In the United States (US), epidemiologists have long documented paradoxically lower rates of adverse perinatal health outcomes among immigrant birthing people than what might be expected in light of ...socioeconomic and language barriers to healthcare, especially as compared to their US-born racial and ethnic counterparts. However, researchers have also documented significant variability in this immigrant birth paradox when examining within and across racial and ethnic subgroups. This review paper summarizes fifty years of research regarding differences in low, preterm birth, and infant mortality in the US, according to the nativity status of the birthing person. While there is ample evidence of the importance of nativity in delineating a pregnant person's risk of adverse infant outcomes, this review also highlights the relative paucity of research exploring the intersection of acculturation, ethnic enclaves, and structural segregation. We also provide recommendations for advancing the study of perinatal outcomes among immigrants.
Background
The introduction of robotic technology has revolutionized radical prostatectomy surgery. However, the potential benefits of robotic techniques may have trade-offs in increased mental ...demand for the surgeon and the physical demand for the assisting surgeon. This study employed an innovative motion tracking tool along with validated workload questionnaire to assess the ergonomics and workload for both assisting and console surgeons intraoperatively.
Methods
Fifteen RARP cases were collected in this study. Cases were performed by 10 different participants, six primarily performed console tasks and four primarily performed assisting tasks. Participants had a median 12 (min—3, max—25) years of surgical experience. Both console and assisting surgeons performed robotic prostatectomy cases while wearing inertial measurement units (IMUs) that continuously track neck, shoulder, and torso motion without interfering with the sterile environment. Postoperatively, participants completed a workload questionnaire (SURG-TLX) and a body part discomfort questionnaire.
Results
Twenty-six questionnaires were completed from 13 assisting and 13 console surgeons over the 15 cases. Postoperative pain was reported highest for the right shoulder and neck. Mental demands were 41 % higher for surgeons at the console than assisting (
p
< 0.05), while physical demands were not significantly different. Assisting surgeons worked in demanding neck postures for 58 % of the procedure compared to 24 % for the console surgeon (
p
< 0.01). Surgeons at the console were primarily static and showed 2–5 times fewer movements than assisting surgeons (
p
< 0.01).
Conclusions
Postures were more ergonomic during console tasks than when assisting by the bedside; however, the console may constrain postures leading to static loads that have been associated with musculoskeletal symptoms for the neck, torso, and shoulders. The IMU sensors were effective at quantifying ergonomics in robotic prostatectomies, and these methods and findings have broad applications to other robotic procedures.
Abstract
We present a framework based on non-equilibrium molecular dynamics (NEMD) to reproduce the phase transformation event of Aluminum under ramp compression loading. The simulated stress-density ...response, virtual x-ray diffraction patterns, and structure analysis are compared against the previously observed experimental laser-driven ramp compression in-situ x-ray diffraction data. The NEMD simulations show the solid–solid phase transitions are consistent to experimental observations with a close-packed face-centered cubic (fcc) (111), hexagonal close-packed (hcp) structure (002), and body-centered cubic bcc (110) planes remaining parallel. The atomic-level analysis of NEMD simulations identifiy the exact phase transformation pathway happening via Bain transformation while the previous in situ x-ray diffraction data did not provide sufficient information for deducing the exact phase transformation path.
Chlamydia trachomatis infection causes severe inflammatory disease resulting in blindness and infertility. The pathophysiology of these diseases remains elusive but myeloid cell-associated ...inflammation has been implicated. Here we show NLRP3 inflammasome activation is essential for driving a macrophage-associated endometritis resulting in infertility by using a female mouse genital tract chlamydial infection model. We find the chlamydial parasitophorous vacuole protein CT135 triggers NLRP3 inflammasome activation via TLR2/MyD88 signaling as a pathogenic strategy to evade neutrophil host defense. Paradoxically, a consequence of CT135 mediated neutrophil killing results in a submucosal macrophage-associated endometritis driven by ATP/P2X7R induced NLRP3 inflammasome activation. Importantly, macrophage-associated immunopathology occurs independent of macrophage infection. We show chlamydial infection of neutrophils and epithelial cells produce elevated levels of extracellular ATP. We propose this source of ATP serves as a DAMP to activate submucosal macrophage NLRP3 inflammasome that drive damaging immunopathology. These findings offer a paradigm of sterile inflammation in infectious disease pathogenesis.
Differences in preterm birth rates between black and white women are the largest contributor to racial disparities in infant mortality. In today's age of precision medicine, analysis of the genome, ...epigenome, metabolome, and microbiome has generated interest in determining whether these biomarkers can help explain racial disparities. We propose that there are pitfalls as well as opportunities when using precision medicine analyses to interrogate disparities in health. To conclude that racial disparities in complex conditions are genetic in origin ignores robust evidence that social and environmental factors that track with race are major contributors to disparities. Biomarkers measured in omic assays that may be more environmentally responsive than genomics, such as the epigenome or metabolome, may be on the causal pathway of race and preterm birth, but omic observational studies suffer from the same limitations as traditional cohort studies. Confounding can lead to false conclusions about the causal relationship between omics and preterm birth. Methodological strategies (including stratification and causal mediation analyses) may help to ensure that associations between biomarkers and exposures, as well as between biomarkers and outcomes, are valid signals. These epidemiologic strategies present opportunities to assess whether precision medicine biomarkers can uncover biology underlying perinatal health disparities.
Distributional environmental injustices in residential exposure to air pollution in Arab American enclaves have not been examined. We conducted our investigation at the census tract-level across the ...continental United States using a set of socio-demographic variables to predict cancer risk from hazardous air pollutant (HAP) exposure. Arab enclaves had a mean cancer risk score of 44.08, as compared to 40.02 in non-enclave tracts. In terms of the specific origin groups, Moroccan enclaves had the highest cancer risk score (46.93), followed by Egyptian (45.33), Iraqi (43.13), Jordanian (41.67), and Lebanese (40.65). In generalized estimating equations controlling for geographic clustering and other covariates, Arab enclaves had significantly higher cancer risks due to HAPs (
< 0.001) than non-enclaves. When looking at specific ethnic origins, Iraqi, Palestinian, and Lebanese enclaves had significantly higher cancer risks due to HAPs (all
< 0.01) than non-enclaves. Results reveal significant environmental injustices for Arab American enclaves that should be examined in future studies. Results suggest that environmental injustice may be another way in which Arab Americans are disadvantaged as a racialized minority group without minority status.
Earth‐abundant Cu2BaSnS4 (CBTS) thin films exhibit a wide bandgap of 2.04–2.07 eV, a high absorption coefficient > 104 cm−1, and a p‐type conductivity, suitable as a top‐cell absorber in tandem solar ...cell devices. In this work, sputtered oxygenated CdS (CdS:O) buffer layers are demonstrated to create a good p–n diode with CBTS and enable high open‐circuit voltages of 0.9–1.1 V by minimizing interface recombination. The best power conversion efficiency of 2.03% is reached under AM 1.5G illumination based on the configuration of fluorine‐doped SnO2 (back contact)/CBTS/CdS:O/CdS/ZnO/aluminum‐doped ZnO (front contact).
Earth‐abundant Cu2BaSnS4 (CBTS) thin films exhibit the optoelectronic and defect properties suitable as an absorber for the top cell of tandem photovoltaic solar cell devices. Oxygenated CdS (CdS:O) buffers enable high open‐circuit voltages of 0.9–1.1 V in CBTS thin‐film solar cells by minimizing interface recombination.
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