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A description of the molecular make-up of the ancestral multicellular animal is emerging from the growing availability of molecular biological and biochemical data gleaned from the study of modern members of ancient groups of animals. We use the distributions of classes of transcription factors, signal transduction systems and other molecular innovations among metazoan phyla to infer some of the characteristics of the first animals.

A Hydra has a simple body plan consisting of a single axis with radial symmetry. The body regions along the axis are the head, body column, and foot. Since the tissue dynamics of an adult Hydra involve the continuous production, displacement, and loss of tissue, the processes governing axial patterning are continuously active to maintain the form of the animal. At a tissue level patterning of the head is governed by an organizer located in the head which sets up a pair of gradients that are maximal in the head and extend down the body column. As tissue is displaced from the body column into the head, epithelial cells undergo changes from a stem-cell-like state of the body column to that of a differentiated state in the tentacles. This switch involves a number of genes, some of which are homologues of genes associated with axial patterning in bilaterians. Cnox-2, a Dfd/Gsx homologue, negatively regulates head formation. Cnox-3, a labial homologue; HyAlx, an aristaless homologue; and Hym-301. encoding a peptide. are involved in the transition from the stem-cell-like state to the differentiated state.

Objectives: This paper examines the health, work, and financial experiences of older adults with disabling conditions during the COVID-19 pandemic. It also explores the role of county- and state-level conditions in these experiences., Methods: Using data from the 2020 Health and Retirement Study, we estimated regression models to assess differences in outcomes between those with and without disabling conditions and by race/ethnicity. We used multilevel modeling to assess whether and how county or state factors might be associated with the differences in these effects., Results: Older adults with disabilities were more likely to report experiencing financial hardships, delaying health care, and experiencing effects on work than those without disabilities; these differences are heighted between race and ethnicity. Older adults with disabilities were more likely to live in counties with greater social vulnerability., Discussion: This work underscores the importance of developing a robust, disability-inclusive public health response that protects older adults., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

To address claims of human exceptionalism, we determine where humans fit within the greater mammalian distribution of reproductive inequality. We show that humans exhibit lower reproductive skew (i.e., inequality in the number of surviving offspring) among males and smaller sex differences in reproductive skew than most other mammals, while nevertheless falling within the mammalian range. Additionally, female reproductive skew is higher in polygynous human populations than in polygynous nonhumans mammals on average. This patterning of skew can be attributed in part to the prevalence of monogamy in humans compared to the predominance of polygyny in nonhuman mammals, to the limited degree of polygyny in the human societies that practice it, and to the importance of unequally held rival resources to women's fitness. The muted reproductive inequality observed in humans appears to be linked to several unusual characteristics of our species-including high levels of cooperation among males, high dependence on unequally held rival resources, complementarities between maternal and paternal investment, as well as social and legal institutions that enforce monogamous norms.

Rationale, Aims and Objectives: Clinical inertia, defined as a delay in treatment intensification, is prevalent in people with diabetes. Treatment intensification rates are as low as 37.1% in people with haemoglobin A1c (HbA1c) values >7%. Intensification by addition of medication therapy may take 1.6 to more than 7 years. Clinical inertia increases the risk of cardiovascular events. The primary objective was to evaluate rates of clinical inertia in people whose diabetes is managed by both pharmacists and primary care providers (PCPs). Secondary objectives included characterizing types of treatment intensification, HbA1c reduction, and time between treatment intensifications., Method: Retrospective chart review of persons with diabetes managed by pharmacists at an academic, safety-net institution. Eligible subjects were referred to a pharmacist-managed cardiovascular risk reduction clinic while continuing to see their PCP between October 1, 2016 and June 30, 2018. All progress notes were evaluated for treatment intensification, HbA1c value, and type of medication intensification., Results: Three hundred sixty-three eligible patients were identified; baseline HbA1c 9.6% (7.9, 11.6) (median interquartile range [IQR]). One thousand one hundred ninety-two pharmacist and 1739 PCP visits were included in data analysis. Therapy was intensified at 60.5% (n = 721) pharmacist visits and 39.3% (n = 684) PCP visits (P < .001). The median (IQR) time between interventions was 49 (28, 92) days for pharmacists and 105 (38, 182) days for PCPs (P < .001). Pharmacists more frequently intensified treatment with glucagon-like peptide-1 agonists and sodium glucose cotransporter-2 inhibitors., Conclusion: Pharmacist involvement in diabetes management may reduce the clinical inertia patients may otherwise experience in the primary care setting., (© 2020 John Wiley & Sons, Ltd.)

The Nutrition Services Program is the largest program that provides prepared meals to older adults in need. However, little is known about the factors associated with participants' continued receipt of meals. This study uses longitudinal nationally representative survey data and residential location information to examine the factors associated with continuing to receive congregate meals ( N  = 383). 71.6% of participants in a given month continued to receive program meals in all of the next 12 months. Participants with geographic access to food proximate to their home were significantly more likely to stop receiving meals than those with more limited access (OR = 0.37, CI 0.16, 0.85); this was true among participants who lived alone, were older, had lower income, or lived in an urban area. Understanding the factors associated with continuing to receive congregate meals will ensure that older adults can meet their food needs and have a primary access point for community services.

Background: As people age, they are more likely to face financial, medical, and mobility related challenges that can put them at risk of food insecurity. This is a serious public health concern that has been associated with many adverse health outcomes., Objectives: This study examined factors associated with food insecurity among older adults who receive congregate meals from the Administration on Aging's Nutrition Services Program. Combining participant, geographic, and provider data allowed for a more detailed assessment of older adult food insecurity than is typically possible using other national surveys., Design: A cross-sectional study. We conducted a cross-sectional data analysis using national survey data from the Administration on Aging's Nutrition Services Program Outcomes Survey, conducted from 2015 to 2016. The data were linked to provider data from the meal site where participants ate. Logistic regression analysis was conducted to estimate the associations between food insecurity and demographic, household, geographic, and provider-level characteristics and circumstances., Setting: Interviews with congregate meal participants were conducted in person at congregate meal sites or another preferred place., Participants: A total of 520 older adults were included as study participants. All older adults were participating in the Nutrition Services Program and receiving congregate meals at the time of the survey interview. All participants were at least 67 years old., Measurements: This study used a 6-item food security measure as the dependent variable. Older adults who answered at least 3 of the 6 questions affirmatively were considered food insecure. Food security was assessed over a 30-day recall period., Results: 18% of congregate meal participants lived in food insecure households. Among congregate meal participants, having low income, difficulty reaching family and friends, past military service, and mobility challenges, and attending a site that provided nutrition counseling were associated with increased food insecurity (most odds ratios ranged from 1.1 to 2.6). Older age, geographic access to food, certain chronic health conditions, and provider-offered nutrition screening and social activities reduced the odds of experiencing food insecurity (most odds ratios ranged from 0.2 to 0.4)., Conclusions: Although the Nutrition Services Program helps to alleviate food insecurity, a nontrivial percentage of participants remain food insecure. Nutrition programs can help address clients' food access limitations by broadening nutrition screenings at meal sites to include more comprehensive assessments based on non-traditional risk factors for food insecurity., Competing Interests: The authors have no conflicts of interest to disclose., (© 2020 - JARLIFE.)

Purpose The purpose of this study is to evaluate the impact of a collaborative diabetes shared medical appointment on patient outcomes in an urban family medicine practice. Methods Fifty-nine patients were enrolled to participate in multiple shared medical appointments (SMAs) over 12 months. Baseline data included hemoglobin (A1C), lipids, systolic blood pressure (SBP), weight, adherence to American Diabetes Association (ADA) guidelines, and surveys, including the Problem Areas in Diabetes (PAID-2) scale and the Spoken Knowledge in Low Literacy in Diabetes Scale (SKILLD). A1C and SBP were evaluated at each visit. Lipid control was assessed at baseline and at 6 and 12 months. Adherence to ADA guidelines, SKILLD and PAID-2 survey scores, and number of antihyperglycemic and antihypertensive medications were also evaluated at 12 months. Results Thirty-eight patients completed the study. Compared with baseline, A1C and low-density lipoprotein cholesterol (LDL-C) levels decreased significantly over 12 months ( P < .001 and P = .004, respectively). More patients became compliant with the ADA guidelines throughout the course of the study. Specifically, more patients achieved the LDL-C goal of ≤100 mg/dL (2.59 mmol/L; P < .001), were prescribed appropriate antihypertensive medications ( P < .001) and aspirin ( P < .001), and received the pneumonia vaccine ( P < .001). PAID-2 and SKILLD survey scores also significantly improved over the course of the study ( P ≤ .001 and P = .003, respectively). Conclusion Short-term interdisciplinary SMAs decreased A1C and LDL-C, improved patient adherence to ADA guidelines, improved emotional distress related to diabetes, and increased knowledge of diabetes.

Monogamy appears to have become the predominant human mating system with the emergence of highly unequal agricultural populations that replaced relatively egalitarian horticultural populations, challenging the conventional idea-based on the polygyny threshold model-that polygyny should be positively associated with wealth inequality. To address this polygyny paradox, we generalize the standard polygyny threshold model to a mutual mate choice model predicting the fraction of women married polygynously. We then demonstrate two conditions that are jointly sufficient to make monogamy the predominant marriage form, even in highly unequal societies. We assess if these conditions are satisfied using individual-level data from 29 human populations. Our analysis shows that with the shift to stratified agricultural economies: (i) the population frequency of relatively poor individuals increased, increasing wealth inequality, but decreasing the frequency of individuals with sufficient wealth to secure polygynous marriage, and (ii) diminishing marginal fitness returns to additional wives prevent extremely wealthy men from obtaining as many wives as their relative wealth would otherwise predict. These conditions jointly lead to a high population-level frequency of monogamy., (© 2018 The Authors.)

Small-scale human societies range from foraging bands with a strong egalitarian ethos to more economically stratified agrarian and pastoral societies. We explain this variation in inequality using a dynamic model in which a population's long-run steady-state level of inequality depends on the extent to which its most important forms of wealth are transmitted within families across generations. We estimate the degree of intergenerational transmission of three different types of wealth (material, embodied, and relational), as well as the extent of wealth inequality in 21 historical and contemporary populations. We show that intergenerational transmission of wealth and wealth inequality are substantial among pastoral and small-scale agricultural societies (on a par with or even exceeding the most unequal modern industrial economies) but are limited among horticultural and foraging peoples (equivalent to the most egalitarian of modern industrial populations). Differences in the technology by which a people derive their livelihood and in the institutions and norms making up the economic system jointly contribute to this pattern.

We have identified a gene encoding a member of the Csk family of non-receptor protein-tyrosine kinases (PTKs) in the early-diverging metazoan Hydra. In situ hybridization analysis of the distribution of RNA from the Hydra Csk gene indicates that it is expressed in most of the epithelial cells of the adult polyp and in gametogenic cells. Comparison of the expression pattern of Hydra Csk with that of STK, the Hydra Src gene orthologue, reveals that the two genes are largely co-expressed. Such co-expression is consistent with a role for Hydra Csk in regulation of STK activity. This possibility was tested directly by coexpressing Hydra Csk with STK in yeast. Co-expression suppressed the growth inhibition seen when STK alone is expressed in yeast. Suppression was dependent on the presence of the putative regulatory tyrosine in the carboxyl-terminal tail of STK. Phosphotyrosine immunoblot analysis confirmed that expression of Csk resulted in suppression of STK kinase activity. Taken together these data indicate that the regulatory circuit involving Src and Csk PTKs was established prior to the divergence of the phylum Cnidaria from the rest of the metazoans.

Semipurified K99 and F41 fimbrial antigens were used to prepare an oil-emulsified vaccine against bovine enterotoxigenic colibacillosis. Nine Nelore cows about 7 months pregnant were divided into 3 groups (A, B and C) of 3 animals each, which received different doses of vaccine (1,500 HU, 750 HU and 380 HU, respectively) 8 and 2 weeks before delivery, in the neck by the subcutaneous route. As a control (group D), 3 pregnant cows of the same breed were not vaccinated for later challange of their calves. Vaccine efficiency was measured by the serological tests double diffusion and ELISA. Challenge of calves from the vaccinated and from the three control unvaccinated cows was carried out with the virulent Escherichia coli B41 strain (0101, STa+, K99+, F41+). Two of the 3 calves from the unvaccinated cows died within 48 h with acute diarrhea. E. coli B41 was recovered as pure culture from their stools. In contrast, none of the calves born from vaccinated cows presented diarrhea. These data suggest that the antibody transfer to calves through colostrum gave full protection against the challenge. This semipurified fimbrial vaccine against K99-F41-harboring strains is the first oil-emulsified immunogen prepared in Brazil, which was not only efficient, but also had no adverse effects on vaccinated pregnant cows.

Using PCR, six genes of the HOM/HOX class have been identified in hydra. One of them, Cnox-2, has been sequenced and resembles the Deformed gene of Drosophila. As shown previously, the expression pattern of Cnox-2 suggested that it may be involved in axial patterning as it was strongly expressed in the epithelial cells of the body column and foot, but only weakly expressed in the head. In addition, expression of Cnox-2 decreased sharply in body column tissue as it was converted into head tissue, thereby providing further support for a role in hydra pattern formation. To examine this possibility further, additional manipulations were carried out which convert body column tissue into either head or foot tissue. When body column tissue was converted into head tissue by regeneration, transplantation, or during budding, Cnox-2 expression was sharply reduced, indicating that expression of this gene is suppressed during head formation. When body column tissue was converted into foot tissue by regeneration or Li+ treatment, the changes in Cnox-2 expression patterns indicated that Cnox-2 had no direct role in foot formation. Surprisingly, however, the observed changes in Cnox-2 expression patterns indicate that following bisection, both head and foot regeneration processes are initiated at the injured edge of the bisected animal.

An analysis of the tissue sections from previous implant studies was performed define additional criteria which could be considered in determinations of biocompatibility of implant materials. Adult albino rabbits were implanted with biomaterials in the sacrospinalis muscle for periods of 2, 6, 18, and 54 weeks. Fourteen different implant materials were used in this study. The tissues were examined histologically for the appearance of adipose fat cells within the membrane surrounding the implant as an important criterion of tissues implant compatibility. The results were compared with other previously used criteria in judging biocompatibility of implant materials. For the most compatible nonreactive materials, adipose tissue formation within the pseudomembrane began at 6 weeks and was quite extensive at 54 weeks. The reactive materials studied by us did not exhibit this phenomenon.