value of the bread. Significant differences (p<0.05) were found in loaf density, specific volume, color (crust L∗ and b∗; crumb L∗, a∗, and b∗), pH, water activity, and crumb firmness. Additionally, a consumer sensory study was performed on the most well-liked formulations. Consumer testing yielded significant differences (p<0.05) between the yeast-leavened control (0% breadfruit flour) and yeast-leavened breadfruit bread (20% breadfruit flour). Nonceliac consumers rated the breadfruit treatment as significantly less acceptable than the control for all sensory characteristics assessed. These results indicate that breadfruit flour can be used at ≤20%, when leavened with yeast, to produce quality gluten-free bread. Future studies should be conducted to assess the impact of breadfruit variety and milling practices on breadfruit flour properties before further attempts are made to investigate how breadfruit flour impacts the gluten-free bread quality.

Underestimation of precipitation in topographically complex regions plagues most gauge-based gridded precipitation datasets. Gauge locations are usually in or near population centers, which tend to lie at low elevations relative to the surrounding terrain. For hydrologic modeling purposes, the resulting bias can result in serious underprediction of observed flows. A hydrologic water balance approach to develop a globally consistent correction for the underestimation of gridded precipitation in mountainous regions is described. The adjustment is based on a combination of the catchment water balances and variations of the BudykoĒ/P̄versus P̄ĒT̄/P̄curve. The method overlays streamflow measurements onto watershed boundaries and then performs watershed water balances to determine “true” precipitation. Rather than relying on a modeled runoff ratio, evaporation is estimated using the Budyko curves. The average correction ratios for each of 357 mountainous river basins worldwide are spatially distributed across the basins and are then interpolated to ungauged areas. Following application of adjustments for precipitation catch deficiencies, the correction ratios are used to scale monthly precipitation from an existing monthly global dataset (1979–99, 0.5° resolution). The correction for orographic effects resulted in a net increase in global terrestrial precipitation of 6.2% (20.2% in orographically influenced regions only) for the 1979–99 climatology. The approach developed here is applicable to any precipitation dataset in regions where good streamflow data exist. As a cautionary note, the correction factors are dataset dependent, and therefore the adjustments are strictly applicable only to the data from which they were derived.

In this work of sweeping erudition, one of our foremost historians of early Christianity considers a variety of theoretical critiques to examine the problems and opportunities posed by the ways in which history is written. Elizabeth Clark argues forcefully for a renewal of the study of premodern Western history through engagement with the kinds of critical methods that have transformed other humanities disciplines in recent decades. History, Theory, Text provides a user-friendly survey of crucial developments in nineteenth- and twentieth-century debates surrounding history, philosophy, and critical theory. Beginning with the \"noble dream\" of \"history as it really was\" in the works of Leopold von Ranke, Clark goes on to review Anglo-American philosophies of history, schools of twentieth-century historiography, structuralism, the debate over narrative history, the changing fate of the history of ideas, and the impact of interpretive anthropology and literary theory on current historical scholarship. In a concluding chapter she offers some practical case studies to illustrate how attending to theoretical considerations can illuminate the study of premodernity. Written with energy and clarity, History, Theory, Text is a clarion call to historians for richer and more imaginative use of contemporary theory.

Wildfires affect the coupled dynamics of vegetation, runoff response, and sediment production, as well as the sequencing of post‐fire precipitation and snowmelt in forested watersheds. We examined these interactions by applying a spatially distributed hydrologic model to multiple‐year periods before and after a major fire that occurred in 1970 in the Entiat River basin, Washington. The effects of precipitation sequencing on post‐fire sediment delivery were examined by simulating the 1970 fire as if it had occurred at other times in a 50‐year period. Simulated sediment delivery varied by a factor of two depending on fire timing. We also compared the effects of fire suppression and found that simulated sediment production was about 20% higher for natural compared with current conditions.

A study of how asceticism was promoted through Biblical interpretation,Reading Renunciationuses contemporary literary theory to unravel the writing strategies of the early Christian authors. Not a general discussion of early Christian teachings on celibacy and marriage, the book is a close examination, in the author's words, of how \"the Fathers' axiology of abstinence informed their interpretation of Scriptural texts and incited the production of ascetic meaning.\" Elizabeth Clark begins with a survey of scholarship concerning early Christian asceticism that is designed to orient the nonspecialist. Section Two is organized around potentially troubling issues posed by Old Testament texts that demanded skillful handling by ascetically inclined Christian exegetes. The third section, \"Reading Paul,\" focuses on the hermeneutical problems raised by I Corinthians 7, and the Deutero-Pauline and Pastoral Epistles. Elizabeth Clark's remarkable work will be of interest to scholars of late antiquity, religion, literary theory, and history.

My thanks to Maria Doerfler for organizing a session at the January 2020 meeting of the American Society of Church History on my book The Fathers Refounded: Protestant Liberalism, Roman Catholic Modernism, and the Teaching of Ancient Christianity in Early Twentieth-Century America, to the editors of Church History for suggesting that the (revised) papers from the session could find a home in print, and, especially, to the panelists for their insightful comments.

BackgroundCalculating Abraham descriptors from solubility values requires that the solute have the same form when dissolved in all solvents. However, carboxylic acids can form dimers when dissolved in non-polar solvents. For such compounds Abraham descriptors can be calculated for both the monomeric and dimeric forms by treating the polar and non-polar systems separately. We illustrate the method of how this can be done by calculating the Abraham descriptors for both the monomeric and dimeric forms of trans-cinnamic acid, the first time that descriptors for a carboxylic acid dimer have been obtained.ResultsAbraham descriptors were calculated for the monomeric form of trans-cinnamic acid using experimental solubility measurements in polar solvents from the Open Notebook Science Challenge together with a number of water-solvent partition coefficients from the literature. Similarly, experimental solubility measurements in non-polar solvents were used to determine Abraham descriptors for the trans-cinnamic acid dimer.ConclusionAbraham descriptors were calculated for both the monomeric and dimeric forms of trans-cinnamic acid. This allows for the prediction of further solubilities of trans-cinnamic acid in both polar and non-polar solvents with an error of about 0.10 log units.