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INTRODUCTION: Psychosocial factors and life stressors have an impact on long-term health effects on mothers and their children. Recent studies examining maternal mental health have predominantly focused on identifying maternal experiences with depression; however, there has been minimal research investigating maternal experiences with psychosocial risk factors and its relationship with child well-being. METHODS: Secondary analysis was conducted using data from the Fragile Families and Child Well-Being Study. The study sample includes 2396 adolescents and their biological mothers. Adolescents were between the ages of 14 and 19. We examined primary outcomes regarding mental health (depression and anxiety), life-satisfaction, and substance usage (alcohol and drugs). RESULTS: The association between maternal psychosocial factors an adolescent depression was significant, F(26) = 5.29, p < .01. Mothers educational attainment and poverty level significantly predicted adolescent depression; with completion of some college (B = -0.411, p 0.025), a college degree (B = -0.540, p = 0.018), and living at the 300% poverty level (B = -0.725, p = 0.002) predicting lower levels of adolescent depression. CONCLUSION: Our study demonstrates that there was a positive relationship between maternal mental health and adolescent mental health. Further, this study demonstrated that maternal mental health and social determinants of health are predictors of adolescent mental health and social functioning, thus indicating an inextricable connection to child well-being.
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Salud Mental , Madres , Adolescente , Adulto , Ansiedad/epidemiología , Ansiedad/psicología , Niño , Salud Infantil , Depresión/epidemiología , Depresión/psicología , Femenino , Humanos , Madres/psicología , Adulto JovenRESUMEN
This research provides an updated energy yield assessment for a large tidal stream turbine array in the Alderney Race. The original array energy yield estimate was presented in 2004. Enhancements to this original work are made through the use of a validated two-dimensional hydrodynamic model, enabling the resolution of flow modelling to be improved and the impacts of array blockage to be quantified. Results show that a range of turbine designs (i.e. rotor diameter and power capacity) are needed for large-scale development, given the spatial variation in bathymetry and flow across the Alderney Race. Array blockage causes a reduction in flow speeds in the array of up to 2.5 m s-1, increased flow speeds around the array of up to 1 m s-1 and a reduction in the mean volume flux through the Alderney Race of 8%. The annual energy yield estimate of the array is 3.18 TWh, equivalent to the electricity demand of around 1 million homes. The capacity factor of the array is 18%, implying sub-optimal array design. This result demonstrates the need for turbine rated speed to be selected based on the altered flow regime, not the ambient flow. Further enhancement to array performance is explored through increases to rotor diameter and changes to device micro-siting, demonstrating the significant potential for array performance improvement. This article is part of the theme issue 'New insights on tidal dynamics and tidal energy harvesting in the Alderney Race'.
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Costs of tidal stream energy generation are anticipated to fall considerably with array expansion and time. This is due to both economies of volume, where arrays comprising of large numbers of turbines can split fixed costs over a greater number of devices, and learning rates, where the industry matures and so arrays of the same size become cheaper due to lessons learned from previous installations. This paper investigates how tidal energy arrays can be designed to minimize the levelized cost of energy (LCOE), by optimizing not only the location but also the number of devices, to find a suitable balance between decreased costs due to economies of volume and diminishing returns due to global blockage effects. It focuses on the Alderney Race as a case study site due to the high velocities found there, making it a highly suitable site for large-scale arrays. It is demonstrated that between 1 and 2 GW could be feasibly extracted as costs in the tidal industry fall, with the LCOE depending greatly on the assumed costs. A Monte-Carlo analysis is undertaken to account for variability in capital and operational cost data used as inputs to the array optimization. Once optimized, the estimated P50 LCOE of an 80 MW array is £110/MWh. This estimate aligns closely with the level of subsidy considered for tidal stream projects in the Alderney Race in the past. This article is part of the theme issue 'New insights on tidal dynamics and tidal energy harvesting in the Alderney Race'.
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The tides are a predictable, renewable, source of energy that, if harnessed, can provide significant levels of electricity generation. The Alderney Race (AR), with current speeds that exceed 5 m s-1 during spring tides, is one of the most concentrated regions of tidal energy in the world, with the upper-bound resource estimated at 5.1 GW. Owing to its significance, the AR is frequently used for model case studies of tidal energy conversion, and here we review these model applications and outcomes. We examine a range of temporal and spatial modelling scales, from regional models applied to resource assessment and characterization, to more detailed models that include energy extraction and array optimization. We also examine a range of physical processes that influence the tidal energy resource, including the role of waves and turbulence in tidal energy resource assessment and loadings on turbines. The review discusses model validation, and covers a range of numerical modelling approaches, from two-dimensional to three-dimensional tidal models, two-way coupled wave-tide models, Large Eddy Simulation (LES) models, and the application of optimization techniques. The review contains guidance on model approaches and sources of data that can be used for future studies of the AR, or translated to other tidal energy regions. This article is part of the theme issue 'New insights on tidal dynamics and tidal energy harvesting in the Alderney Race'.
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Introduction Four Virginia communities participated in a community services enhancement pilot to centralize intake and referral for childbearing women eligible for home visiting support through the Maternal, Infant and Early Childhood Home Visiting (MIECHV) program. Methods As an aspect of the study, project-trained intake workers administered behavioral health and psychosocial risk screening (including emotional health, substance use, interpersonal violence, and smoking) during intake eligibility assessment. Participants identified as at-risk were referred for community intervention concurrently with referral to MIECHV services. Results In the study sample (N = 1515), emotional health was identified as the most common single risk factor (n = 326, 21.5%) and clusters of 2 or more behavioral health risks were identified for 223 (14.7%) of women. Among those with two or more behavioral health risks, smoking was significantly related to all other areas of behavioral health risk. Conclusion Findings from this multi-site pilot emphasize concomitant behavioral health and psychosocial risks in childbearing women and reinforce the importance of embedding comprehensive public health interventions in community systems of care.
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Medicina de la Conducta/métodos , Medición de Riesgo/métodos , Adulto , Medicina de la Conducta/normas , Femenino , Humanos , Tamizaje Masivo/métodos , Tamizaje Masivo/normas , Proyectos Piloto , Atención Posnatal/métodos , Psicología , Psicometría/instrumentación , Psicometría/métodos , Medición de Riesgo/normas , Factores de Riesgo , VirginiaRESUMEN
This study aimed to critically review methods for ranking risks related to food safety and dietary hazards on the basis of their anticipated human health impacts. A literature review was performed to identify and characterize methods for risk ranking from the fields of food, environmental science and socio-economic sciences. The review used a predefined search protocol, and covered the bibliographic databases Scopus, CAB Abstracts, Web of Sciences, and PubMed over the period 1993-2013. All references deemed relevant, on the basis of predefined evaluation criteria, were included in the review, and the risk ranking method characterized. The methods were then clustered-based on their characteristics-into eleven method categories. These categories included: risk assessment, comparative risk assessment, risk ratio method, scoring method, cost of illness, health adjusted life years (HALY), multi-criteria decision analysis, risk matrix, flow charts/decision trees, stated preference techniques and expert synthesis. Method categories were described by their characteristics, weaknesses and strengths, data resources, and fields of applications. It was concluded there is no single best method for risk ranking. The method to be used should be selected on the basis of risk manager/assessor requirements, data availability, and the characteristics of the method. Recommendations for future use and application are provided.
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Inocuidad de los Alimentos , Enfermedades Transmitidas por los Alimentos/epidemiología , Medición de Riesgo/métodos , Costo de Enfermedad , Técnicas de Apoyo para la Decisión , Árboles de Decisión , Contaminación de Alimentos , Microbiología de Alimentos , Enfermedades Transmitidas por los Alimentos/microbiología , Humanos , Años de Vida Ajustados por Calidad de Vida , RiesgoRESUMEN
CONTEXT: Trabecular Bone Score (TBS) has been recently proposed as a good tool to investigate secondary osteoporosis. OBJECTIVE: The aim of this study was to assess TBS from spine DXA images in patients with primary hyperparathyroidism (PHPT) and look at its correlates. SUBJECTS AND METHODS: 153 patients, mean age 59.1 ± 12.1 yrs, females and males (10%), mean BMI 26.2 ± 4.8 kg/m2, mean serum calcium and PTH of 11.3 ± 1.2 mg/dL and 232 ± 329 pg/mL, respectively; 89% had osteoporosis/osteopenia by LS DXA and 46% had renal involvement. There were 7.6% patients with vertebral fractures, 13.2% patients with nonvertebral fractures. TBS indices were derived from LS-DXA images and cutoff points used were those previously reported. RESULTS: Mean TBS was in the partially degraded range (1.258 ± 0.115); 32% of patients had degraded microarchitecture (TBS ≤ 1.20), 51% had partially degraded microarchitecture (TBS > 1.20 and < 1.35) and 17% had normal TBS. TBS was significantly correlated with areal BMD both at the LS (r=0.544; p<0.001) and FN (r = 0.315; p < 0.001), and negatively with age (r= - 0.354; p < 0.001) and years since menopause - YSM (r = - 0.257, p = 0.005). Patients with vertebral fractures had mean values of TBS in the degraded range, significantly lower than those without vertebral fractures (1.173 ± 0.076 vs. 1.263 ± 0.115; p = 0.006). The presence of vertebral fracture was independently associated only with YSM (OR = 1.131, 95% CI = 0.032 - 0.214, p = 0.008) but not with TBS. CONCLUSIONS: In a cohort of symptomatic PHPT patients, including postmenopausal, premenopausal and male patients, we have shown that TBS was in the partially degraded range, but it was not independently associated with fractures.
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AIMS: To utilize comparative accessory gene fingerprinting to discriminate between naturalized and faecal Escherichia coli, with particular emphasis on strains from phylogroup B1. METHODS AND RESULTS: Fourteen accessory genes that were potentially ecotype-specific were selected on the basis of comparative genomic DNA sequence analysis between faecal and environmental strains and also using a literature-based strategy. PCR assays were designed for each gene, and used to screen 107 faecal strains from various hosts and 106 environmental strains from surface water and sediment. While none of the 14 accessory genes were ecotype-specific, six of the genes were ecotype-enriched. Specifically, toxin-antitoxin system genes were more abundant among faecal strains, whereas genes involved in iron acquisition, complement resistance/surface exclusion, and biofilm formation were more abundant among environmental strains. These six genes were used to form composite fingerprints which revealed the presence of several ecotype-specific and -enriched fingerprints. Notably, some of the environmental strain-specific or -enriched fingerprints consisted of strains putatively belonging to clade ET-1, which has been previously recognized as a naturalized subpopulation. CONCLUSIONS: Unlike single genes which did not reliably distinguish between faecal and naturalized phylogroup B1 E. coli strains, composite fingerprints of ecotype-enriched accessory genes may offer a novel method for distinguishing between these two populations. SIGNIFICANCE AND IMPACT OF THE STUDY: Accessory gene fingerprinting may have important practical implications for improving the specificity of methods that are widely used for quantifying and identifying the sources of faecal contamination in surface water.
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Técnicas de Tipificación Bacteriana/métodos , Dermatoglifia del ADN/métodos , Proteínas de Escherichia coli/genética , Escherichia coli/clasificación , Escherichia coli/genética , Agua Dulce/microbiología , Escherichia coli/aislamiento & purificación , Escherichia coli/metabolismo , Proteínas de Escherichia coli/metabolismo , Heces/microbiología , Humanos , Datos de Secuencia Molecular , Filogenia , Reacción en Cadena de la PolimerasaRESUMEN
In an effort to address social determinants of health and to reduce barriers to care, there have been increased attempts to understand and mitigate public health concerns in ethnic minority communities. As knowledge increases regarding the impact of health disparities on ethnic minority communities, social workers practice knowledge must expand to include intersectional approaches and methods that are inclusive of mechanisms that address inconsistencies in access to health care. Using the 2018 National Survey on Drug Use and Health (NSDUH), this study examined behavioral health and psychosocial risk factors that African American and Latinx women (n = 7008) experienced and identified how these factors are associated with self-reported overall health. Results indicated that overall health and wellbeing is linked to psychosocial risk factors, such as depression, substance use, and even age for African American and Latinx women.
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Negro o Afroamericano , Etnicidad , Humanos , Femenino , Grupos Minoritarios , Hispánicos o Latinos/psicología , Factores de RiesgoRESUMEN
Ruthenium-106 has been observed to migrate in ground water at about the same velocity as tritium from the site of an underground nuclear explosion to a pumped satellite well 91 meters distant. This finding contradicts the prediction, based on laboratory batch sorption measurements, that ruthenium-106 should migrate at a much lower rate than tritium. To predict migration of radionuclides in ground water, more relevant laboratory measurements are required.
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A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has not been fixed in the paper.
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Effectively promoting women's health during and around the time of pregnancy requires early, nonstigmatizing identification and assessment of behavioral health risks (such as depression, substance use, smoking, and interpersonal violence) combined with timely linkage to community support and specialized interventions. This article describes an integrated approach to behavioral health risk screening woven into a point of first contact with the health care delivery system: centralized intake for maternal and child health home visiting programs. Behavioral Health Integrated Centralized Intake is a social work-informed, community-designed approach to screening, brief intervention, and service linkage targeting communities at high risk for fetal and infant mortality. Women enrolled in this study were receptive to holistic risk screening as well as guided referral for both home visiting support and specialized mental health interventions. Results from this multi-community study form the foundation for strengths-based, social work-informed enhancements to community health promotion programs.
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Atención Prenatal , Medición de Riesgo , Salud de la Mujer , Adulto , Niño , Servicios de Salud del Niño , Femenino , Visita Domiciliaria , Humanos , Embarazo , Derivación y ConsultaRESUMEN
Organic materials exhibit exceptional room temperature light emitting characteristics and enormous exciton oscillator strength, however, their low charge carrier mobility prevent their use in high-performance applications such as electrically pumped lasers. In this context, ultralow threshold polariton lasers, whose operation relies on Bose-Einstein condensation of polaritons - part-light part-matter quasiparticles, are highly advantageous since the requirement for high carrier injection no longer holds. Polariton lasers have been successfully implemented using inorganic materials owing to their excellent electrical properties, however, in most cases their relatively small exciton binding energies limit their operation temperature. It has been suggested that combining organic and inorganic semiconductors in a hybrid microcavity, exploiting resonant interactions between these materials would permit to dramatically enhance optical nonlinearities and operation temperature. Here, we obtain cavity mediated hybridization of GaAs and J-aggregate excitons in the strong coupling regime under electrical injection of carriers as well as polariton lasing up to 200 K under non-resonant optical pumping. Our demonstration paves the way towards realization of hybrid organic-inorganic microcavities which utilise the organic component for sustaining high temperature polariton condensation and efficient electrical injection through inorganic structure.
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Two-dimensional transition metal dichalcogenides exhibit strong optical transitions with significant potential for optoelectronic devices. In particular they are suited for cavity quantum electrodynamics in which strong coupling leads to polariton formation as a root to realisation of inversionless lasing, polariton condensation and superfluidity. Demonstrations of such strongly correlated phenomena to date have often relied on cryogenic temperatures, high excitation densities and were frequently impaired by strong material disorder. At room-temperature, experiments approaching the strong coupling regime with transition metal dichalcogenides have been reported, but well resolved exciton-polaritons have yet to be achieved. Here we report a study of monolayer WS2 coupled to an open Fabry-Perot cavity at room-temperature, in which polariton eigenstates are unambiguously displayed. In-situ tunability of the cavity length results in a maximal Rabi splitting of hΩRabi = 70 meV, exceeding the exciton linewidth. Our data are well described by a transfer matrix model appropriate for the large linewidth regime. This work provides a platform towards observing strongly correlated polariton phenomena in compact photonic devices for ambient temperature applications.
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One hundred eight eligible patients with advanced, metastatic non-small-cell lung cancer (NSCLC) were randomized to treatment with either cyclophosphamide, doxorubicin, and cisplatin (CAP) followed by mitomycin, lomustine, and methotrexate (MCM) on progression (sequential, 54 patients) or to CAP alternating with MCM (alternating, 54 patients). The regression rate (30%) was identical for both treatments. In addition, there were no statistically significant differences noted between treatments for regression duration (6.9 months v 7.6 months), time to progression (2.1 months v 4.4 months), or overall survival (5.5 months v 6.9 months). The lack of advantage for the theoretically superior alternating approach was probably due to a combination of relative ineffectiveness of each treatment and lack of complete non-cross resistance.
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Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Neoplasias Pulmonares/tratamiento farmacológico , Anciano , Carcinoma de Pulmón de Células no Pequeñas/mortalidad , Cisplatino/administración & dosificación , Ensayos Clínicos como Asunto , Ciclofosfamida/administración & dosificación , Doxorrubicina/administración & dosificación , Esquema de Medicación , Femenino , Humanos , Lomustina/administración & dosificación , Neoplasias Pulmonares/mortalidad , Masculino , Metotrexato/administración & dosificación , Persona de Mediana Edad , Mitomicina , Mitomicinas/administración & dosificación , Distribución Aleatoria , Factores de TiempoRESUMEN
We have used digitally recorded interference microscopy with automatic phase shifting (DRIMAPS) to investigate the crawling locomotion of normal and mutant mouse myoblasts. Contraction forces that give rise to cell body movement, tail retraction and cell adhesion to the substrate in myoblasts and other locomoting tissue cells arise from the interactions of actin and non-muscle myosin II. The activity of non-muscle myosin II is regulated differently from that of skeletal myosin. Using DRIMAPS, we found that crawling locomotion was altered in myoblasts that heterologously expressed human beta-cardiac myosin heavy chain (MHC); the cells moved more slowly and had reduced rates of protrusion and retraction. Immunolocalization demonstrated that MHC and non-muscle myosin II were not co-localized, suggesting that MHC does not compete directly with myosin II, but interferes with cell locomotion by binding inappropriately to actin filaments and possibly cross-linking them. Myosin I may be involved in protrusion of the lamellipodia. However, using DRIMAPS, we found that crawling locomotion was unaltered in myoblasts that heterologously expressed a truncated myosin I which lacked the membrane-binding tail domain. This suggests that, if endogenous myosin I is important for cell locomotion, this mutant was unable to interfere with its action. We conclude that the effects on locomotion of expressing foreign or mutant proteins of the cytoskeleton in vertebrate cells can be subtle and can be swamped by the intrinsic variability of the cells. Their characterization requires automated methods of acquiring data, such as DRIMAPS, and careful statistical analysis in order to take account of other sources of variation.
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Movimiento Celular/genética , Músculos/citología , Actinas/fisiología , Secuencia de Aminoácidos , Animales , Movimiento Celular/fisiología , Humanos , Ratones , Datos de Secuencia Molecular , Mutación , Miosinas/química , Miosinas/genética , Miosinas/fisiologíaRESUMEN
Thymomas and thymic carcinomas are thymic epithelial tumors that constitute approximately 15% of all mediastinal masses. From 28 to 66% of thymomas cause chest symptoms as the initial manifestation; the rest are discovered on routine chest roentgenograms or during investigations prompted by the presence of a paraneoplastic syndrome. Forty percent of patients with thymoma have one or more paraneoplastic syndromes, including myasthenia gravis, pure red cell aplasia, and hypogammaglobulinemia. Extrathymic malignant lesions develop in up to 20% of patients. Traditional histologic classifications have not accurately predicted tumor behavior; a recently developed classification based on cellular differentiation toward thymic medullary or cortical epithelium may correlate better with prognosis. Nevertheless, the prognosis is best predicted by stage of the tumor determined intraoperatively and is poorer in patients with incomplete resection than in those with complete resection of the thymoma. In addition to surgical intervention, irradiation and chemotherapy have important roles in the management of thymomas, particularly in advanced stages. In this article, the clinical manifestations, diagnosis, pathologic features, staging, and treatment of thymomas are reviewed, and the prognosis of affected patients is discussed.
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Timoma , Neoplasias del Timo , Humanos , Estadificación de Neoplasias , Síndromes Paraneoplásicos/etiología , Pronóstico , Timoma/complicaciones , Timoma/diagnóstico , Timoma/patología , Timoma/terapia , Timo/anatomía & histología , Timo/fisiología , Neoplasias del Timo/complicaciones , Neoplasias del Timo/diagnóstico , Neoplasias del Timo/patología , Neoplasias del Timo/terapiaRESUMEN
Based on a 10-year experience with 50 patients who had Wegener's granulomatosis, a new classification is proposed based on anatomic site of involvement: upper airway or ear, nose, and throat (designated E), lung (L), and kidney (K). All combinations of ELK were seen. The system is offered as a unifying concept to embrace the terms midline granuloma, generalized or classic Wegener's granulomatosis, and limited Wegener's granulomatosis. Fourteen patients have died despite the use of corticosteroids and immunosuppressant therapy. Thirteen patients with renal involvement have survived for periods as long as 114 months; all were taking immunosuppressive agents.
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Granulomatosis con Poliangitis/clasificación , Adolescente , Adulto , Anciano , Niño , Femenino , Granulomatosis con Poliangitis/tratamiento farmacológico , Granulomatosis con Poliangitis/patología , Humanos , Inmunosupresores/efectos adversos , Inmunosupresores/uso terapéutico , Masculino , Persona de Mediana Edad , Prednisona/uso terapéuticoRESUMEN
In 35 cases of pulmonary blastomycosis, the roentgenologic features were as follows: consolidation 26%, mass 31%, intermediate-sized nodules 6%, miliary pattern 11%, solitary cavity 9%, fibrotic and cavitary changes 6%, interstitial pattern 6%, diffuse alveolar involvement 3%, and mixed alveolar and interstitial infiltrate 3%. All symptomatic cases of consolidation were acute (symptoms for less than 1 month), and most were in young patients (mean age, 34 years). Consolidation constituted 58% of the acute cases in this series. Two of the nine cases of consolidation were asymptomatic epidemic cases detected by screening. A pulmonary mass was the most common initial manifestation in this series; it tended to occur in patients with chronic symptoms (more than 1 month). The mass was considered suggestive enough of bronchogenic carcinoma to necessitate resection in 55% of cases. The military form of pulmonary blastomycosis occurred in older patients with disseminated disease. Fibrotic and cavitary disease was chronic in nature. The presence of intermediate-sized nodules elsewhere in the lung proved to be a helpful diagnostic finding in several patients with consolidation, mass, or cavitary disease. Hilar adenopathy, postinfectious calcification, chest wall invasion, and pleural effusion occurred infrequently or not at all in this series.
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Blastomicosis/diagnóstico por imagen , Enfermedades Pulmonares Fúngicas/diagnóstico por imagen , Adolescente , Adulto , Anciano , Blastomicosis/terapia , Niño , Femenino , Humanos , Pulmón/diagnóstico por imagen , Enfermedades Pulmonares Fúngicas/terapia , Masculino , Persona de Mediana Edad , RadiografíaRESUMEN
Gossypibomas, masses of retained cotton materials, may produce a variety of postoperative complications. This case report of hemoptysis of 18 months' duration and cavitating chest masses in a 62-year-old man with previous cardiac operations illustrates several salient features about the presentation, differential diagnosis, and management of gossypibomas.