Organic-inorganic polymer hybrids containing butyl stannoxane dodecamer cages (Sn_POSS) as nano-building blocks were prepared and investigated. Sn_POSS was employed as a linear, crosslinking or non-bonding molecularly blended unit. For this purpose, it was synthesized with two acrylamido, primary- or secondary amino, or with two additional non- functional groups, which were attached via ionic-bonded sulfonate substituents. The nano- building block was then incorporated in matrices such as PS, PAOS, PETA, PEMA, PHEMA and PPO-based epoxies (the latter with different mesh sizes). Sn_POSS reinforces the studied matrixes by filler-filler interactions (self-assembly to nano-domains). Specific interactions of the ionic bonds of Sn_POSS with suitable pendant groups of the matrixes also can generate reinforcement and suppress filler aggregation. Moreover, the Sn_POSS can undergo several types of chemical reactions like heat-induced oligomerization, dissociation of the ionic substituents, acidolysis of the Sn-butyl bonds, as well as radical reactions of the latter. The influence of ionically bonded cages on the hybrids' morphology, as well as their ability of dissociation and short-distance migration in the polymer network at elevated temperature, was evaluated by TEM, IR and NMR analyses. The mechanical...

Introduction: Contraceptive decision-making is individual in nature and access to high-quality contraceptive care, including counseling and the full range of contraceptive methods, can help individuals achieve their personal reproductive goals and prevent unintended pregnancy. The COVID-19 pandemic disrupted provision and utilization of contraceptive counseling and contraceptive methods. Long-acting reversible contraception (LARC) methods, such as the contraceptive implant and intrauterine devices (IUDs), were particularly affected by the pandemic because they require placement by a health care provider in a clinical setting. Choose Well (CW), an ongoing statewide contraceptive access initiative in South Carolina, launched in 2017 and continues through 2022. CW aims to implement best practices of contraceptive care via training and funding for IUD and implant methods. This study examined the perceptions of access to contraceptive counseling and implant and IUD methods during the pandemic in 2020 among CW hospital partners. Methods: Data were collected in 2021 via key informant interviews with partners (n=9) at CW implementing hospitals to assess perceptions of CW activities in 2020, the first year of the COVID-19 pandemic. A semi-structured interview guide was used, and interviews were recorded, transcribed, and consensus coded. A codebook was developed based on the interview guide. Data from select questions of interest related to perceived access to contraceptive counseling, access to LARC methods, and the impact of the pandemic on contraceptive care services were analyzed for this study. Coding was conducted with NVivo software version 1.6.1. Results: Findings show that there was continued provision of contraceptive services during COVID-19 at CW partner hospitals, including an increase in access to contraceptive counseling and LARCs in 2020. The most prevalent facilitator for increased access to contraceptive counseling and LARCs at CW partner hospitals was having key personnel available such as physicians and Obstetrics (OB) navigators. Expanded access to outpatient sites was also noted as a facilitator of contraceptive counseling. Advertising and wide-spread patient education, buy-in and engagement from staff were additional facilitators for the increased access to LARCs. Considering the context of the COVID-19 pandemic, patients wanting to quickly leave the hospital and challenges with staffing contributed to an overall decline in access in some hospital locations. Challenges with staffing included not being able to receive training and nurses being overworked and overburdened. Conclusion: While COVID-19 has posed challenges to contraceptive care service provision, most individuals perceived an increase in access to contraceptive counseling and LARCs at CW partner hospitals. Hospital partners have continued to provide contraceptive services during COVID-19. The findings suggest the success of the CW initiative in increasing access to contraceptive services, particularly during COVID-19 through key facilitators. Staffing positions such as OB Navigators should be funded and maintained to increase access to contraceptive care services in hospital inpatient settings. Coordinating care between hospital inpatient and outpatient settings is similarly important for widespread patient education about contraceptive care services.

Objective: State medicaid programs provide access to effective contraception for people with lower incomes. This study examined contraception use and pregnancy among reproductive-age women enrolled in the South Carolina Medicaid, by eligibility program and socio-demographic sub-groups. Methods: A retrospective cohort of women aged 15–45 who were newly eligible for South Carolina Medicaid from 2012 to 2016 was examined. Log-binomial regression and average marginal effects assessed relationships between contraception use and pregnancies ending in live and non-live births. Contraception was categorized as permanent, long acting reversible contraception (LARC), short-acting hormonal contraception (SAC), or no contraceptive claims. Women with family planning or full-benefit medicaid coverage were included. Results: Approximately 11% of women used LARC methods, 41% used SAC methods, and 46% had no evidence of contraceptive claims. Method utilization varied by eligibility program, race/ethnicity and age. The likelihood of pregnancy was lower among SAC users and lowest among LARC users compared to women with no evidence of contraception across all three programs (family planning APR = 0.44; 95% CI 0.41–0.49 and APR = 0.13, 95% CI 0.10–0.17; Low income families APR = 0.82; 95% CI 0.77–0.88 and APR = 0.33, 95% CI 0.28–0.38; Partners for Healthy Children APR = 0.72; 95% CI 0.68–0.77 and APR = 0.35, 95% CI 0.30–0.43, respectively). Non-Hispanic Black and Hispanic teens were less likely to experience a pregnancy than non-Hispanic white teens. Conclusions for Practice: The likelihood of pregnancy was lower among women using SAC methods and markedly lower among women using LARC. Variation in contraceptive use among racial/ethnic groups was noted despite Medicaid coverage. As new policies and initiatives emerge, these findings provide important context for understanding the role of Medicaid programs in reducing financial barriers to contraceptive services and ensuring access to effective contraception, while fostering reproductive health autonomy among women.

Patient-centered contraceptive care is key for ensuring that individuals achieve their personal reproductive goals. Despite public health efforts, preventing undesired pregnancies and improving maternal and child health outcomes remains unresolved in the United States (US). In Tennessee (TN), the rate of unintended pregnancies remains higher than the national rate (32.4% vs. 30.3%). Long-acting reversible contraceptives (LARCs) are 99% effective in preventing undesired pregnancies; however, uptake remains low in rural and underserved communities. Previous research has provided some insight into women’s perceptions of LARCs; however, those guided by conceptual frameworks to understand the multiple influences that impact perceptions towards LARCs, especially among rural regions, are scarce. This multimethod qualitative study explored multiple influences that impact northeast Tennessee women’s perceptions and attitudes toward LARCs using the Socio-ecological Model (SEM) as a guiding framework. The qualitative study comprised six focus groups and seven individual interviews of women aged 18-44, not pregnant, and current residents of five Counties in Northeast TN. Participants’ demographics were captured through an anonymous survey administered through REDCap. Qualitative data from these sessions were recorded via Zoom, an online audio/video conferencing platform. Each interview and focus group lasted 60 to 90 minutes. Focus group and interview data were combined, transcribed, and uploaded into NVivo for thematic analysis. A priori list of codes identified from the constructs of the SEM was initially used to deductively code the data. Subsequently, the data were analyzed inductively for new codes and themes that did not apply to the a priori categories. Quotations that were representative of or inconsistent with the codes of interest were identified. Fifteen themes and 20 sub-themes were identified using the SEM; On the intrapersonal level of the SEM, participants’ attitudes towards a method, perception of method features, and perceived side effects were identified as themes that delineate influences on their LARC utilization. On the interpersonal level, perception of partner support, perceived support from peer/social networks, and provider trust were themes that describe influences on participants’ LARC utilization. On the community level, the cost of the method, access to information, perceived accessibility to a method, social services, and cultural norms themes were identified as influences on participants’ use of LARCs. On the organizational level, the availability of preferred methods in a clinic, the need for multiple clinic visits to enable the use of a method, and provider counseling practices were salient themes impacting LARC utilization. On the policy level, insurance, and billing policies, sex education policies were identified as impacting LARC utilization. The study presents multi-layered influences on LARC utilization among Northeast TN women, highlighting the utility of the SEM in understanding factors that influence contraceptive use. Findings are critical for programming as they highlight the areas of influence that can be addressed to increase LARC uptake and enable women in rural and underserved regions of the US to achieve personal reproductive goals.

Power dissipation in modern technologies is an important matter and overheating is a severe concern for both manufacturer (impossibility of introducing new and smaller scale technologies and limited temperature range for operating the product) and customer (power supply, which is especially important for mobile systems). One of the main profits that reversible circuit carries is theoretically the zero power dissipation in the sense that it is independent of underlying technology; irreversibility means heat generation. In the other words, reversible circuits may offer a feasible solution in the future that will aid certain reduction of the power loss. Reversible circuits are circuits that do not lose information during computation. These circuits can create unique output vector from each input vector, and vice versa, that is, there is a one-to-one mapping between the input and the output vectors. Historically, the reversible circuits have been inspired by theoretical research in low power electronics as well as practical progress of bit-manipulation transforms in cryptography and computer graphics. Interest in reversible circuit is also sparked by its applications in several up-to-date technologies, such as Nanotechnology, Quantum Computing, Optical Computing, Quantum Dot Cellular Automata, and Low Power Adiabatic CMOS. However, the most important application of reversible circuits is in Quantum Computing. Logic synthesis methodologies for reversible circuits are very different from those for classical CMOS and other technologies. The dissertation introduces a new concept of reversible logic circuits synthesis based on EXOR-sum of Products-of-EXOR-sums (EPOE). The motivation for this work is to reduce the number of the multiple-controlled Toffoli gates as well as the numbers of their inputs. To achieve these reductions the research generalizes from the existing 2-level AND-EXOR structures (ESOP) commonly used in reversible logic to a mixture of 3-level EXOR-AND-EXOR structures and ESOPs. The approaches can be applied to reversible and permutative quantum circuits to synthesize both completely and incompletely specified single-output functions as well as multiple-output functions. This dissertation describes the research intended to examine the methods to synthesize reversible circuits based on this new concept. The examinations indicate that the synthesis of reversible logic circuits based on EPOE approach produces circuits with significantly lower quantum costs than the common ESOP approach.

This dissertation describes the development of automated synthesis algorithms that construct reversible quantum circuits for reversible functions with large number of variables. Specifically, the research area is focused on reversible, permutative and fully specified binary and ternary specifications and the applicability of the resulting circuit to the physical limitations of existing quantum technologies. Automated synthesis of arbitrary reversible specifications is an NP hard, multiobjective optimization problem, where 1) the amount of time and computational resources required to synthesize the specification, 2) the number of primitive quantum gates in the resulting circuit (quantum cost), and 3) the number of ancillary qubits (variables added to hold intermediate calculations) are all minimized while 4) the number of variables is maximized. Some of the existing algorithms in the literature ignored objective 2 by focusing on the synthesis of a single solution without the addition of any ancillary qubits while others attempted to explore every possible solution in the search space in an effort to discover the optimal solution (i.e., sacrificed objective 1 and 4). Other algorithms resorted to adding a huge number of ancillary qubits (counter to objective 3) in an effort minimize the number of primitive gates (objective 2). In this dissertation, I first introduce the MMDSN algorithm that is capable of synthesizing binary specifications up to 30 variables, does not add any ancillary variables, produces better quantum cost (8-50% improvement) than algorithms which limit their search to a single solution and within a minimal amount of time compared to algorithms which perform exhaustive search (seconds vs. hours). The MMDSN algorithm introduces an innovative method of using the Hasse diagram to construct candidate solutions that are guaranteed to be valid and then selects the solution with the minimal quantum cost out of this subset. I then introduce the Covered Set Partitions (CSP) algorithm that expands the search space of valid candidate solutions and allows for exploring solutions outside the range of MMDSN. I show a method of subdividing the expansive search landscape into smaller partitions and demonstrate the benefit of focusing on partition sizes that are around half of the number of variables (15% to 25% improvements, over MMDSN, for functions less than 12 variables, and more than 1000% improvement for functions with 12 and 13 variables). For a function of n variables, the CSP algorithm, theoretically, requires n times more to synthesize; however, by focusing on the middle k (k by MMDSN which typically yields lower quantum cost. I also show that using a Tabu search for selecting the next set of candidate from the CSP subset results in discovering solutions with even lower quantum costs (up to 10% improvement over CSP with random selection). In Chapters 9 and 10 I question the predominant methods of measuring quantum cost and its applicability to physical implementation of quantum gates and circuits. I counter the prevailing literature by introducing a new standard for measuring the performance of quantum synthesis algorithms by enforcing the Linear Nearest Neighbor Model (LNNM) constraint, which is imposed by the today's leading implementations of quantum technology. In addition to enforcing physical constraints, the new LNNM quantum cost (LNNQC) allows for a level comparison amongst all methods of synthesis; specifically, methods which add a large number of ancillary variables to ones that add no additional variables. I show that, when LNNM is enforced, the quantum cost for methods that add a large number of ancillary qubits increases significantly (up to 1200%). I also extend the Hasse based method to the ternary and I demonstrate synthesis of specifications of up to 9 ternary variables (compared to 3 ternary variables that existed in the literature). I introduce the concept of ternary precedence order and its implication on the construction of the Hasse diagram and the construction of valid candidate solutions. I also provide a case study comparing the performance of ternary logic synthesis of large functions using both a CUDA graphic processor with 1024 cores and an Intel i7 processor with 8 cores. In the process of exploring large ternary functions I introduce, to the literature, eight families of ternary benchmark functions along with a Multiple Valued file specification (the Extended Quantum Specification XQS). I also introduce a new composite quantum gate, the multiple valued Swivel gate, which swaps the information of qubits around a centrally located pivot point. In summary, my research objectives are as follows: * Explore and create automated synthesis algorithms for reversible circuits both in binary and ternary logic for large number of variables. * Study the impact of enforcing Linear Nearest Neighbor Model (LNNM) constraint for every interaction between qubits for reversible binary specifications. * Advocate for a revised metric for measuring the cost of a quantum circuit in concordance with LNNM, where, on one hand, such a metric would provide a way for balanced comparison between the various flavors of algorithms, and on the other hand, represents a realistic cost of a quantum circuit with respect to an ion trap implementation. * Establish an open source repository for sharing the results, software code and publications with the scientific community. With the dwindling expectations for a new lifeline on silicon-based technologies, quantum computations have the potential of becoming the future workhorse of computations. Similar to the automated CAD tools of classical logic, my work lays the foundation for creating automated tools for constructing quantum circuits from reversible specifications.

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