The American Society of Nephrology Presidential Address was delivered by Mark Rosenberg at Kidney Week 2019 on November 7, 2019 in Washington, DC. The Address describes a remarkable alignment-a ...syzygy of policy, science, innovation accelerators, clinical trials, clinical care delivery, and activated patients-that exists today in the kidney space. As a community, we must ensure that the strategies developed to take advantage of this alignment, such as Advancing American Kidney Health, succeed. We must overcome our current challenges to thrive as a meaningful specialty. We have an incredible opportunity to come together as a kidney community to ensure success that realigns the priorities and incentives in kidney medicine to better achieve kidney health for all people throughout the world. The time is now to act.
The human breast cancer resistance protein (BCRP/ABCG2) is the second member of the G subfamily of the large ATP-binding cassette (ABC) transporter superfamily. BCRP was initially discovered in ...multidrug resistant breast cancer cell lines where it confers resistance to chemotherapeutic agents such as mitoxantrone, topotecan and methotrexate by extruding these compounds out of the cell. BCRP is capable of transporting non-chemotherapy drugs and xenobiotiocs as well, including nitrofurantoin, prazosin, glyburide, and 2-amino-1-methyl-6-phenylimidazo4,5-bpyridine. BCRP is frequently detected at high levels in stem cells, likely providing xenobiotic protection. BCRP is also highly expressed in normal human tissues including the small intestine, liver, brain endothelium, and placenta. Therefore, BCRP has been increasingly recognized for its important role in the absorption, elimination, and tissue distribution of drugs and xenobiotics. At present, little is known about the transport mechanism of BCRP, particularly how it recognizes and transports a large number of structurally and chemically unrelated drugs and xenobiotics. Here, we review current knowledge of structure and function of this medically important ABC efflux drug transporter.
Hand, foot, and mouth disease (HFMD) is a public health issue in Hubei and studies of- spatiotemporal clustering at a fine scale are limited. The purpose of this research was to analyze the ...epidemiological characteristics, temporal variation characteristics, and spatiotemporal clustering of HFMD cases at the town level from 2009 to 2019 to improve public health outcomes.
Mathematical statistics, a seasonal index, wavelet analysis, and spatiotemporal scans were used to analyze epidemiological characteristics, time series trends, and spatiotemporal clusters of HFMD in Hubei.
EV-A71 (Enterovirus A71) and CVA16 (Coxsackievirus A16) constitute the two primary pathogens of the HFMD epidemic in Hubei, among which EV-A71 is the dominant pathogen, especially in 2016. In terms of age distribution, a major peak occurred at 0-5 years and a very small increase appeared at 25-35 years, with the former having a higher incidence among males than females and the latter having the opposite difference between males and females. The number/rate of HFMD cases exhibited a considerable increase followed by a moderate decline from 2009 to 2019, with the first large peak in April-July and a smaller peak in November-December. HFMD in Hubei exhibited the characteristics of a 270-day cycle with multiscale nesting, which was similar to the periodicity of HFMD cases caused by EV-A71 (9 months). Cities with a higher incidence of HFMD formed a part of an "A-shaped urban skeleton". Subdistricts had the highest incidence of HFMD, followed by towns and villages. The spatiotemporal scan results showed one most likely cluster and 22 secondary clusters, which was consistent with the geographic location of railways and rivers in Hubei.
These findings may be helpful in the prevention and control of HFMD transmission and in implementing effective measures in Hubei Province.
Most of these deaths could be prevented by using research to find interventions that both reduce gun violence and protect gun rights. using science to identify evidence-based solutions similar to ...those that saved so many lives from motor vehicle crashes. heart disease. cancer. and smallpox. Scientists at the Centers for Disease Control and Prevention iCDC) had seen how research to address an epidemic of young people being killed in car crashes led to safer cars. roads. and drivers and saved more than 600 000 lives from I960 to 2012.1 With this example clearly in mind. these CDC scientists initiated a research program to find ways to prevent firearm injuries. Interventions that lack definitive evidence include background checks. bans on the sale of assault weapons and high-capacity magazines. concealed-carry laws. firearm sales reporting requirements. gun-free zones. licensing and permitting requirements. lost or stolen firearm reporting requirements. minimum age requirements. prohibitions associated with mental illness. standyour-ground laws. surrender of firearms by prohibited possessors. and waiting periods. Rosenberg oversaw the development of the public health approach to violence prevention at the Centers for Disease Control andPrevention (CDC) from 1983 to 1987, and then from 1989 to 1999, when he retired as assistant surgeon general and founding director of the National Center for Injury Prevention and Control.
Reflecting on different theoretical premises within geographies of care, this paper develops their connections and responds to the normativity and universalism in care literature through ...conceptualising live‐in elder care (LEC). Considering the relationality of differential contributions to care, we propose a conceptualisation of multiple interrelated approaches by: (1) extending the critical frameworks of care to understand the broader frames of institution, market, and morality in mediating interpersonal connectedness of elder care; (2) thinking care relationally, we challenge the dominant conceptualisation of care and power as unidirectional flows and elder care relationships as a receiver–giver dyad; (3) emplacing care, we focus on the actual conditions of care through which ethics are assembled in their geo‐historical context; (4) treating care as grounded, we centre voices from both older people and LEC workers and how ethics of care are comprehended in the everyday rather than prescribed for commodified care. Our thematic analysis starts with a commodification process where LEC is negotiated in tensions; yet moving beyond arguments around systems of dominance and ideal ethics of care, findings show LEC also creates a space of care where LEC workers and older people constantly negotiate norms, boundaries, and care as a relational process. Conceptually, this paper recognises the role of power in shaping the market and intimate relationships of elder care by elaborating on the inequities of age, gender, and place (not just gender). Moving beyond critiques, this paper emphasises the entangled and relational nature of care as grounded in a series of everyday concerns and resistance, where ethics of difference are negotiated and a cultural‐historical configuration of care still perpetuates in its locale. Finally, this paper speaks to the active yet overlooked role of age and ageing in constructing an ethics of care.
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This paper recognises the role of power in shaping the market and intimate relationships of elder care by elaborating on the inequities of age, gender, and place (not just gender). Moving beyond critiques, this paper emphasises the relational nature of care as grounded and emplaced in a series of everyday concerns and resistance, where ethics of difference are negotiated and a cultural‐historical configuration of care still perpetuates in its locale. Finally, this paper speaks to the active yet overlooked role of age and ageing in constructing an ethics of care.
Physical activity is a highly gendered health behaviour, with women less likely than men to meet internationally accepted physical activity guidelines. In this article, we take up recent arguments on ...the potential of indoor spaces to illuminate processes shaping health, together with social theories of gender, to conceptualize the place of the gym as a window into understanding and intervening in wider gender disparities in physical activity. Using a triangulated strategy of qualitative methods, including semi-structured interviews, drawing, and journaling with men and women in a mid-sized Canadian city, we examine how gender influences exercise practices and mobilities in gym environments. Results of our thematic analysis reveal three socio-spatial processes implicated in the gendering of physical activity: 1) embodying gender ideals, 2) policing gender performance, and 3) spatializing gender relations. A fourth theme illustrates the situated agency some individuals enact to disrupt gendered divisions. Although women were unduly disadvantaged, both women and men experienced significant limitations on their gym participation due to the presiding gendered social context of the gym. Gender-transformative interventions that go beyond engaging women to comprehensively contend with the place-based gender relations that sustain gender hegemony are needed. While gyms are potentially sites for health promotion, they are also places where gendered inequities in health opportunities emerge.
•Geographies of physical activity rarely focus on gendered inequities.•We examine the gym as a window into gender disparities in physical activity.•Qualitative analysis reveals three socio-spatial gendering processes.•Women and men experienced limitations on participation due to gendering processes.•Gender-transformative interventions must target everyday physical activity places.
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