Adolescents and young adults (AYA; 15-39 years) with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) experience inferior survival when compared with children. Impact of care at ...NCI-designated Comprehensive Cancer Centers (CCC) or Children's Oncology Group sites (COG) on survival disparities remains unstudied.
Using the Los Angeles cancer registry, we identified 1,870 ALL or AML patients between 1 and 39 years at diagnosis. Cox regression analyses assessed risk of mortality; younger age + CCC/COG served as the referent group. Logistic regression was used to determine odds of care at CCC/COG, adjusting for variables above.
ALL outcome: AYAs at non-CCC/COG experienced inferior survival (15-21 years: HR = 1.9,
= 0.005; 22-29 years: HR = 2.6,
< 0.001; 30-39 years: HR = 3.0,
< 0.001). Outcome at CCC/COG was comparable between children and young AYAs (15-21 years: HR = 1.3,
= 0.3; 22-29 years: HR = 1.2,
= 0.2) but was inferior for 30- to 39-year-olds (HR = 3.4,
< 0.001). AML outcome: AYAs at non-CCC/COG experienced inferior outcome (15-21 years: HR = 1.8,
= 0.02; 22-39 years: HR = 1.4,
= 0.06). Outcome at CCC/COG was comparable between children and 15- to 21-year-olds (HR = 1.3,
= 0.4) but was inferior for 22- to 39-year-olds (HR = 1.7,
= 0.05). Access: 15- to 21-year-olds were less likely to use CCC/COG than children (
< 0.001). In 22- to 39-year-olds, public/uninsured (ALL:
= 0.004; AML<0.001), African American/Hispanics (ALL:
= 0.03), and 30- to 39-year-olds (ALL:
= 0.03) were less likely to use CCC/COG.
Poor survival in AYAs with ALL and AML is mitigated by care at CCC/COG. Barriers to CCC/COG care include public/uninsured, and African American/Hispanic race/ethnicity.
Care at CCC/COG explains, in part, inferior outcomes in AYAs with ALL and AML. Key sociodemographic factors serve as barriers to care at specialized centers.
.
Modeling the climate of urban areas is of interest for studying urban heat islands (UHIs). Reliable assessment of the primary causes of UHIs and the efficacy of various heat mitigation strategies ...requires accurate prediction of urban temperatures and realistic representation of land surface physical characteristics in models. In this study, we expand the capabilities of the Weather Research and Forecasting (WRF) model by implementing high‐resolution, real‐time satellite observations of green vegetation fraction (GVF) and albedo. Satellite‐based GVF and albedo replace constant values that are assumed for urban pixels in the default version of WRF. Simulations of urban meteorology in Los Angeles using the improved model show marked improvements relative to the default model. The largest improvements are for nocturnal air temperatures, with a reduction in root‐mean‐square deviation between simulations and observations from 3.8 to 1.9°C. Utilizing the improved model, we quantify relationships between surface and 2 m air temperatures versus urban fraction, GVF, albedo, distance from the ocean, and elevation. Distance from the ocean is found to be the main contributor to variations in temperatures around Los Angeles. After conditionally sampling pixels to minimize the influence of distance from the ocean and elevation, we find that variations in GVF and urban fraction are responsible for up to 58 and 27% of the variance in temperatures. The satellite‐supported meteorological modeling framework reported here can be used for studying UHIs in other cities and can serve as a foundation for testing the efficacy of various heat mitigation strategies.
Key Points
Satellite‐supported WRF‐UCM is developed using MODIS observed GVF and albedo
Satellite observations are implemented over both urban and vegetated pixels
Urban heat island in Los Angeles is related to surface characteristics
Los Angeles, November 2019 steht am Beginn des für seine dystopische Zukunftsvision bekannten Films Blade Runner, in dem überfüllte Straßen und verfallende Fassaden im Kontrast zu futuristischen ...Videoprojektionen stehen. Die im Jahr 1982 imaginierte Zukunft von L.A. ist heute real erfahrbare Gegenwart - Anlass sich mit der Stadtentwicklung des Drehorts, der Downtown von Los Angeles, zu beschäftigen. In Blade Runner ist die Stadt der Zukunft eine Stadt mit Vergangenheit. Der Zyklus von Verdichtung, Verarmung und Wiederentdeckung hat auf die verschiedenen Bezirke der Downtown, wie South Park, Skid Row oder den in Art District umbenannten Industrial District, unterschiedliche Auswirkungen. Christiane Feuerstein untersucht den Turnaround Urbanism aus der historischen Perspektive der Stadtentwicklung.
Off the page Bernardi, Daniel; Hoxter, Julian
2017., 20170912, 2017, 2017-09-12
eBook
Off the Page examines the business and craft of screenwriting in the era of media convergence. Daniel Bernardi and Julian Hoxter use the recent history of screenwriting labor coupled with close ...analysis of scripts in the context of the screenwriting paraindustry—from “how to write a winning script” books to screenwriting software—to explore the state of screenwriting today. They address the conglomerate studios making tentpole movies, expanded television, Indiewood, independent animation, microbudget scripting, the video games industry, and online content creation. Designed for students, producers, and writers who want to understand what studios want and why they want it, this book also examines how scripting is developing in the convergent media, beneath and beyond the Hollywood tentpole. By addressing specific genres across a wide range of media, this essential volume sets the standard for anyone in the expanded screenwriting industry and the scholars that study it.
The purpose of this study was to use geospatial indicators of mental health need and homelessness in Los Angeles County Service Planning Areas (SPAs) and a psychiatric sample of adults who were ...homeless to investigate 1) overlap between SPA level of mental health need and corresponding volume of involuntary psychiatric hospitalizations over time; 2) overlap between SPA level of unsheltered homelessness and corresponding volume of involuntary psychiatric hospitalizations over time; and 3) associations between SPA level of mental health need, SPA level of unsheltered homelessness, and initiation of a mental health conservatorship for grave disability. A sample of 373 adults who were homeless and hospitalized on an involuntary psychiatric hold from 2016 to 2018 were linked to data from the Greater Los Angeles Homeless Count on unsheltered homelessness and from the California Health Interview Survey on need for mental health services and suicidality, using admission zip codes to link variables at the SPA level. Geospatial mapping and bivariate tests were used to examine geographic overlap of SPA mental health need and unsheltered homelessness with volume of involuntary psychiatric admissions over the study period. Multiple logistic regression modeling was used to examine associations of SPA mental health need and unsheltered homelessness with conservatorship initiation. The volume of patients admitted from SPAs with higher levels of mental illness need grew from 2016 to 2018 (Tau = 0.27, P < 0.001; Tau = 0.40, P < 0.001), but there were fewer patients admitted from SPAs with higher levels of unsheltered homelessness over the same years (Tau of −0.33, P < 0.001). Being admitted from SPAs with the highest levels of unsheltered homelessness was associated with higher odds of conservatorship initiation (OR = 1.73, 95% CI = 1.82–16.74). Results suggest a need for targeted mental health and housing services to reach areas of highest need in Los Angeles County.
•Regional unsheltered homelessness was associated with severe mental illness.•Psychiatric admissions from areas with high levels of homelessness decreased.•Psychiatric admissions from areas with high levels of mental health need increased.•Mental health and housing services should be targeted to areas of highest need.•Housing first approaches are essential to long-term mental illness stability.
We present a new, seismologically consistent expression for the total area and volume of populations of earthquake‐triggered landslides. This model builds on a set of scaling relationships between ...key parameters, such as landslide spatial density, seismic ground acceleration, fault length, earthquake source depth, and seismic moment. To assess the model we have assembled and normalized a catalog of landslide inventories for 40 shallow, continental earthquakes. Low landscape steepness causes systematic overprediction of the total area and volume of landslides. When this effect is accounted for, the model predicts the total landslide volume of 63% of 40 cases to within a factor 2 of the volume estimated from observations (R2=0.76). The prediction of total landslide area is also sensitive to the landscape steepness, but less so than the total volume, and it appears to be sensitive to controls on the landslide size‐frequency distribution, and possibly the shaking duration. Some outliers are likely associated with exceptionally strong rock mass in the epicentral area, while others may be related to seismic source complexities ignored by the model. However, the close match between prediction and estimate for about two thirds of cases in our database suggests that rock mass strength is similar in many cases and that our simple seismic model is often adequate, despite the variety of lithologies and tectonic settings covered. This makes our expression suitable for integration into landscape evolution models and application to the anticipation or rapid assessment of secondary hazards associated with earthquakes.
Key Points
Earthquake‐triggered landsliding modeled based on seismological laws
Predictions tested against data from 40 earthquakes
Landscape steepness control over triggered slope failure empirically quantified
The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) changed the food packages provided to its participants in 2009, to better align them with the Dietary Guidelines for ...Americans. Previous research found that the 2009 WIC food package change was associated with reduced obesity risk, particularly among breastfed infants but also among those who were never breastfed. The objective of this study was to determine if the new child food package introduced in 2009, including more produce and whole grains for 1-4-year old children, was associated with healthier growth trajectories and reduced obesity risk at age 4 years among children who were exclusively formula fed during infancy.
Administrative data on WIC-participating children in Los Angeles County, 2003-2016, were used (N = 74,871), including repeated measures of weight and length (or height); child's age, gender, and race/ethnicity; maternal education and language; and family poverty. Gender-stratified spline mixed models were used to examine weight-for-height z-score (WHZ) growth trajectories from 0 to 4 years and Poisson regression models were used to assess obesity (BMI-for-age > 95th percentile) at age 4. The main independent variable was duration of receipt (dose) of the new child package, categorized as 0, > 0 to < 1, 1 to < 2, 2 to < 3, 3 to < 4, and 4 years.
WHZ growth trajectories were similar for children across new child package dose groups. Boys and girls who were fully formula fed during infancy but received the new child food package for 4 years had a 7% (RR = 0.93; 95%CI = 0.89-0.98) and a 6% (RR = 0.94; 95%CI = 0.89-0.99) lower obesity risk, respectively, compared to children who received the new child food package for 0 years. There were no differences in obesity risk for children receiving < 4 years of the new child package vs. 0 years.
Providing healthy foods during childhood to children who were exclusively formula fed as infants was associated with modest improvements in obesity outcomes. While breastfeeding promotion should still be prioritized among WIC participants, providing healthy foods during childhood may provide health benefits to formula fed children, who comprise a sizeable proportion of children served by WIC.
► Patterns of park (non)use are configured by socio-cultural and socio-spatial factors. ► Ethno-racial differences in park use reflect ideologies of park-making and management. ► Social exclusion of ...Latinos from parks may explain lower presence in national parks. ► The historical production of White natures seems to affect park (non)use by Latinos. ► The cultural politics of nature is a useful frame to explore park (non)use.
Scholars have attributed park (non)use, especially ethno-racially differentiated (non)use, to various factors, including socio-cultural (e.g. poverty, cultural preferences, etc.) and socio-spatial determinants (e.g. travel distance, park features, etc.). But new geographic research is proposing alternative explanations for park (non)use, employing a ‘cultural politics’ theoretical lens. The cultural politics frame offers fresh insights into how practices of socio-ecological exclusion and attachment in parks may be undergirded by political struggles over the making and ordering of racialized identities. Challenging partial and essentialist explanations from leisure research, some cultural politics scholars have recently argued that ethno-racial formations, cultural histories of park-making (e.g. segregated park systems), and land-use systems (e.g. zoning and property taxes) can operate to circumscribe park access and use for some people of color. Using the cultural politics frame, this paper documents the ethno-racial and nativist barriers Latino focus group participants faced in accessing and using some Los Angeles parks. Participants reported feeling ‘out of place’, ‘unwelcome’ or excluded from these parks. They identified the predominantly White clientele of parks; the ethno-racial profile of park-adjacent neighborhoods; a lack of Spanish-language signs; fears of persecution; and direct experiences of discrimination as exclusionary factors. These findings have implications for future research and for park planning and management.
This systematic review and meta-analysis aims to analyze the sport habits of patients before and after primary total knee arthroplasty (TKA) by answering the following questions: (1) Is there a ...postoperative improvement of sport activity based on validated activity scores? (2) Does age influence the postoperative improvement of sport activity based on validated activity scores? (3) What are the preoperative and postoperative sport participation rates and the return to sport rates (RTS)? (4) What are the sport disciplines and sport patterns?
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, MEDLINE and Scopus were searched for studies reporting the physical activity level and sport habits of patients before and after primary TKA based on validated activity scores or an activity questionnaire. Random effect models were implemented to pool the mean differences (MDs) of activity score values and the difference between preoperative and postoperative sport participation rates.
Twenty-five studies were included reporting on 6035 TKAs. Physical activity levels improved significantly according to the University of California, Los Angeles (UCLA) activity score (MD 1.55, 95% confidence interval CI 0.35-2.76, n = 1239, I2 = 99%, P < .01) and the Tegner score (MD 1.14, 95% CI −0.48 to 2.76, n = 483, I2 = 93%, P < .01). Younger patients (≤55 years) had the highest improvement in the UCLA activity scores following primary TKA (MD 3.12, 95% CI −1.79 to 8.04, n = 67, I2 = 96%, P < .01). Sport participation decreased slightly but not significantly (incidence rate difference −8%, 95% CI −0.14 to −0.2, n = 2673 patients, I2 = 38%, P = .09). The median RTS was 71.2%. Patients predominantly engaged in low-impact sports, especially walking, cycling, and swimming.
According to validated activity scores, the level of physical activity significantly increases following primary TKA. Young patients (≤55 years) had the highest gain in physical activity according to the UCLA activity score following primary TKA. Sport participation shows a slight but nonsignificant decrease; intermediate and high-impact sports were abandoned to a large degree while participation rates for low-impact sports predominantly increased. RTS varied, although approximately 70% resume sport activities.
IV (review including case series)
Oxidative potential (OP) has been proposed as a possible integrated metric for particles smaller than 2.5 μm in diameter (PM2.5) to evaluate adverse health outcomes associated with particulate air ...pollution exposure. Here, we investigate how OP depends on sources and chemical composition and how OP varies by land use type and neighborhood socioeconomic position in the Los Angeles area. We measured OH formation (OPOH), dithiothreitol loss (OPDTT), black carbon, and 52 metals and elements for 54 total PM2.5 samples collected in September 2019 and February 2020. The Positive Matrix Factorization source apportionment model identified four sources contributing to volume-normalized OPOH: vehicular exhaust, brake and tire wear, soil and road dust, and mixed secondary and marine. Exhaust emissions contributed 42% of OPOH, followed by 21% from brake and tire wear. Similar results were observed for the OPDTT source apportionment. Furthermore, by linking measured PM2.5 and OP with census tract level socioeconomic and health outcome data provided by CalEnviroScreen, we found that the most disadvantaged neighborhoods were exposed to both the most toxic particles and the highest particle concentrations. OPOH exhibited the largest inverse social gradients, followed by OPDTT and PM2.5 mass. Finally, OPOH was the metric most strongly correlated with adverse health outcome indicators.
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