Search

Microplastics and microfibres are found ubiquitously in global oceans as well as marine organisms from different trophic levels. However, little is known about the presence of microplastics and microfibres in marine megafauna, such as sharks. This study provided the first investigation of the presence of microplastics and other anthropogenic fibres (i.e., cellulose based fibres) in intestine and muscle samples of four large apex shark species in Australian coastal waters. Microplastics and other anthropogenic fibres were found in 82% of the analysed intestine samples. The mean abundance in intestine samples was 3.1 ± 2.6 particles/individual, which corresponded to 0.03 ± 0.02 particles/g of intestine, across all shark species. The size of particles ranged from 190 to 4860 μm in length with 92% being fibrous in shape and the rest fragments. FTIR spectroscopy identified that 70% of fibres were cellulose-based followed by polyethylene terephthalate (PET), while the fragments were polyethylene and polypropylene. In shark muscles, 60% of samples contained microplastics and other anthropogenic fibres, again with the majority being cellulose-based fibres followed by PET fibres. Methodological differences hinder a more comprehensive assessment of microplastic contamination across studies. Additionally, we identified some challenges which should be factored in for future studies looking at the presence of microplastics as well as other anthropogenic fibres in these large marine organisms. Overall, the findings provide first evidence of microplastics and other anthropogenic fibres not only in the intestines, but also in muscle tissues of large apex shark species. [Display omitted] • Microplastics and other anthropogenic fibres were found in four apex shark species. • Fibres were predominantly found in both intestine and muscle samples. • Cellulose-based fibres accounted for 61–82% of all fibres detected. • PET plastic fibres accounted for the majority of plastic fibres. • Challenges in methodologies and cross-study comparison were identified. [ABSTRACT FROM AUTHOR]

• Myocarditis is a well known adverse events of special interest following COVID-19 vaccines. • Limited information has been published regarding medium and longer term outcomes. • This clinical survey study found around half of patients still experience symptoms at 6 months. • There are distinct phenotypic differences between genders and age groups. Myocarditis and myopericarditis are well described adverse events of special interest (AESI) following COVID-19 vaccinations. Although reports are reassuring regarding initial clinical outcomes, information about longer term outcomes remains limited. We aimed to further this knowledge and report outcomes to 6 months post diagnosis from a single population cohort. Reports of myocarditis following COVID-19 vaccination were followed up by SAEFVIC (Surveillance of Adverse Events Following Vaccination in the Community), the state-wide vaccine safety service for Victoria, Australia. Confirmed myocarditis cases (Brighton Collaboration Criteria levels 1–3) were followed up via surveys at 1, 3 and 6 months post symptom onset. Responses received between 22 February 2021 and 30 September 2022 were analysed. 87.5 % (N = 182) of eligible participants completed at least 1 survey report. 377 reports were analysed. 76.9 % of completed reports were from male patients. The median age of patients was 21 years [IQR: 16 to 32]. 54.8 % (n = 74) of survey reports at 6 months, reported ongoing symptoms. At all follow-up time points, females were significantly more likely to have ongoing symptoms. At 6 months, 51.9 % of male respondents reported symptom resolution compared to 22.6 % of female patients (p = 0.002). Females were also more likely to continue medication and have ongoing exercise restrictions. However, males were significantly more likely to have higher initial peak troponin results and abnormal initial cardiac imaging investigations. There appears to be a significant proportion of patients who experience ongoing symptoms to 6 months post onset amongst patients that experience these AESI. Male patients were more likely to report earlier and more complete symptom recovery, despite significantly higher average initial peak troponin. This difference in phenotypic presentation in females compared to males warrants further investigation and there is a need for longer term follow up data. [ABSTRACT FROM AUTHOR]

Purpose We evaluated whether brain development continues and brain injury is prevented during Artificial Placenta (AP) support utilizing extracorporeal life support (ECLS). Methods Lambs at EGA 118 days (term = 145; n = 4) were placed on AP support (venovenous ECLS with jugular drainage and umbilical vein reinfusion) for 7 days and sacrificed. Early (EGA 118; n = 4) and late (EGA 127; n = 4) mechanical ventilation (MV) lambs underwent conventional MV for up to 48 h and were sacrificed, and early (n = 5) and late (n = 5) tissue control (TC) lambs were sacrificed at delivery. Brains were harvested, formalin-fixed, rehydrated, and studied by magnetic resonance imaging (MRI). The gyrification index (GI), a measure of cerebral folding complexity, was calculated for each brain. Diffusion-weighted imaging was used to determine fractional anisotropy (FA) and apparent diffusion coefficient (ADC) in multiple structures to assess white matter (WM) integrity. Results No intracranial hemorrhage was observed. GI was similar between AP and TC groups. ADC and FA did not differ between AP and late TC groups in any structure. Compared to late MV brains, AP brains demonstrated significantly higher ADC (0.45 ± 0.08 vs. 0.27 ± 0.11, p = 0.02) and FA (0.61 ± 0.04 vs. 0.44 ± 0.05; p = 0.006) in the cerebral peduncles. Conclusions After 7 days of AP support, WM integrity is preserved relative to mechanical ventilation. Type of study Research study. [ABSTRACT FROM AUTHOR]

Pandemic preparedness and COVID-19 response indicators focus on public health outcomes (such as infections, case fatalities, and vaccination rates), health system capacity, and/or the effects of the pandemic on the economy, yet this avoids more political questions regarding how responses were mobilized. Pandemic preparedness country rankings have been called into question due to their inability to predict COVID-19 response and outcomes, and COVID-19 response indicators have ignored one of the most well documented secondary effects of the pandemic – its disproportionate effects on women. This paper analyzes pandemic preparedness and response indicators from a feminist perspective to understand how indicators might consider the secondary effects of the pandemic on women and other equity deserving groups. Following a discussion of the tensions that exist between feminist methodologies and the reliance on indicators by policymakers in preparing and responding to health emergencies, we assess the strengths and weakness of current pandemic preparedness and COVID-19 response indicators. The risk with existing pandemic preparedness and response indicators is that they give only limited attention to secondary effects of pandemics and inequities in terms of who is disproportionately affected. There is an urgent need to reconceptualize what 'successful' pandemic preparedness and response entails, moving beyond epidemiological and economic measurements. We suggest how efforts to design COVID response indicators on gender inclusion could inform pandemic preparedness and associated indicators. • A feminist perspective on debates about the use of indicators in global health. • Pandemic preparedness and response indicators consideration of gender is limited. • COVID-19 has led to the development of innovative gender-based approaches. • These can be built upon through greater integration of feminist approaches. [ABSTRACT FROM AUTHOR]

Monoacylglycerol acyltransferase 2 (MGAT2) is an important enzyme highly expressed in the human small intestine and liver for the regulation of triglyceride absorption and homeostasis. We report that treatment with BMS-963272, a potent and selective MGAT2 inhibitor, decreased inflammation and fibrosis in CDAHFD and STAM, two murine nonalcoholic steatohepatitis (NASH) models. In high-fat-diet-treated cynomolgus monkeys, in contrast to a selective diacylglycerol acyltransferase 1 (DGAT1) inhibitor, BMS-963272 did not cause diarrhea. In a Phase 1 multiple-dose trial of healthy human adults with obesity (NCT04116632), BMS-963272 was safe and well tolerated with no treatment discontinuations due to adverse events. Consistent with the findings in rodent models, BMS-963272 elevated plasma long-chain dicarboxylic acid, indicating robust pharmacodynamic biomarker modulation; increased gut hormones GLP-1 and PYY; and decreased body weight in human subjects. These data suggest MGAT2 inhibition is a promising therapeutic opportunity for NASH, a disease with high unmet medical needs. [Display omitted] • MGAT2 inhibitor BMS-963272 decreased inflammation and fibrosis in murine NASH models • BMS-963272 increased PYY and FGF-21 and decreased body weight in human subjects • Elevation of long-chain DCAs is a specific PD biomarker for MGAT2 inhibitors • MGAT2 inhibition is a promising approach for the treatment of NASH Cheng et al. demonstrate that MGAT2 inhibitor BMS-963272 decreased inflammation and fibrosis in CDAHFD and STAM mice and body weight in human obese subjects, which is consistent with elevation of gut hormone PYY and GLP-1 levels. Long-chain DCAs can serve as a specific translational PD biomarker for MGAT2 inhibitors. [ABSTRACT FROM AUTHOR]

To explore midwives' experiences working on the frontlines of the COVID-19 pandemic in British Columbia, Canada. Qualitative study involving three semi-structured focus groups and four in-depth interviews with midwives. The COVID-19 pandemic in British Columbia, Canada from 2020-2021. 13 midwives working during the first year of the COVID-19 pandemic in British Columbia. Qualitative analysis surfaced four key themes. First, midwives faced a substantial lack of support during the pandemic. Second, insufficient support was compounded by a lack of recognition. Third, participants felt a strong duty to continue providing high-quality care despite COVID-19 related restrictions and challenges. Lastly, lack of support, increased workloads, and moral distress exacerbated burnout among midwives and raised concerns around the sustainability of their profession. Lack of effective support for midwives during the initial months of the COVID-19 pandemic exacerbated staffing shortages that existed prior to the pandemic, creating detrimental gaps in essential care for pregnant people, especially with increasing demands for homebirths. Measures to support midwives should combat inequities in the healthcare system, mitigating the risks of disease exposure, burnout, and professional and financial impacts that may have long-lasting implications on the profession. Given the crucial role of midwives in women- and people-centred care and advocacy, protecting midwives and the communities they serve should be prioritized and integrated into pandemic preparedness and response planning to preserve women's health and rights around the world. [ABSTRACT FROM AUTHOR]

Aims Patient-centered medical home (PCMH) principles including provider continuity, coordination of care, and advanced access align with healthcare needs of patients with Type II diabetes mellitus (DM-II). We investigate changes in trend for DM-II quality indicators after PCMH implementation at Southcentral Foundation, a tribal health organization in Alaska. Methods Monthly rates of DM-II incidence, hemoglobin A1c (HbA1c) measurements, and service utilization were calculated from electronic health records from 1996 to 2009. We performed interrupted time series analysis to estimate changes in trend. Results Rates of new DM-II diagnoses were stable prior to ( p = 0.349) and increased after implementation ( p < 0.001). DM-II rates of HbA1c screening increased, though not significantly, before ( p = 0.058) and remained stable after implementation ( p = 0.969). There was non-significant increasing trend in both periods for percent with average HbA1c less than 7% (53 mmol/mol; p = 0.154 and p = 0.687, respectively). Number of emergency visits increased before ( p < 0.001) and decreased after implementation ( p < 0.001). Number of inpatient days decreased in both periods, but not significantly ( p = 0.058 and p = 0.101, respectively). Conclusions We found positive changes in DM-II quality trends following PCMH implementation of varying strength and onset of change, as well as duration of sustained trend. [ABSTRACT FROM AUTHOR]

Purpose In an effort to standardize practices and reduce unnecessary hospital resource utilization, we implemented guidelines for management of patients with isolated skull fractures (ISF). We sought to examine the impact of these guidelines. Methods Patients with nondisplaced/depressed fracture of the skull vault without intracranial hemorrhage were prospectively enrolled from February 2010 to February 2014. Results Eighty-eight patients (median age = 10 months) were enrolled. Fall was the most common mechanism of injury (87%). The overall admission rate was 57%, representing an 18% decrease from that reported prior to guideline implementation (2003–2008; p = 0.001). Guideline criteria for admission included vomiting, abnormal neurologic exam, concern for abuse, and others. Forty-two percent of patients were admitted outside of the guideline, primarily because of young age (20%). Patients transferred from another hospital (36%) were more likely to be admitted, though the majority (63%) did not meet admission criteria. No ED-discharged patient returned for neurologic symptoms, and none reported significant ongoing symptoms on follow-up phone call. Conclusions Implementation of a new guideline for management of ISF resulted in a reduction of admissions without compromising patient safety. Young age remains a common concern for practitioners despite not being a criterion for admission. Interhospital transfer may be unnecessary in many cases. [ABSTRACT FROM AUTHOR]

Most studies of behavioral/developmental effects of iron deficiency anemia (IDA) or iron supplementation in infancy have found social-emotional differences. Differences could relate to behavioral inhibition or lack of positive affect and altered response to reward. To determine long-term behavioral effects, the study was a follow-up of a randomized controlled trial of behavioral/developmental effects of preventing IDA in infancy. Healthy Chilean infants free of IDA at age ± mo were randomly assigned to iron supplementation or no added iron (formula with iron/powdered cow milk, vitamins with/without iron) from ages ± to 12 mo. At age 10 y, 59% (666 of 1123) and 68% (366 of 534) of iron-supplemented and no-added-iron groups were assessed. Social-emotional outcomes included maternal-reported behavior problems, self-reported behavior, examiner ratings, and video coding of a social stress task and game like paradigms. Examiners rated the iron-supplemented group as more cooperative, confident, persistent after failure, coordinated, and direct and reality-oriented in speech and working harder after praise compared with the no-added-iron group. In a task designed to elicit positive affect, supplemented children spent more time laughing and smiling together with their mothers and started smiling more quickly. In the social stress task they smiled and laughed more and needed less prompting to complete the task. All P values were <0.05; effect sizes were 0.14-0.36. There were no differences in behaviors related to behavioral inhibition, such as anxiety/depression or social problems. In sum, iron supplementation in infancy was associated with more adaptive behavior at age 10 y, especially in affect and response to reward, which may improve performance at school and work, mental health, and personal relationships. [ABSTRACT FROM AUTHOR]

Study objective: The objective of this study was to determine the diagnostic performance of right ventricular dilatation identified by emergency physicians on bedside echocardiography in patients with a suspected or confirmed pulmonary embolism. The secondary objective included an exploratory analysis of the predictive value of a subgroup of findings associated with advanced right ventricular dysfunction (right ventricular hypokinesis, paradoxical septal motion, McConnell's sign). Methods: This was a prospective observational study using a convenience sample of patients with suspected (moderate to high pretest probability) or confirmed pulmonary embolism. Participants had bedside echocardiography evaluating for right ventricular dilatation (defined as right ventricular to left ventricular ratio greater than 1:1) and right ventricular dysfunction (right ventricular hypokinesis, paradoxical septal motion, or McConnell's sign). The patient's medical records were reviewed for the final reading on all imaging, disposition, hospital length of stay, 30-day inhospital mortality, and discharge diagnosis. Results: Thirty of 146 patients had a pulmonary embolism. Right ventricular dilatation on echocardiography had a sensitivity of 50% (95% confidence interval [CI] 32% to 68%), a specificity of 98% (95% CI 95% to 100%), a positive predictive value of 88% (95% CI 66% to 100%), and a negative predictive value of 88% (95% CI 83% to 94%). Positive and negative likelihood ratios were determined to be 29 (95% CI 6.1% to 64%) and 0.51 (95% CI 0.4% to 0.7%), respectively. Ten of 11 patients with right ventricular hypokinesis had a pulmonary embolism. All 6 patients with McConnell's sign and all 8 patients with paradoxical septal motion had a diagnosis of pulmonary embolism. There was a 96% observed agreement between coinvestigators and principal investigator interpretation of images obtained and recorded. Conclusion: Right ventricular dilatation and right ventricular dysfunction identified on emergency physician performed echocardiography were found to be highly specific for pulmonary embolism but had poor sensitivity. Bedside echocardiography is a useful tool that can be incorporated into the algorithm of patients with a moderate to high pretest probability of pulmonary embolism. [Copyright &y& Elsevier]

Objective: To evaluate adulthood function following chronic iron deficiency in infancy. Study design: At 25 years, we compared 33 subjects with chronic iron deficiency in infancy to 89 who were iron-sufficient before and/or after iron therapy. Outcomes included education, employment, marital status, and physical and mental health. Results: Adjusting for sex and socioeconomic status, a higher proportion of the group with chronic iron deficiency did not complete secondary school (58.1% vs 19.8% in iron-sufficient group; Wald value = 8.74; P = .003), were not pursuing further education/training (76.1% vs 31.5%; Wald value = 3.01; P = .08; suggestive trend), and were single (83.9% vs 23.7%, Wald value = 4.49; P = .03). They reported poorer emotional health and more negative emotions and feelings of dissociation/detachment. Results were similar in secondary analyses comparing the chronic iron-deficient group with subjects in the iron-sufficient group who had been iron-deficient before treatment in infancy. Path analysis showed direct paths for chronic iron deficiency in infancy and being single and more detachment/dissociation at 25 years. There were indirect paths for chronic iron deficiency and not completing secondary school via poorer cognitive functioning in early adolescence and more negative emotions via behavior problems in adolescence, indicating a cascade of adverse outcomes. Conclusion: The observational nature of this study limits our ability to draw causal inference, even when controlling for background factors. Nonetheless, our results indicate substantial loss of human potential. There may be broader societal implications, considering that many adults worldwide had chronic iron deficiency in infancy. Iron deficiency can be prevented or treated before it becomes chronic or severe. [Copyright &y& Elsevier]

Background: In women with BRCA mutations, risk-reducing bilateral salpingo-oophorectomy has been shown to decrease gynecologic cancer-specific and overall mortality. The National Comprehensive Cancer Network recommends that patients with BRCA mutations undergo risk-reducing bilateral salpingo-oophorectomy between the ages of 35 and 40 years for BRCA1 mutation carriers and between the ages of 40 and 45 years for BRCA2 mutation carriers or after childbearing is complete. Currently, uptake and timing of risk-reducing bilateral salpingo-oophorectomy and reasons for delays in risk-reducing bilateral salpingo-oophorectomy are not well understood.Objective: We sought to evaluate uptake and timing of risk-reducing bilateral salpingo-oophorectomy among women with BRCA1 and BRCA2 mutations concerning the National Comprehensive Cancer Network guidelines and reasons for delays in risk-reducing bilateral salpingo-oophorectomy.Study Design: In this retrospective chart review, we identified women with BRCA1 and BRCA2 mutations who discussed risk-reducing bilateral salpingo-oophorectomy with a provider between 2012 and 2021. Uptake of risk-reducing bilateral salpingo-oophorectomy was documented, and patients were classified as having timely or delay in risk-reducing bilateral salpingo-oophorectomy based on the National Comprehensive Cancer Network guidelines. For those with delay in risk-reducing bilateral salpingo-oophorectomy, reasons cited for delay were collected. Comparative statistical analyses were performed to evaluate characteristics of those with timely vs delayed risk-reducing bilateral salpingo-oophorectomy. A multivariable logistic regression model was used to evaluate the associations among factors related to timing of risk-reducing bilateral salpingo-oophorectomy.Results: We identified 638 BRCA1 and BRCA2 mutation carriers seen between 2012 and 2021. Of these patients, 306 (48.0%) had undergone risk-reducing bilateral salpingo-oophorectomy and 332 (52.0%) had not. When evaluating the timing of risk-reducing bilateral salpingo-oophorectomy, 136 (21.3%) underwent timely risk-reducing bilateral salpingo-oophorectomy, 239 (37.5%) had delays in risk-reducing bilateral salpingo-oophorectomy, and 263 (41.2%) had not undergone risk-reducing bilateral salpingo-oophorectomy but were younger than the National Comprehensive Cancer Network age guidelines; therefore, they were neither timely nor delayed. Patients with delay in risk-reducing bilateral salpingo-oophorectomy were significantly older at the time of genetic testing than those with timely risk-reducing bilateral salpingo-oophorectomy (mean, 49.8 vs 36.3 years; P<.001). Of the 306 patients who underwent risk-reducing bilateral salpingo-oophorectomy, those with delayed risk-reducing bilateral salpingo-oophorectomy had a significantly shorter interval between BRCA identification and risk-reducing bilateral salpingo-oophorectomy than those with timely risk-reducing bilateral salpingo-oophorectomy (median, 8.7 vs 17.6 months; P<.001). Patients with delay in risk-reducing bilateral salpingo-oophorectomy were more likely to have a personal history of cancer than those with timely risk-reducing bilateral salpingo-oophorectomy (49.8% vs 37.5%; P=.028). Of the 239 women with delay in risk-reducing bilateral salpingo-oophorectomy, 188 (78.7%) had delayed BRCA mutation identification, 29 (12.1%) had menopausal concerns, 17 (7.1%) had ongoing cancer treatment, 12 (5.0%) had coordination with breast surgery, 20 (8.4%) had miscellaneous reasons, and 19 (7.9%) had no reason documented. In the multivariate model, older age at BRCA diagnosis (odds ratio, 0.73; 95% confidence interval, 0.68-0.78; P<.001) was significantly associated with delayed risk-reducing bilateral salpingo-oophorectomy timing; those with BRCA2 mutation type were 7.54 times as likely to have timely risk-reducing bilateral salpingo-oophorectomy than BRCA1 mutation carriers (odds ratio, 7.54; 95% confidence, 3.70-16.42; P<.001).Conclusion: Nearly 38% of BRCA1 and BRCA2 mutation carriers undergo or have yet to undergo risk-reducing bilateral salpingo-oophorectomy over the recommended National Comprehensive Cancer Network age. The most common reason for the delay in risk-reducing bilateral salpingo-oophorectomy was delayed identification of BRCA mutation, noted in 79% of patients with delayed risk-reducing bilateral salpingo-oophorectomy. Timely genetic testing for eligible patients can increase appropriately timed risk-reducing bilateral salpingo-oophorectomy for the prevention of ovarian cancer and reduction of mortality in BRCA mutation carriers. [ABSTRACT FROM AUTHOR]

This study used Hierarchical Linear Modeling to analyze the relationship between school organizational behaviors and practices (at the school level) on teachers' reports of internal and external physiological sources of efficacy. Six hundred sixty-one teachers from 42 schools in the United States were surveyed to measure both individual sources of teacher efficacy and their school's professional learning community organizational behaviors. Findings from this study support existing research which suggests a relationship between collaborative organizational culture and these efficacy sources. It also adds to existing research by demonstrating which efficacy sources have a positive or negative relationship to the organizational behaviors. [Copyright &y& Elsevier]

Abstract: Prostaglandin E2 (PGE2) is an inflammatory mediator implicated in several gastrointestinal pathologies that cause diarrhoea. The aim of this study was to establish the contributions of the four different EP receptors (EP1–4) to PGE2-induced anion secretion in human and mouse colon mucosa. Electrogenic anion secretion (short-circuit current; I sc) was measured across colonic mucosae or T84 monolayers placed in Ussing chambers in response to EP receptor agonists and antagonists. PGE2 and PGE1-alcohol increased I sc in human colon mucosa, T84 epithelia and mouse colon mucosa, and these responses were inhibited by the EP4 receptor antagonist, GW627368X alone. In addition, the EP2 agonist, butaprost increased I sc in all three preparations and these responses were inhibited by the non-selective EP1,2,3 receptor antagonist, AH6809 but not by GW627368X. Conversely, responses mediated by EP1 and EP3 receptors were not observed in human colon or T84 monolayers. However, in mouse colon mucosa the EP3-preferring agonist, sulprostone reduced I sc, indicative of G iα -signalling. Taken together these results indicate that PGE2-induced ion secretion is mediated predominantly by Gs-coupled EP4 receptors and also by EP2 receptors in human mucosa. Furthermore, tumour necrosis factor alpha (TNFα) and interleukin 1beta (IL1β) increased I sc and these responses were also inhibited by the EP4 receptor antagonist in human colon mucosa. This study establishes the EP receptor pharmacology present in human epithelial preparations, and suggests that EP4 receptors may be a therapeutic target for the treatment of secretory diarrhoea where PGE2 is implicated in the aetiology. [Copyright &y& Elsevier]

Study objective: Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most common causes of skin and soft tissue infections in patients presenting to the emergency department (ED). The prevalence of asymptomatic MRSA colonization in ED patients is less well described, particularly in the absence of a skin and soft tissue infection–related complaint. The goals of this study are to assess the prevalence of nasal and extranasal staphylococcal colonization in ED patients, evaluate risk factors, and molecularly characterize the strains. Methods: We performed active surveillance for methicillin-susceptible S aureus (MSSA) and MRSA colonization in 400 subjects presenting to an urban ED. Risk factor assessment was performed and culture testing was conducted on anterior nares, oropharynx, palms, groin, perirectal area, wounds, and catheter insertion sites. Multiplex polymerase chain reaction was used to identify the USA300/400 clonal types. Results: The prevalence of colonization with MSSA was 39% (95% confidence interval 34.2% to 44.0%), and prevalence of colonization with MRSA was 5% (95% confidence interval 3.1% to 7.6%). Among MRSA-colonized subjects, an extranasal site tested positive in 80% of subjects, and 45% had exclusive extranasal colonization. USA300 was identified in 55% of MRSA-colonized subjects. The main risk factors for MRSA colonization included HIV infection, diabetes, and participation in contact sports. Conclusion: The overall prevalence of MRSA colonization in this ED population was lower than that reported in other high-risk ambulatory care settings. However, extranasal colonization was present in more than half of MRSA-colonized subjects, and USA300 was the predominant clonal type. [Copyright &y& Elsevier]

A correction is presented to the article "Why we march! Feminist activism in critical times: Lessons from the women's march on Washington" which appeared in the September 2020 issue.

As professors, we have witnessed, anecdotally, a shift in doing social justice advocacy teaching. We have witnessed within some of our classrooms a more empowered hostility and intolerance to conversations pertaining to social justice. We agree that this phenomenon is pedagogical because this language usage not only teaches, but also legitimizes hate speech. We have witnessed the illogical extension of this hate speech with an increase in hate crimes across the country since the 2016 election, Without peaceful protest and grassroots feminist activism, we fear that this speech, this pedagogy, will spread even more violent forms of hate. This research was conducted in and around the first Women's March of 2017. We wanted to know: What were marchers' prior histories of political activism prior to the election? If this was their first time participating in such a manner, how did the election and its early political fallout inspire marchers to attend? 2) What plans did marchers have for political activism after the march? 3) What can be learned from these participants about the current state of political activism in our current era? A total of 788 individuals had taken part in the online survey. Among the participants, 45% marched on Washington, and 55% participated in the march in their local cities. We found that issues of gender equality were of great concern to many of the marchers. In particular, issues related to economic and social equity, including salary. These findings are interesting as they speak to the broader implications of gender equality. And, as the past few years have demonstrated, these issues continue to be of concern. [ABSTRACT FROM AUTHOR]

• Immigrant parents guide young children's peer play according to their cultural beliefs. • The cultural beliefs about their children's education most likely vary greatly based on numerous factors including their cultural backgrounds, and these beliefs have been shown to be correlated with children's social and developmental outcomes. • There is a need to include culturally and linguistically appropriate measures in understanding parents' play beliefs among children from diverse backgrounds. • The current study underscores the importance of incorporating immigrant parents' voices in assessments of children's behavior to better reflect cultural nuance and variability, parenting strategies, and/or beliefs that may differ from mainstream US culture. Parents' beliefs have an important influence on their children's play and learning experiences in the home and at school. Given the dramatic increase in the number of Chinese immigrant families and children living in the United States (the population has grown more than six-fold since 1980, reaching 2.3 million in 2019), it is particularly important to gain a better understanding of these immigrant parents' beliefs. Their beliefs about their children's education most likely vary greatly based on numerous factors including their cultural backgrounds, and these beliefs have been shown to be correlated with children's social and developmental outcomes. The present study aim was twofold: first, to examine play beliefs among this rapidly growing group by validating an existing parent report measure of play beliefs and comparing parents' beliefs to children's interactive peer play and social skills in Head Start classrooms; second, to provide more nuanced information via qualitative data analysis about how Chinese immigrant parents make meaning of their children's play in the context of early learning opportunities. Families of 213 preschool children enrolled in Head Start programs located in a large, northeastern city participated in this study. Findings extend the validity of the Parent Play Beliefs Scale (PPBS; Fogle & Mendez, 2006) for use with Chinese immigrants in the US. Qualitative data suggest that Chinese immigrant parents hold positive beliefs about play, while also displaying some concerns about preschool curriculum in the United States, which likely derive from their own learning experiences when they were in China. The current study underscores the importance of incorporating immigrant parents' voices in assessments of children's behavior to better reflect cultural nuance and variability, parenting strategies, and/or beliefs that may differ from mainstream US culture. [ABSTRACT FROM AUTHOR]

Urban areas impact wildlife populations through multiple pathways, notably habitat fragmentation and degradation. Wildlife can respond to development and other human-driven environmental change at multiple scales, from the individual to the population level, ultimately driving biodiversity patterns and processes in built and adjacent natural landscapes. However, multiple scales of space use are rarely considered in an integrated framework. Focusing on bobcats, a species associated with intermediate sensitivity to development, we explored factors affecting multi-scale space use and population density across San Diego County, a region in southern California characterized by a pronounced development gradient. We used remote camera data and GPS collar data in an integrated spatial capture-recapture + resource selection function approach. At the individual scale, bobcats selected against developed areas, while at the population level, bobcat densities were higher in habitat patches surrounded by development, suggesting that bobcat populations in these areas may be experiencing home range pile-up, a manifestation of the fence effect. Our results provide an integrated multi-scale view of the impacts of human-modified landscapes on wildlife, confirming that research on space use at the individual and population levels should be considered jointly to advance understanding of the mechanisms driving wildlife response to development. This approach has promise to improve conservation and management efforts for urban wildlife. [ABSTRACT FROM AUTHOR]

STUDY OBJECTIVE: We examine the attitudes of emergency department (ED) key informants about the perceived effects of a statewide ban on ambulance diversion on patients, providers, and working relationships in a large urban emergency medical system. METHODS: We performed a qualitative study to examine the effects of a diversion ban on Boston area hospitals. Key informants at each site completed semistructured interviews that explored relevant domains pre- and postban. Interviews were deidentified, transcribed, coded, and analyzed with grounded theory for emerging themes. We identified important themes focused on patient safety, quality of care, and relationships before and after implementation of the diversion ban. RESULTS: Nine of 9 eligible sites participated. Eighteen interviews were completed: 7 MD ED directors, 2 MD designees, and 9 registered nurse leaders. Although most participants had negative opinions about diversion, some had considered diversion a useful procedure. Key themes associated with diversion were adverse effects on patient care quality, patient satisfaction, and a source of conflict among ED staff and with emergency medical services (EMS). All key informants described some positive effect of the ban, including those who reported that the ban had no direct effect on their individual hospital. Although the period preceding the ban was reported to be a source of apprehension about its effects, most key informants believed the ban had improved quality of care and relationships between hospital staff and EMS. CONCLUSION: Key informants considered the diversion ban to have had a favorable effect on emergency medical care in Boston. These results may inform the discussion in other states considering a diversion ban. [ABSTRACT FROM AUTHOR]

The article presents a study on the mental health, protective factors, and risk among Sierra Leonean former child soldiers. It states that 260 former child soldiers ages 10 to 17 from non-governmental organization were recruited and interviewed in Kono District in 2002, 2004, 2008 using linear growth models to investigate trends regarding postconflict and war experiences. The results show association of former child soldiers' long-term mental health with postconflict risk factors and war.

Background: Although most patients with epithelial ovarian cancer respond to frontline platinum-based chemotherapy, around 70% will relapse within 3 years. The phase 3 JAVELIN Ovarian 100 trial compared avelumab (anti-PD-L1 monoclonal antibody) in combination with chemotherapy followed by avelumab maintenance, or chemotherapy followed by avelumab maintenance, versus chemotherapy alone in patients with treatment-naive epithelial ovarian cancer.Methods: JAVELIN Ovarian 100 was a global, open-label, three-arm, parallel, randomised, phase 3 trial run at 159 hospitals and cancer treatment centres in 25 countries. Eligible women were aged 18 years and older with stage III-IV epithelial ovarian, fallopian tube, or peritoneal cancer (following debulking surgery, or candidates for neoadjuvant chemotherapy), and had an Eastern Cooperative Oncology Group performance status of 0 or 1. Patients were randomly assigned (1:1:1) via interactive response technology to receive chemotherapy (six cycles; carboplatin dosed at an area under the serum-concentration-time curve of 5 or 6 intravenously every 3 weeks plus paclitaxel 175 mg/m2 every 3 weeks or 80 mg/m2 once a week [investigators' choice]) followed by avelumab maintenance (10 mg/kg intravenously every 2 weeks; avelumab maintenance group); chemotherapy plus avelumab (10 mg/kg intravenously every 3 weeks) followed by avelumab maintenance (avelumab combination group); or chemotherapy followed by observation (control group). Randomisation was in permuted blocks of size six and stratified by paclitaxel regimen and resection status. Patients and investigators were masked to assignment to the two chemotherapy groups without avelumab at the time of randomisation until completion of the chemotherapy phase. The primary endpoint was progression-free survival assessed by blinded independent central review in all randomly assigned patients (analysed by intention to treat). Safety was analysed in all patients who received at least one dose of study treatment. This trial is registered with ClinicalTrials.gov, NCT02718417. The trial was fully enrolled and terminated at interim analysis due to futility, and efficacy is no longer being assessed.Findings: Between May 19, 2016 and Jan 23, 2018, 998 patients were randomly assigned (avelumab maintenance n=332, avelumab combination n=331, and control n=335). At the planned interim analysis (data cutoff Sept 7, 2018), prespecified futility boundaries were crossed for the progression-free survival analysis, and the trial was stopped as recommended by the independent data monitoring committee and endorsed by the protocol steering committee. Median follow-up for progression-free survival for all patients was 10·8 months (IQR 7·1-14·9); 11·1 months (7·0-15·3) for the avelumab maintenance group, 11·0 months (7·4-14·5) for the avelumab combination group, and 10·2 months (6·7-14·0) for the control group. Median progression-free survival was 16·8 months (95% CI 13·5-not estimable [NE]) with avelumab maintenance, 18·1 months (14·8-NE) with avelumab combination treatment, and NE (18·2 months-NE) with control treatment. The stratified hazard ratio for progression-free survival was 1·43 (95% CI 1·05-1·95; one-sided p=0·99) with the avelumab maintenance regimen and 1·14 (0·83-1·56; one-sided p=0·79) with the avelumab combination regimen, versus control treatment. The most common grade 3-4 adverse events were anaemia (69 [21%] patients in the avelumab maintenance group, 63 [19%] in the avelumab combination group, and 53 [16%] in the control group), neutropenia (91 [28%], 99 [30%], and 88 [26%]), and neutrophil count decrease (49 [15%], 45 [14%], and 59 [18%]). Serious adverse events of any grade occurred in 92 (28%) patients in the avelumab maintenance group, 118 (36%) in the avelumab combination group, and 64 (19%) in the control group. Treatment-related deaths occurred in one (<1%) patient in the avelumab maintenance group (due to atrial fibrillation) and one (<1%) patient in the avelumab combination group (due to disease progression).Interpretation: Although no new safety signals were observed, results do not support the use of avelumab in the frontline treatment setting. Alternative treatment regimens are needed to improve outcomes in patients with advanced epithelial ovarian cancer.Funding: Pfizer and Merck KGaA, Darmstadt, Germany. [ABSTRACT FROM AUTHOR]

Abstract: To date, very few studies have focused on autobiographical memory in patients with bipolar disorder. We examined whether mood state at the time of event encoding (i.e., manic, depressed, euthymic) influences subsequent recollection in these patients. We administered the Autobiographical Interview, a method that allowed us to dissociate episodic and semantic aspects of autobiographical memory. We also compared the memory perspective from which patients recollected these events. Patients were selectively impaired in recollecting episodic details of events encoded during mania but not depression or euthymia. No significant differences emerged between patients and controls for recollection of non-episodic details, regardless of mood state. Patients with bipolar disorder were also more likely than matched controls to recall memories from an observer perspective. These preliminary findings indicate a moderating influence of mood state at the time of event encoding on the subsequent recollection of autobiographical events in patients with bipolar disorder. [Copyright &y& Elsevier]

Abstract: Estrogen alone cannot explain the differences in breast cancer (BC) recurrence and incidence rates in pre- and postmenopausal women. In this study, we have tested a hypothesis that, in addition to estrogen, both iron deficiency due to menstruation and iron accumulation as a result of menstrual stop play important roles in menopause-related BC outcomes. We first tested this hypothesis in cell culture models mimicking the high-estrogen and low-iron premenopausal condition or the low-estrogen and high-iron postmenopausal condition. Subsequently, we examined this hypothesis in mice that were fed iron-deficient and iron-overloaded diets. We show that estrogen only slightly up-regulates vascular endothelial growth factor (VEGF), an angiogenic factor known to be important in BC recurrence. It is, rather, iron deficiency that significantly promotes VEGF by stabilizing hypoxia-inducible factor-1α. Conversely, high iron levels increase oxidative stress and sustain mitogen-activated protein kinase activation, which are mechanisms of known significance in BC development. Taken together, our results suggest, for the first time, that an iron-deficiency-mediated proangiogenic environment could contribute to the high recurrence of BC in young patients, and iron-accumulation-associated pro-oxidant conditions could lead to the high incidence of BC in older women. [Copyright &y& Elsevier]

Abstract: Patients with panic disorder (PD) show maladaptive coping but the role of coping in the pathogenesis of panic is unclear. This study examined general coping and panic-specific coping as predictors of fear responding to CO2 inhalation. Subjective and physiological responses including panic attacks were assessed in 45 patients with PD and 45 matched nonclinical controls. Measures of coping were the primary predictors used in the analyses. Consistent with other reports, patients with PD reported increased emotion-focused coping and there was an association between emotion-focused coping and subjective reactivity. However, only panic-specific coping predicted panic attacks in response to the CO2 challenge. [Copyright &y& Elsevier]

Abstract: This experiment examined the efficacy of an acustimulation wrist band for the relief of chemotherapy-induced nausea using a randomized three-arm clinical trial (active acustimulation, sham acustimulation, and no acustimulation) in 96 women with breast cancer who experienced nausea at their first chemotherapy treatment. Five outcomes related to wrist band efficacy (acute nausea, delayed nausea, vomiting, QOL, and total amount of antiemetic medication used) were examined. The five outcomes were examined separately using analysis of covariance controlling for age and severity of past nausea. There were no significant differences in any of these study measures among the three treatment conditions (P >0.1 for all). Study results do not support the hypothesis that acustimulation bands are efficacious as an adjunct to pharmacological antiemetics for control of chemotherapy-related nausea in female breast cancer patients. [Copyright &y& Elsevier]

Abstract: During the course of studies investigating novel anti-emetic therapies we serendipitously observed a previously unreported behaviour related to emesis in the house musk shrew. This behaviour consisted of spontaneous ingestion of vomit in about half of the animals (males and females) in which emesis was induced by either nicotine (4 mg kg−1 sc.) or horizontal motion (1 Hz, 4 cm, 10 min). Analysis of vomit samples and gastric contents revealed that in a “typical” individual the gastric contents would be voided by as few as 3 vomits. Energetic calculations of the metabolisable energy of food, gastric contents, vomit and field metabolic rate (FMR) predict that a male weighing 60 g would lose 17.3% of its hourly energy requirement for FMR if it vomited once. A 40 g female, however, would experience an hourly energy loss of approximately 22.8%. The possible energetic consequences and resulting ecological implications of this unusual behaviour are discussed. [Copyright &y& Elsevier]

Assesses the structure of the symptoms of phobia elicited by blood and injection. Blood-Injection Symptom Scale (BISS); Symptoms of fear and faintness; Test of the construct validity of the BISS; Usefulness of the BISS.