Search

Objective: We examine how state spending on children is associated with the size of socioeconomic gaps in maternal childcare time. Background: Persistent socioeconomic divides in the amount and nature of parental time with children have prompted consideration of the factors that mitigate inequalities within the family. At both the national and local levels, the welfare state plays an important role in structuring opportunities for children. Thus, it is important to understand the institutional factors that shape parental behavior. Yet, little research examines how the social safety net is associated with family processes. Method: Using rich data on maternal time with children from the American Time Use Surveys (2003–2016), combined with longitudinal data on public spending in states on major programs affecting children and families, we examine how state spending on children is associated with the size of socioeconomic gaps in maternal childcare time. Results: We found that higher levels of state spending were associated with significant increases in childcare time among low‐educated mothers at both the extensive and intensive margin, increasing the likelihood of spending any minutes on primary childcare in a typical day, as well as increasing the number of minutes spent on childcare. In contrast, we observed no variation in the behavior of highly educated mothers as state spending changes. Implications: State‐level investments could meaningfully narrow socioeconomic gaps in maternal time with children. [ABSTRACT FROM AUTHOR]

Rapid changes in American families have reshaped inequalities in child well-being. This paper examines the unequal consequences of family structures for infant health, focusing on birthweight. Existing studies mainly address the average association between marriage (versus singlehood) and birthweight. I extend the literature by 1) explicitly considering cohabitation and 2) exploring the heterogeneous associations based on mother's likelihood of union formation at conception. Pooling nationally representative data from the National Survey of Family Gro wth 2011-17, I analyze a sample of recent births (N = 4,376) born to mothers aged between 20 and 49 years. Propensity score methods are used to address selections. Results show that 1) compared to single mothers, married mothers reap birthweight benefits, while cohabiting mothers do not; 2) married mothers with a higher likelihood to marry at conception (i.e., more advantaged) reap even larger birthweight benefits than their low-likelihood counterparts (i.e., less advantaged). Overall, the findings reveal important and nuanced roles of family structure in the reproduction of intergenerational inequality through infant health. [ABSTRACT FROM AUTHOR]

Objective. To investigate the diagnostic value of circulating integrins β1, 2, and 3 in venous thrombosis (VTE). Materials and Methods. A total of 474 VTE patients and 306 patients with nonhigh risk for VTE as the control group were studied. Levels of adhering integrins β1, 2, and 3 were detected by flow cytometry. Levels of circulating integrins β1, 2, and 3 in serum were measured by enzyme-linked immunosorbent assay. Results. We found that integrins β1, 2, and 3 were expressed highly both in serum and on the surface of leukocytes and platelets in venous thromboembolism. The levels of circulating integrins β1, 2, and 3 are positively correlated with adhering integrins. It showed excellent clinical diagnostic performance of circulating integrins β1, 2, and 3 in venous thromboembolism. Conclusions. Integrin subunit β can be used as a diagnostic marker with high sensitivity and specificity for venous thromboembolism. [ABSTRACT FROM AUTHOR]

Purpose: To develop a weakly supervised deep learning (WSDL) method that could utilize incomplete/missing survival data to predict the prognosis of extranodal natural killer/T cell lymphoma, nasal type (ENKTL) based on pretreatment 18F-FDG PET/CT results. Methods: One hundred and sixty-seven patients with ENKTL who underwent pretreatment 18F-FDG PET/CT were retrospectively collected. Eighty-four patients were followed up for at least 2 years (training set = 64, test set = 20). A WSDL method was developed to enable the integration of the remaining 83 patients with incomplete/missing follow-up information in the training set. To test generalization, these data were derived from three types of scanners. Prediction similarity index (PSI) was derived from deep learning features of images. Its discriminative ability was calculated and compared with that of a conventional deep learning (CDL) method. Univariate and multivariate analyses helped explore the significance of PSI and clinical features. Results: PSI achieved area under the curve scores of 0.9858 and 0.9946 (training set) and 0.8750 and 0.7344 (test set) in the prediction of progression-free survival (PFS) with the WSDL and CDL methods, respectively. PSI threshold of 1.0 could significantly differentiate the prognosis. In the test set, WSDL and CDL achieved prediction sensitivity, specificity, and accuracy of 87.50% and 62.50%, 83.33% and 83.33%, and 85.00% and 75.00%, respectively. Multivariate analysis confirmed PSI to be an independent significant predictor of PFS in both the methods. Conclusion: The WSDL-based framework was more effective for extracting 18F-FDG PET/CT features and predicting the prognosis of ENKTL than the CDL method. [ABSTRACT FROM AUTHOR]

To evaluate the consistency on the target heart rate for exercise determined by simple target heart rate (sTHR) based on resting heart rate (HRrest) and heart rate at anaerobic threshold (HRAT) in cardiopulmonary exercise test (CPET) for patients with chronic heart failure. This is a retrospective cohort study, in which CHF patients who underwent CPET in Tongji Hospital Cardiac Rehabilitation Center Affiliated to Tongji University from March 2007 to December 2018 were enrolled. The clinical data of the patients from the electronic medical record system, HRrest and HRAT measured by CPET were collected. Patients were further divided into subgroups according to gender, age (<60 years group and ≥ 60 years group), with or without beta-blocker therapy and subgroup of heart failure (heart failure with reduced, mid-range and preserved ejection fraction). The sTHR (HRrest plus 10, 15, 20, 25 and 30 bpm) and HRAT were all calculated in each patient. Paired t- test was used for the difference between the two methods, correlation analysis was shown by pearson analysis and intraclass correlation coefficient (ICC) was calculated for consistency test. A total of 547 CHF patients were enrolled, including 447 males (81.7%), aged 63 (56,69) years, with BMI of 25.2 (23.5,26.4) kg/m2 and LVEF of 45.0 (36.0, 52.0) %. The target heart rate determined by HRAT method was (93.59 ± 13.95) bpm, and its counterpart determined by HRrest plus 20 bpm (HRrest +20) was (93.16 ± 7.69) bpm. There was no significant difference between the two methods (P >0.05). However, it was statistically different between HRrest plus 10, 15, 25, 30 bpm and HRAT respectively (P <0.001). And HRrest +20 was positively correlated with HRAT (r = 0.418, P <0.001). Therefore, HRrest +20 below was regarded as sTHR. The ICC of the consistency test between sTHR and HRAT was 0.523,95%CI 0.435–0.596 (P < 0.001) in all patients (n = 547). In patients with beta-blocker therapy (n = 464), the ICC of sTHR and HRAT consistency test was 0.534,95%CI 0.441–0.612, P < 0.001; The ICC of the consistency test between sTHR and HRAT of patients without beta-blocker therapy (n = 83) was 0.407,95%CI 0.083–0.616, P < 0.05. In the sinus rhythm group (n = 466), the ICC of sTHR and HRAT consistency test was 0.527,95%CI 0.433–0.606, P < 0.001; The ICC of the consistency test between sTHR and HRAT of atrial fibrillation patients in group (n = 81) was 0.482,95%CI 0.195–0.667, P < 0.05.The ICC of the consistency test between sTHR and HRAT was 0.501,95%CI 0.338–0.623 (P < 0.001) in patients under 60 years old (n = 195); The ICC of the consistency test between sTHR and HRAT in patients ≥60 years old (n = 352) was 0.533,95%CI 0.424–0.621, P < 0.001. In the male group (n = 447), the ICC of sTHR and HRAT consistency test was 0.577,95%CI 0.491–0.649, P < 0.001; The ICC of the consistency test between sTHR and HRAT of female patients in group (n = 100) was 0.344,95%CI 0.025–0.559, P < 0.05. The ICC of sTHR and HRAT consistency test in HFrEF group (n = 170) was 0.395,95%CI 0.181–0.553, P < 0.01; The ICC values of the consistency test between sTHR and HRAT was 0.543, 95%CI 0.405–0.649 (P < 0.001) in patients with HFmrEF (n = 222); In HFpEF group (n = 155), the ICC of sTHR and HRAT consistency test was 0.620,95%CI 0.478–0.723, P < 0.001. The exercise target heart rate calculated by HRrest is consistent with that determined by HRAT in patients with CHF. For primary hospitals without CPET, exercise prescription equivalent to AT intensity for patients with CHF can be determined by HRrest. However, the target heart rate calculated by HRrest can't replace that determined by HRAT in this patient cohort completely. • In patients with CHF, the exercise target heart rate determined by HRrest plus 20 bpm is consistent with by AT. • It's feasible to develop exercise prescription equivalent to AT intensity for CHF patients by HRrest without CPET. • HRrest plus 20 bpm can be of clinical value in exercise therapy for CHF patients in primary hospitals. [ABSTRACT FROM AUTHOR]

This paper presents a search-theoretic model of union formation among women, aged 55 and older. Specifically, it provides new estimates of gender differentials in cohabitation and marriage at older ages, and documents recent patterns of assortative mating using data from the 2008–2017 American Community Survey. Our analyses reveal that cohabitation represents a much smaller share of all older unmarried women, all partnered women, and all women in comparison to patterns observed among their male counterparts. The results also reveal highly uneven patterns of union formation by age, race and marital history, which reflect demographically uneven constraints and preferences. Our analyses also document, for the first time, patterns of assortative mating at older ages. Shortages of similarly-aged men, especially among older African American women, seemingly heighten the likelihood of demographically mismatched unions. Older women are less likely to form unions with same-race or economically attractive partners, defined as men having a college-degree. This study shows that older single women, in general, are at a comparative disadvantage in the marriage market, both in forming co-residential unions and in finding partners who match their own social, demographic, and economic profiles. This paper highlights considerable heterogeneity in the experiences of America's older women. It calls for new theoretical approaches that acknowledge the unequal resources and bargaining power among older women in the marriage market. [ABSTRACT FROM AUTHOR]

Systemic vasculitis is a heterogeneous group of multisystem autoimmune disorders characterized by inflammation of blood vessels. Although many progresses in diagnosis and immunotherapies have been achieved over the past decades, there are still many unanswered questions about vasculitis from pathological understanding to more advanced therapies. Extracellular vesicles (EVs) are double-layer phospholipid membrane vesicles harboring various cargoes. EVs can be classified into exosomes, microvesicles (MVs), and apoptotic bodies depending on their size and origin of cellular compartment. EVs can be released by almost all cell types and may be involved in physical and pathological processes including inflammation and autoimmune responses. In systemic vasculitis, EVs may have pathogenic involvement in inflammation, autoimmune responses, thrombosis, endothelium injury, angiogenesis and intimal hyperplasia. EV-associated redox reaction may also be involved in vasculitis pathogenesis by inducing inflammation, endothelial injury and thrombosis. Additionally, EVs may serve as specific biomarkers for diagnosis or monitoring of disease activity and therapeutic efficacy, i.e. AAV-associated renal involvement. In this review, we have discussed the recent advances of EVs, especially their roles in pathogenesis and clinical involvements in vasculitis. [Display omitted] • EVs can be released from activated or aging cells, and cells undergoing different types of programmed cell death. • Redox reactions may be involved in modulation of the release and biological functions of EVs. • EVs contribute to vasculitis through different pathogenic effects. • EVs may serve as biomarkers for diagnosis or monitoring of disease activity and therapeutic efficacy. [ABSTRACT FROM AUTHOR]