We hypothesize that black women experience accelerated biological aging in response to repeated or prolonged adaptation to subjective and objective stressors. Drawing on stress physiology and ...ethnographic, social science, and public health literature, we lay out the rationale for this hypothesis. We also perform a first population-based test of its plausibility, focusing on telomere length, a biomeasure of aging that may be shortened by stressors. Analyzing data from the Study of Women's Health Across the Nation (SWAN), we estimate that at ages 49--55, black women are 7.5 years biologically 'older' than white women. Indicators of perceived stress and poverty account for 27% of this difference. Data limitations preclude assessing objective stressors and also result in imprecise estimates, limiting our ability to draw firm inferences. Further investigation of black-white differences in telomere length using large-population-based samples of broad age range and with detailed measures of environmental stressors is merited. Adapted from the source document.
Abstract
Objectives
GCA is a large vessel vasculitis (LVV) presenting with headache, jaw claudication, musculoskeletal and visual involvement. Current treatment is glucocorticoids and anti-IL-6 ...tocilizumab in refractory disease. The objective of this study was to explore the impact of GCA and its treatment on people’s health-related quality of life (HRQoL), to inform the development of a disease-specific patient-reported outcome measure (PROM) for use in clinical trials and practice.
Methods
Participants from the UK and Australia, with biopsy- or imaging-confirmed GCA, were interviewed to identify salient aspects of HRQoL in relation to GCA and its treatment. Purposive sampling included a range of demographic and disease features (cranial, LVV-GCA and visual involvement). Inductive analysis identified individual themes of importance, then domains. Candidate questionnaire items were developed from the individual themes, refined by piloting, cognitive interviews and a linguistic translatability assessment.
Results
Thirty-six interviews were conducted to saturation with participants with GCA from the UK (25) and Australia (11). Mean age was 74 years, 23 (63.9%) were female, 13 (36.1%) had visual loss and 5 (13.9%) had LVV-GCA. Thirty-nine individual themes within five domains were identified: physical symptoms; activity of daily living and function; participation; psychological impact; and impact on sense of self and perception of health. Sixty-nine candidate items were developed from individual themes; piloting and refinement resulted in a 40-item draft questionnaire.
Conclusion
This international qualitative study underpins the development of candidate items for a disease-specific PROM for GCA. The draft questionnaire is now ready for psychometric testing.
Abstract
The 3q29 deletion (3q29Del) confers high risk for schizophrenia and other neurodevelopmental and psychiatric disorders. However, no single gene in this interval is definitively associated ...with disease, prompting the hypothesis that neuropsychiatric sequelae emerge upon loss of multiple functionally-connected genes. 3q29 genes are unevenly annotated and the impact of 3q29Del on the human neural transcriptome is unknown. To systematically formulate unbiased hypotheses about molecular mechanisms linking 3q29Del to neuropsychiatric illness, we conducted a systems-level network analysis of the non-pathological adult human cortical transcriptome and generated evidence-based predictions that relate 3q29 genes to novel functions and disease associations. The 21 protein-coding genes located in the interval segregated into seven clusters of highly co-expressed genes, demonstrating both convergent and distributed effects of 3q29Del across the interrogated transcriptomic landscape. Pathway analysis of these clusters indicated involvement in nervous-system functions, including synaptic signaling and organization, as well as core cellular functions, including transcriptional regulation, posttranslational modifications, chromatin remodeling, and mitochondrial metabolism. Top network-neighbors of 3q29 genes showed significant overlap with known schizophrenia, autism, and intellectual disability-risk genes, suggesting that 3q29Del biology is relevant to idiopathic disease. Leveraging “guilt by association”, we propose nine 3q29 genes, including one hub gene, as prioritized drivers of neuropsychiatric risk. These results provide testable hypotheses for experimental analysis on causal drivers and mechanisms of the largest known genetic risk factor for schizophrenia and highlight the study of normal function in non-pathological postmortem tissue to further our understanding of psychiatric genetics, especially for rare syndromes like 3q29Del, where access to neural tissue from carriers is unavailable or limited.
A porous scandium MOF denoted STA-27 (St Andrews Porous Material-27) has been synthesised solvothermally using the 2,3,5,6-tetrakis(4-carboxyphenyl)pyrazine anion (TCPP 4− ) as the tetratopic ...carboxylate linker. STA-27 possesses a unique scandium-based 1D rod secondary building unit (SBU) comprising corner-sharing scandium Sc 2 O 11 dimers connected via carboxylate groups from the linker. After activation under mild conditions STA-27 is an active Lewis acidic catalyst, while heating at elevated temperatures results in rupturing of the Sc–O–Sc linkages and a phase transition to a different topological type. Under similar synthesis conditions the smaller Al 3+ and Ga 3+ cations give isostructural MOFs with a different, previously reported, topology type based on chains of corner-sharing MO 4 (OH) 2 octahedra: the Al-form possesses attractive properties for CO 2 adsorption.
The Children’s Hospital Association’s Improving Pediatric Sepsis Outcomes (IPSO) collaborative is a multi-center quality improvement (QI) learning collaborative of 61 U.S. children’s hospitals that ...seeks to improve sepsis outcomes through collaborative learning and reliable implementation of evidence-based interventions in pediatric emergency departments, intensive care units, general care units, and hematology/oncology units. Specifically, IPSO’s goals are to decrease sepsis-attributable mortality and prevent hospital-onset sepsis among children.
The following 10 abstracts represent a select group of projects undertaken by IPSO participating hospitals that were presented at one of three collaborative events in 2020 and 2021. IPSO’s Research Workgroup reviewed all submitted abstracts and selected the top 10 for inclusion in this Supplement
We investigate the effects of extended multiyear light curves (9 yr photometry and 5 yr spectroscopy) on the detection of time lags between the continuum variability and broad-line response of ...quasars at z 1.5, and compare with the results using 4 yr photometry+spectroscopy presented in a companion paper. We demonstrate the benefits of the extended light curves in three cases: (1) lags that are too long to be detected by the shorter-duration data but can be detected with the extended data; (2) lags that are recovered by the extended light curves but are missed in the shorter-duration data due to insufficient light-curve quality; and (3) lags for different broad-line species in the same object. These examples demonstrate the importance of long-term monitoring for reverberation mapping to detect lags for luminous quasars at high redshift, and the expected performance of the final data set from the Sloan Digital Sky Survey Reverberation Mapping project that will have 11 yr photometric and 7 yr spectroscopic baselines.
The Prehospital Emergency Anaesthetic in 2022 Morton, Sarah; Dawson, Jonathan; Wareham, Gaynor ...
Air medical journal,
November-December 2022, 2022 Nov-Dec, 2022-11-00, 20221101, Letnik:
41, Številka:
6
Journal Article
Recenzirano
Prehospital emergency anesthesia (PHEA) is a commonly performed prehospital procedure with inherent risks. The processes and drug regimens behind PHEA are continually updated by prehospital teams ...across the country as part of their governance structure. Essex & Herts Air Ambulance has recently updated this practice by reviewing the entire process of performing PHEA. Through experiential learning in a high-volume service, audit, and a contemporary literature review, a new standard operating procedure has been developed to combat common problems, such as hypotension, associated with the more traditional methods of performing PHEA. The aim of this article was to summarize the literature behind this new standard operating procedure, systematically breaking down the core components of performing a PHEA and the rationale behind them. The key components identified in the review are indications for PHEA, airway assessment, peri-intubation oxygenation, preparation for PHEA, drug dosing, special circumstances, and failed intubation. One significant change is the drug dosage regimen; 1 μg/kg fentanyl, 2 mg/kg ketamine, and 2 mg/kg rocuronium is recommended as the main drug dosing regimen for both medical and trauma patients. Other changes include preoxygenation with a nasal cannula in addition to the nonrebreather mask, optimizing patients in the preparation phase by considering inopressors or fluid bolus and ensuring a “sterile cockpit” to control the surrounding environment to ensure the first intubation attempt is the best attempt.
Negative communication between partners can impede the enactment of prosocial, relationship maintenance behaviors. These processes are especially critical to consider for Latine young adults who hold ...cultural values, like familism, which emphasize the great importance of personal relationships. Using a sample of 475 Latine young adults ( M = 24.8 years, SD = 3.22), we examined the moderating role of familism on the association between negative communication (e.g., partners’ propensity to withdraw or criticize during interactions) and relationship maintenance (e.g., affectionate and supportive efforts to sustain the relationship). We found that negative communication was inversely associated with individuals’ own relationship maintenance enactment. However, familism buffered the association between negative communication and relationship maintenance; under conditions of high familism, the association between negative communication and relationship maintenance remained negative, but with a weaker effect than under conditions of low familism. Findings reinforce the negative effects of maladaptive communication in relationships more broadly and highlight the protective role of relationally oriented cultural values.
Introduction
Despite bronchopulmonary dysplasia (BPD) being a common morbidity of preterm birth, there is no validated objective tool to assess outpatient respiratory symptom control for clinical and ...research purposes.
Methods
Data were obtained from 1049 preterm infants and children seen in outpatient BPD clinics of 13 US tertiary care centers from 2018 to 2022. A new standardized instrument was modified from an asthma control test questionnaire and administered at the time of clinic visits. External measures of acute care use were also collected. The questionnaire for BPD control was validated in the entire population and selected subgroups using standard methodology for internal reliability, construct validity, and discriminative properties.
Results
Based on the scores from BPD control questionnaire, the majority of caregivers (86.2%) felt their child's symptoms were under control, which did not differ by BPD severity (p = 0.30) or a history of pulmonary hypertension (p = 0.42). Across the entire population and selected subgroups, the BPD control questionnaire was internally reliable, suggestive of construct validity (albeit correlation coefficients were −0.2 to −0.4.), and discriminated control well. Control categories (controlled, partially controlled, and uncontrolled) were also predictive of sick visits, emergency department visits, and hospital readmissions.
Conclusion
Our study provides a tool for assessing respiratory control in children with BPD for clinical care and research studies. Further work is needed to identify modifiable predictors of disease control and link scores from the BPD control questionnaire to other measures of respiratory health such as lung function testing.
Abstract Background The combination of low-dose radiation therapy with PARP inhibition enhances anti-tumor efficacy through potentiating DNA damage. We combined low-dose fractionated whole abdominal ...radiation (LDFWAR) with ABT-888 in patients with peritoneal carcinomatosis with a dose escalation in ovarian and fallopian cancer patients (OV). Methods Patients were treated with veliparib, 40–400 mg orally BID on days 1–21 of 3 28-day cycles on 6 dose levels. Dose levels 5 and 6 included only OV patients. LDFWAR consisted of 21.6Gy in 36 fractions, 0.6 Gy twice daily on days 1 and 5 for weeks 1–3 of each cycle. Circulating tumor material and quality of life were serially assessed. Results 32 pts were treated. Median follow-up was 45 months (10–50). The most common treatment-related grade 3 and 4 toxicities were lymphopenia (59%), anemia (9%), thrombocytopenia (12%), neutropenia (6%), leukopenia (6%), nausea (6%), diarrhea (6%), anorexia (6%), vomiting (6%) and fatigue (6%). The maximum tolerated dose was determined to be 250 mg PO BID. Median PFS was 3.6 months and median OS was 9.1 months. In OV patients, OS was longer for platinum-sensitive patients (10.9 mo) compared to platinum-resistant patients (5.8 mo). QoL decreased for all groups during treatment. Germline BRCA status was known for 14/18 patients with OV cancers, 5 of whom were BRCA mutation carriers. One objective response (3%) was observed. Conclusion ABT-888 plus LDFWAR is tolerable with gastrointestinal symptoms, fatigue and myelosuppression as the most common toxicities. The single observed objective response was in a germline BRCA mutated, platinum-sensitive patient.
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