Preterm birth in the United States is associated with maternal clinical factors such as diabetes, hypertension and social factors including race, ethnicity, and socioeconomic status. In California, ...8.7% of all live births are preterm, with African American and Black families experiencing the greatest burden. The impact of paternal factors on birth outcomes has been studied, but little is known about the experience of men of color (MOC). The purpose of this study was to explore the experiences of MOC who are partners to women at medical and social risk for preterm birth.
This study used a qualitative research design and focus group methods. The research was embedded within an existing study exploring experiences of women of color at risk for preterm birth conducted by the California Preterm Birth Initiative.
Twelve MOC participated in the study and among them had 9 preterm children. Four themes emerged from thematic analysis of men's experiences: (1) "Being the Rock": Providing comfort and security; (2) "It's a blessing all the way around": Keeping faith during uncertainty; (3) "Tell me EVERYTHING": Unmet needs during pregnancy and delivery; (4) "Like a guinea pig": Frustration with the healthcare system. Participants identified many barriers to having a healthy pregnancy and birth including inadequate support for decision making, differential treatment, and discrimination.
This study shows novel and shared narratives regarding MOC experiences during pregnancy, birth, and postpartum periods. Healthcare providers have an essential role to acknowledge MOC, their experience of discrimination and mistrust, and to assess needs for support that can improve birth outcomes. As MOC and their families are at especially high social and medical risk for preterm birth, their voice and experience should be central in all future research on this topic.
DNA methylation (DNAm)-based biological age (epigenetic age) has been suggested as a useful biomarker of age-related conditions including type 2 diabetes (T2D), and its newest iterations (GrimAge ...measurements) have shown early promise. In this study, we explored the association between epigenetic age and incident T2D in the context of their relationships with obesity. A total of 1,057 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study were included in the current analyses. We stratified the participants into three groups: normal weight, overweight, and obese. A 1-year increase of GrimAge was associated with higher 10-year (study years 15-25) incidence of T2D (odds ratio OR 1.06, 95% CI 1.01-1.11). GrimAge acceleration, which represents the deviation of GrimAge from chronological age, was derived from the residuals of a model of GrimAge and chronological age, and any GrimAge acceleration (positive GrimAA: having GrimAge older than chronological age) was associated with significantly higher odds of 10-year incidence of T2D in obese participants (OR 2.57, 95% CI 1.61-4.11). Cumulative obesity was estimated by years since obesity onset, and GrimAge partially mediated the statistical association between cumulative obesity and incident diabetes or prediabetes (proportion mediated = 8.0%). In conclusion, both older and accelerated GrimAge were associated with higher risk of T2D, particularly among obese participants. GrimAge also statistically mediated the associations between cumulative obesity and T2D. Our findings suggest that epigenetic age measurements with DNAm can potentially be used as a risk factor or biomarker associated with T2D development.
To develop a self-report measure of activity performance for upper limb prosthesis users that quantifies outcomes by level of amputation and prosthesis type.
Telephone survey of 423 adults with major ...upper limb amputation (ULA) who used a prosthesis. Item generation, cognitive, and pilot testing were followed by field testing. Items were categorized as one- or two-handed. Factor and Rasch analyses evaluated unidimensionality, monotonicity, item fit, differential item functioning (DIF), and reliability. Test-retest reliability was evaluated with intraclass correlation coefficients (ICCs). Known group validity was assessed with ANOVAs.
Respondents with unilateral ULA utilized prosthesis for 24% of unilateral and 38% of bilateral tasks. Those with bilateral ULA utilized prostheses for 64% of unilateral and 46% of bilateral tasks. Factor analyses identified a One-handed Task factor (CFI = 0.963, TLI = 0.950, and RMSEA = 0.064) and a Two-Handed Task factor (CFI = 0.958, TLI = 0.953, and RMSEA = 0.053). Response categories were collapsed to address monotonicity. After DIF adjustment, person reliability was 0.49 and 0.82 for One-handed and Two-handed Task scales, respectively, and ICCs were 0.88 and 0.91. Both scales differed by amputation level (p < 0.001).
The Upper Extremity Functional Scale for Prosthesis Users (UEFS-P) measure of upper limb function of prosthesis users has promising psychometric properties.
Implications for rehabilitation
Measurement of upper limb function in persons with amputation is challenging, given currently available measures which do not explicitly grade activity performance with a prosthesis.
The Upper Extremity Functional Scale for Prosthesis Users (UEFS-P) builds upon the original Orthotics and Prosthetics User Survey (OPUS) UEFS Scale with modified instructions, a revised item set, response categories and scoring algorithm.
The UEFS-P consists of two unidimensional scales, the One-handed Tasks scale and the Two-handed Tasks scale.
The UEFS-P scales have clear advantages over existing self-report measures of upper limb function that ask about difficulty with performing functional activities without accounting for prosthesis use, and do not differentiate persons who use and do not use a prosthesis.
Abstract
Background
Jagged ends of plasma DNA are a recently recognized class of fragmentomic markers for cell-free DNA, reflecting the activity of nucleases. A number of recent studies have also ...highlighted the importance of jagged ends in the context of pregnancy and oncology. However, knowledge regarding the generation of jagged ends is incomplete.
Methods
Jaggedness of plasma DNA was analyzed based on Jag-seq, which utilized the differential methylation signals introduced by the DNA end-repair process. We investigated the jagged ends in plasma DNA using mouse models by deleting the deoxyribonuclease 1 (Dnase1), DNA fragmentation factor subunit beta (Dffb), or deoxyribonuclease 1 like 3 (Dnase1l3) gene.
Results
Aberrations in the profile of plasma DNA jagged ends correlated with the type of nuclease that had been genetically deleted, depending on nucleosomal structures. The deletion of Dnase1l3 led to a significant reduction of jaggedness for those plasma DNA molecules involving more than 1 nucleosome (e.g., size ranges 240-290 bp, 330-380 bp, and 420-470 bp). However, less significant effects of Dnase1 and Dffb deletions were observed regarding different sizes of DNA fragments. Interestingly, the aberration in plasma DNA jagged ends related to multinucleosomes was observed in human subjects with familial systemic lupus erythematosus with Dnase1l3 deficiency and human subjects with sporadic systemic lupus erythematosus.
Conclusions
Detailed understanding of the relationship between nuclease and plasma DNA jaggedness has opened up avenues for biomarker development.
Indigenous people worldwide are at high risk of developing severe influenza disease. HLA-A*24:02 allele, highly prevalent in Indigenous populations, is associated with influenza-induced mortality, ...although the basis for this association is unclear. Here, we define CD8
T-cell immune landscapes against influenza A (IAV) and B (IBV) viruses in HLA-A*24:02-expressing Indigenous and non-Indigenous individuals, human tissues, influenza-infected patients and HLA-A*24:02-transgenic mice. We identify immunodominant protective CD8
T-cell epitopes, one towards IAV and six towards IBV, with A24/PB2
-specific CD8
T cells being cross-reactive between IAV and IBV. Memory CD8
T cells towards these specificities are present in blood (CD27
CD45RA
phenotype) and tissues (CD103
CD69
phenotype) of healthy individuals, and effector CD27
CD45RA
PD-1
CD38
CD8
T cells in IAV/IBV patients. Our data show influenza-specific CD8
T-cell responses in Indigenous Australians, and advocate for T-cell-mediated vaccines that target and boost the breadth of IAV/IBV-specific CD8
T cells to protect high-risk HLA-A*24:02-expressing Indigenous and non-Indigenous populations from severe influenza disease.
Sleep disturbance is observed across species, resulting in neurocognitive dysfunction and poor impulse control/regulation of negative emotion. Understanding animal sleep disturbance is thus important ...to understand how environmental factors influence animal sleep and day-to-day welfare. Self-reporting tools for sleep disturbance are commonly used in human research to determine sleep quality, that cannot be transferred to non-verbal animal species research. Human research has, however, successfully used frequency of awakenings to create an objective measurement of sleep quality. The aim of this study was to utilise a novel sleep quality scoring system for a non-human mammalian species. Five separate sleep quality indices calculations were developed using frequency of awakenings and total sleep time/total time spent in different sleep states. These indices were applied to a pre-existing data set of equine sleep behaviour taken from a study investigating the effects of environmental change (lighting and bedding) on the duration of time in different sleep states. Significant treatment effects for index scores both differed and aligned to the original sleep quantity results, thus sleep quality may be a useful alternative measurement of sleep disturbance that could be used to investigate impactful (emotional, cognitive) effects on the animal.
In the western United States vast acreages of land are exposed to low levels of atmospheric nitrogen (N) deposition, with interspersed hotspots of elevated N deposition downwind of large, expanding ...metropolitan centers or large agricultural operations. Biological response studies in western North America demonstrate that some aquatic and terrestrial plant and microbial communities are significantly altered by N deposition. Greater plant productivity is counterbalanced by biotic community changes and deleterious effects on sensitive organisms (lichens and phytoplankton) that respond to low inputs of N (3 to 8 kilograms N per hectare per year). Streamwater nitrate concentrations are elevated in high-elevation catchments in Colorado and are unusually high in southern California and in some chaparral catchments in the southwestern Sierra Nevada. Chronic N deposition in the West is implicated in increased fire frequency in some areas and habitat alteration for threatened species. Between hotspots, N deposition is too low to cause noticeable effects or has not been studied.
Background
Colorectal liver metastases that demonstrate a complete radiographic response during chemotherapy are increasingly common with advances in chemotherapy regimens and are described as ...disappearing liver metastases (DLMs). However, these DLMs often continue to harbor residual viable tumor. If these tumors are found in the operating room with ultrasound (US), they should be treated. The intraoperative sonographic visualization of these lesions, however, can be hindered by chemotherapy-associated liver parenchyma changes. The objective of this study was to evaluate the use of an intraoperative image guidance system, Explorer (Analogic Corporation, Peabody, MA), to aid surgeons in the identification of DLMs initially undetected by US alone.
Study Design
In a single-arm prospective trial, patients with colorectal liver metastases undergoing liver resection and/or ablation with one or more DLMs during neoadjuvant chemotherapy were enrolled. Intraoperatively, DLMs were localized with conventional US. Any DLM not found by conventional US was re-evaluated with the image guidance system. The primary outcome was the proportion of sonographically occult DLMs subsequently located by image-guided US.
Results
Between April 2016 and November 2017, 25 patients with 61 DLMs were enrolled. Thirty-eight DLMs (62%) in 14 patients (56%) were not identified with US alone. Six (16%) DLMs in five patients (36%) were subsequently located with assistance of the image guidance system. The image guidance changed the intraoperative surgical plan in four of these patients.
Conclusions
Image guidance can aid surgeons in the identification of initially sonographically occult DLMs and facilitate the complete surgical clearance of all sites of liver disease.
Advanced persistent threats (APTs) infiltrate cyber systems and compromise specifically targeted data and/or resources through a sequence of stealthy attacks consisting of multiple stages. Dynamic ...information flow tracking has been proposed to detect APTs. In this article, we develop a dynamic information flow tracking game for resource-efficient detection of APTs via multistage dynamic games. The game evolves on an information flow graph, whose nodes are processes and objects (e.g., file, network endpoints) in the system and the edges capture the interaction between different processes and objects. Each stage of the game has prespecified targets that are characterized by a set of nodes of the graph. The goal of the APT is to evade detection and reach a target node of each stage. The goal of the defender is to maximize the detection probability while minimizing performance overhead on the system. The resource costs of the players are different and the information structure is asymmetric, resulting in a nonzero-sum imperfect information game . We first calculate the best responses of the players and then compute Nash equilibrium for single-stage attacks. We then provide a polynomial-time algorithm to compute a correlated equilibrium for the multistage attack case. Finally, we simulate our model and algorithm on real-world nation state attack data obtained from the Refinable Attack INvestigation (RAIN) system.
PDF
