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1.
Proc Natl Acad Sci U S A ; 120(7): e2208738120, 2023 02 14.
Artículo en Inglés | MEDLINE | ID: mdl-36745804

RESUMEN

Founding populations of the first Americans likely occupied parts of Beringia during the Last Glacial Maximum (LGM). The timing, pathways, and modes of their southward transit remain unknown, but blockage of the interior route by North American ice sheets between ~26 and 14 cal kyr BP (ka) favors a coastal route during this period. Using models and paleoceanographic data from the North Pacific, we identify climatically favorable intervals when humans could have plausibly traversed the Cordilleran coastal corridor during the terminal Pleistocene. Model simulations suggest that northward coastal currents strengthened during the LGM and at times of enhanced freshwater input, making southward transit by boat more difficult. Repeated Cordilleran glacial-calving events would have further challenged coastal transit on land and at sea. Following these events, ice-free coastal areas opened and seasonal sea ice was present along the Alaskan margin until at least 15 ka. Given evidence for humans south of the ice sheets by 16 ka and possibly earlier, we posit that early people may have taken advantage of winter sea ice that connected islands and coastal refugia. Marine ice-edge habitats offer a rich food supply and traversing coastal sea ice could have mitigated the difficulty of traveling southward in watercraft or on land over glaciers. We identify 24.5 to 22 ka and 16.4 to 14.8 ka as environmentally favorable time periods for coastal migration, when climate conditions provided both winter sea ice and ice-free summer conditions that facilitated year-round marine resource diversity and multiple modes of mobility along the North Pacific coast.


Asunto(s)
Ecosistema , Agua Dulce , Humanos , América del Norte , Migración Humana , Océanos y Mares , Cubierta de Hielo
2.
Proc Natl Acad Sci U S A ; 120(23): e2219688120, 2023 Jun 06.
Artículo en Inglés | MEDLINE | ID: mdl-37252961

RESUMEN

Reversible scavenging, the oceanographic process by which dissolved metals exchange onto and off sinking particles and are thereby transported to deeper depths, has been well established for the metal thorium for decades. Reversible scavenging both deepens the elemental distribution of adsorptive elements and shortens their oceanic residence times in the ocean compared to nonadsorptive metals, and scavenging ultimately removes elements from the ocean via sedimentation. Thus, it is important to understand which metals undergo reversible scavenging and under what conditions. Recently, reversible scavenging has been invoked in global biogeochemical models of a range of metals including lead, iron, copper, and zinc to fit modeled data to observations of oceanic dissolved metal distributions. Nonetheless, the effects of reversible scavenging remain difficult to visualize in ocean sections of dissolved metals and to distinguish from other processes such as biological regeneration. Here, we show that particle-rich "veils" descending from high-productivity zones in the equatorial and North Pacific provide idealized illustrations of reversible scavenging of dissolved lead (Pb). A meridional section of dissolved Pb isotope ratios across the central Pacific shows that where particle concentrations are sufficiently high, such as within particle veils, vertical transport of anthropogenic surface-dissolved Pb isotope ratios toward the deep ocean is manifested as columnar isotope anomalies. Modeling of this effect shows that reversible scavenging within particle-rich waters allows anthropogenic Pb isotope ratios from the surface to penetrate ancient deep waters on timescales sufficiently rapid to overcome horizontal mixing of deep water Pb isotope ratios along abyssal isopycnals.

3.
Proc Natl Acad Sci U S A ; 120(30): e2300881120, 2023 Jul 25.
Artículo en Inglés | MEDLINE | ID: mdl-37459536

RESUMEN

Since the beginning of the satellite era, Southern Ocean sea surface temperatures (SSTs) have cooled, despite global warming. While observed Southern Ocean cooling has previously been reported to have minimal impact on the tropical Pacific, the efficiency of this teleconnection has recently shown to be mediated by subtropical cloud feedbacks that are highly model-dependent. Here, we conduct a coupled model intercomparison of paired ensemble simulations under historical radiative forcing: one with freely evolving SSTs and the other with Southern Ocean SST anomalies constrained to follow observations. We reveal a global impact of observed Southern Ocean cooling in the model with stronger (and more realistic) cloud feedbacks, including Antarctic sea-ice expansion, southeastern tropical Pacific cooling, northward-shifted Hadley circulation, Aleutian low weakening, and North Pacific warming. Our results therefore suggest that observed Southern Ocean SST decrease might have contributed to cooler conditions in the eastern tropical Pacific in recent decades.

4.
Proc Natl Acad Sci U S A ; 120(24): e2304773120, 2023 Jun 13.
Artículo en Inglés | MEDLINE | ID: mdl-37279267

RESUMEN

Increasing Asian dust fluxes, associated with late Cenozoic cooling and intensified glaciations, are conventionally thought to drive iron fertilization of phytoplankton productivity in the North Pacific, contributing to ocean carbon storage and drawdown of atmospheric CO2. During the early Pleistocene glaciations, however, productivity remained low despite higher Asian dust fluxes, only displaying glacial stage increases after the mid-Pleistocene climate transition (~800 ka B.P.). We solve this paradox by analyzing an Asian dust sequence, spanning the last 3.6 My, from the Tarim Basin, identifying a major switch in the iron composition of the dust at ~800 ka, associated with expansion of Tibetan glaciers and enhanced production of freshly ground rock minerals. This compositional shift in the Asian dust was recorded synchronously in the downwind, deep sea sediments of the central North Pacific. The switch from desert dust, containing stable, highly oxidized iron, to glacial dust, richer in reactive reduced iron, coincided with increased populations of silica-producing phytoplankton in the equatorial North Pacific and increased primary productivity in more northerly locations, such as the South China Sea. We calculate that potentially bioavailable Fe2+ flux to the North Pacific was more than doubled after the switch to glacially- sourced dust. These findings indicate a positive feedback between Tibetan glaciations, glaciogenic production of dust with enhanced iron bioavailability, and changes in North Pacific iron fertilization. Notably, this strengthened link between climate and eolian dust coincided with the mid-Pleistocene transition to increased storage of C in the glacial North Pacific and more intense northern hemisphere glaciations.

5.
Proc Natl Acad Sci U S A ; 120(33): e2209631120, 2023 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-37549274

RESUMEN

Most current climate models predict that the equatorial Pacific will evolve under greenhouse gas-induced warming to a more El Niño-like state over the next several decades, with a reduced zonal sea surface temperature gradient and weakened atmospheric Walker circulation. Yet, observations over the last 50 y show the opposite trend, toward a more La Niña-like state. Recent research provides evidence that the discrepancy cannot be dismissed as due to internal variability but rather that the models are incorrectly simulating the equatorial Pacific response to greenhouse gas warming. This implies that projections of regional tropical cyclone activity may be incorrect as well, perhaps even in the direction of change, in ways that can be understood by analogy to historical El Niño and La Niña events: North Pacific tropical cyclone projections will be too active, North Atlantic ones not active enough, for example. Other perils, including severe convective storms and droughts, will also be projected erroneously. While it can be argued that these errors are transient, such that the models' responses to greenhouse gases may be correct in equilibrium, the transient response is relevant for climate adaptation in the next several decades. Given the urgency of understanding regional patterns of climate risk in the near term, it would be desirable to develop projections that represent a broader range of possible future tropical Pacific warming scenarios-including some in which recent historical trends continue-even if such projections cannot currently be produced using existing coupled earth system models.

6.
Rev Med Virol ; 34(2): e2521, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38340071

RESUMEN

Dengue, Zika and chikungunya outbreaks pose a significant public health risk to Pacific Island communities. Differential diagnosis is challenging due to overlapping clinical features and limited availability of laboratory diagnostic facilities. There is also insufficient information regarding the complications of these arboviruses, particularly for Zika and chikungunya. We conducted a systematic review and meta-analysis to calculate pooled prevalence estimates with 95% confidence intervals (CI) for the clinical manifestations of dengue, Zika and chikungunya in the Pacific Islands. Based on pooled prevalence estimates, clinical features that may help to differentiate between the arboviruses include headache, haemorrhage and hepatomegaly in dengue; rash, conjunctivitis and peripheral oedema in Zika; and the combination of fever and arthralgia in chikungunya infections. We estimated that the hospitalisation and mortality rates in dengue were 9.90% (95% CI 7.67-12.37) and 0.23% (95% CI 0.16-0.31), respectively. Severe forms of dengue occurred in 1.92% (95% CI 0.72-3.63) of reported cases and 23.23% (95% CI 13.58-34.53) of hospitalised patients. Complications associated with Zika virus included Guillain-Barré syndrome (GBS), estimated to occur in 14.08 (95% CI 11.71-16.66) per 10,000 reported cases, and congenital brain malformations such as microcephaly, particularly with first trimester maternal infection. For chikungunya, the hospitalisation rate was 2.57% (95% CI 1.30-4.25) and the risk of GBS was estimated at 1.70 (95% CI 1.06-2.48) per 10,000 reported cases. Whilst ongoing research is required, this systematic review enhances existing knowledge on the clinical manifestations of dengue, Zika and chikungunya infections and will assist Pacific Island clinicians during future arbovirus outbreaks.


Asunto(s)
Fiebre Chikungunya , Dengue , Infección por el Virus Zika , Humanos , Fiebre Chikungunya/epidemiología , Fiebre Chikungunya/complicaciones , Fiebre Chikungunya/virología , Islas del Pacífico/epidemiología , Infección por el Virus Zika/epidemiología , Infección por el Virus Zika/complicaciones , Infección por el Virus Zika/virología , Dengue/epidemiología , Dengue/virología , Dengue/complicaciones , Prevalencia , Virus Zika , Brotes de Enfermedades , Hospitalización/estadística & datos numéricos , Virus Chikungunya
7.
Proc Natl Acad Sci U S A ; 119(23): e2120335119, 2022 Jun 07.
Artículo en Inglés | MEDLINE | ID: mdl-35639698

RESUMEN

SignificanceThe western Pacific subtropical high (WPSH) channels moisture from the tropics that underpins the East Asian summer climate. Interannual variability of the WPSH dominates climate extremes in the densely populated countries of East Asia. In 2020, an anomalously strong WPSH led to catastrophic floods with hundreds of deaths, 28,000 homes destroyed, and tens of billions in economic damage in China alone. How the frequency of such strong WPSH events will change is of great societal concern. Our finding of an increase in future WPSH variability, translating into an increased frequency of climate extreme as seen in the 2020 episode, highlights the increased risks for the billions of people in the densely populated East Asia with profound socioeconomic consequences.

8.
Proc Natl Acad Sci U S A ; 119(30): e2205602119, 2022 07 26.
Artículo en Inglés | MEDLINE | ID: mdl-35862459

RESUMEN

Comprehensive knowledge of the distribution of active hydrothermal vent fields along midocean ridges is essential to understanding global chemical and heat fluxes and endemic faunal distributions. However, current knowledge is biased by a historical preference for on-axis surveys. A scarcity of high-resolution bathymetric surveys in off-axis regions limits vent identification, which implies that the number of vents may be underestimated. Here, we present the discovery of an active, high-temperature, off-axis hydrothermal field on a fast-spreading ridge. The vent field is located 750 m east of the East Pacific Rise axis and ∼7 km north of on-axis vents at 9° 50'N, which are situated in a 50- to 100-m-wide trough. This site is currently the largest vent field known on the East Pacific Rise between 9 and 10° N. Its proximity to a normal fault suggests that hydrothermal fluid pathways are tectonically controlled. Geochemical evidence reveals deep fluid circulation to depths only 160 m above the axial magma lens. Relative to on-axis vents at 9° 50'N, these off-axis fluids attain higher temperatures and pressures. This tectonically controlled vent field may therefore exhibit greater stability in fluid composition, in contrast to more dynamic, dike-controlled, on-axis vents. The location of this site indicates that high-temperature convective circulation cells extend to greater distances off axis than previously realized. Thorough high-resolution mapping is necessary to understand the distribution, frequency, and physical controls on active off-axis vent fields so that their contribution to global heat and chemical fluxes and role in metacommunity dynamics can be determined.


Asunto(s)
Respiraderos Hidrotermales , Biodiversidad , Ecosistema , Océano Pacífico
9.
J Allergy Clin Immunol ; 153(1): 42-54, 2024 01.
Artículo en Inglés | MEDLINE | ID: mdl-37898409

RESUMEN

Hereditary angioedema (HAE) due to C1-inhibitor deficiency or dysfunction is a rare genetic disorder that causes recurrent episodes of swelling in various parts of the body. Treatment goals of HAE aim to "normalize" life for all patients; however, lack of diagnostic facilities and limited access to effective treatment options in developing nations cause delays in diagnosis and place a significant burden on patients. In this review, we aim to highlight the burden of disease caused by C1-inhibitor HAE across the Asia-Pacific region, considering its epidemiology, morbidity and mortality, and socioeconomic and psychological impact. We also review the availability of guideline-recommended diagnostic facilities and treatments, and how patients are currently managed. Data were collected from published literature and HAE experts in the region, who provided information regarding diagnosis and management in their countries. Current practice was reviewed against international guidelines, as well as local guidelines/consensus used in Australia, Japan, and China. Suggestions are provided for improving the time to diagnosis in the region, increasing access to guideline-recommended treatments, and providing support to reduce the burden on patients and caregivers. There is an urgent need to improve HAE services and provide access to life-saving treatment in developing countries, and efforts should be made to increase awareness of guideline recommendations in high-income economies that do not currently provide long-term prophylactic treatments.


Asunto(s)
Angioedemas Hereditarios , Humanos , Angioedemas Hereditarios/diagnóstico , Angioedemas Hereditarios/epidemiología , Angioedemas Hereditarios/terapia , Proteína Inhibidora del Complemento C1/genética , Resultado del Tratamiento , Asia/epidemiología , China , Japón
10.
Genet Epidemiol ; 47(1): 105-118, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-36352773

RESUMEN

The minor allele of rs373863828, a missense variant in CREB3 Regulatory Factor, is associated with several cardiometabolic phenotypes in Polynesian peoples. To better understand the variant, we tested the association of rs373863828 with a panel of correlated phenotypes (body mass index [BMI], weight, height, HDL cholesterol, triglycerides, and total cholesterol) using multivariate Bayesian association and network analyses in a Samoa cohort (n = 1632), Aotearoa New Zealand cohort (n = 1419), and combined cohort (n = 2976). An expanded set of phenotypes (adding estimated fat and fat-free mass, abdominal circumference, hip circumference, and abdominal-hip ratio) was tested in the Samoa cohort (n = 1496). In the Samoa cohort, we observed significant associations (log10 Bayes Factor [BF] ≥ 5.0) between rs373863828 and the overall phenotype panel (8.81), weight (8.30), and BMI (6.42). In the Aotearoa New Zealand cohort, we observed suggestive associations (1.5 < log10 BF < 5) between rs373863828 and the overall phenotype panel (4.60), weight (3.27), and BMI (1.80). In the combined cohort, we observed concordant signals with larger log10 BFs. In the Samoa-specific expanded phenotype analyses, we also observed significant associations between rs373863828 and fat mass (5.65), abdominal circumference (5.34), and hip circumference (5.09). Bayesian networks provided evidence for a direct association of rs373863828 with weight and indirect associations with height and BMI.


Asunto(s)
Adiposidad , Pueblos Isleños del Pacífico , Proteínas Supresoras de Tumor , Humanos , Teorema de Bayes , Índice de Masa Corporal , Análisis Multivariante , Obesidad/genética , Proteínas Supresoras de Tumor/genética , Mutación Missense
11.
Emerg Infect Dis ; 30(8): 1683-1686, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39043453

RESUMEN

Ceftriaxone-resistant Neisseria gonorrhoeae FC428-like strains have disseminated across the Asia-Pacific region, with a continuous rise in prevalence during 2015-2022. To mitigate the effect of these strains, we advocate for enhanced molecular diagnostics, expanded surveillance networks, and a regionally coordinated effort to combat the global spread of FC428-like strains.


Asunto(s)
Antibacterianos , Ceftriaxona , Farmacorresistencia Bacteriana , Gonorrea , Neisseria gonorrhoeae , Neisseria gonorrhoeae/efectos de los fármacos , Neisseria gonorrhoeae/genética , Ceftriaxona/farmacología , Humanos , Gonorrea/microbiología , Gonorrea/epidemiología , Gonorrea/tratamiento farmacológico , Asia/epidemiología , Antibacterianos/farmacología , Pruebas de Sensibilidad Microbiana , Prevalencia , Historia del Siglo XXI
12.
Cancer Sci ; 115(4): 1273-1282, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38287788

RESUMEN

Durvalumab has been administered to patients with unresectable stage III non-small cell lung cancer (NSCLC). However, it remains unclear whether durvalumab benefits these patients with epidermal growth factor receptor (EGFR) mutation. We conducted a retrospective, multicenter study of patients with EGFR mutation who received chemoradiotherapy (CRT) between June 2018 and March 2021. We assessed patient characteristics, efficacy of durvalumab, and durvalumab safety before and after targeted therapy. We collected data on a total of 673 patients, of whom 401 (59.6%) underwent EGFR mutation testing. Fifty-one patients were EGFR positive and 311 were EGFR negative. In the EGFR-positive group, there were higher proportions of females, never-smokers, and patients with adenocarcinoma histology. Of the 51 patients in the positive group and 311 in the negative group who received CRT, 45 (88.2%) and 247 (79.4%) received durvalumab, with median progression-free survival of 23.0 and 24.2 months in the positive and negative groups, respectively (hazard ratio 1.03; 95% confidence interval: 0.64-1.67). The main adverse event was pneumonitis (positive group: 62.2%; 4.4% grade 3; negative group: 62.3%; 6.9% grade 3). No treatment-related deaths were observed. Of the 45 patients in the positive group who received durvalumab, 14 (31.1%) received targeted therapy after durvalumab at the data cutoff. One patient discontinued targeted therapy after developing pneumonitis. In patients with unresectable stage III NSCLC with EGFR mutation, durvalumab after CRT is potentially safe and effective. This may be a suitable treatment sequence for these patients.


Asunto(s)
Anticuerpos Monoclonales , Carcinoma de Pulmón de Células no Pequeñas , Neoplasias Pulmonares , Neumonía , Femenino , Humanos , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Carcinoma de Pulmón de Células no Pequeñas/genética , Estudios Retrospectivos , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/genética , Quimioradioterapia , Mutación , Receptores ErbB/genética
13.
Am J Epidemiol ; 2024 Jun 12.
Artículo en Inglés | MEDLINE | ID: mdl-38872337

RESUMEN

Nguyen et al. (Am J Epidemiol. 2024;XXX(XX):XXX-XXX) analyzed data from the U.S. National Survey of Drug Use and Health (NSDUH) to show that Asian American Native Hawaiian/Pacific Islander (AANHPI) adults with limited English proficiency have substantially lower levels of mental health services utilization compared with White adults without limited English proficiency. The findings add to the growing literature using an intersectionality framework to understand health and healthcare disparities. We comment on the authors' notable examination of intersecting minoritized identities in mental health services utilization and the welcome emphasis on AANHPI health. We discuss the limitations of the NSDUH data, which is administered in English and Spanish only, and its limited ability to support analyses disaggregated by ethnoracial subgroups. We conclude by identifying gaps related to funding, training, and data disaggregation, and highlight the role of mixed methods approaches to advance our understanding of intersectionality and health disparities research.

14.
Am J Epidemiol ; 2024 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-38973744

RESUMEN

Literature shows heterogeneous age-standardized dementia incidence rates across US Asian American, Native Hawaiian, and Pacific Islanders (AANHPI), but no estimates of population-representative dementia incidence exist due to lack of AANHPI longitudinal probability samples. We compared harmonized characteristics between AANHPI Kaiser Permanente Northern California members (KPNC cohort) and the target population of AANHPI 60+ with private or Medicare insurance using the California Health Interview Survey. We used stabilized inverse odds of selection weights (sIOSW) to estimate ethnicity-specific crude and age-standardized dementia incidence rates and cumulative risk by age 90 in the target population. Differences between the KPNC cohort and target population varied by ethnicity. sIOSW eliminated most differences in larger ethnic groups; some differences remained in smaller groups. Estimated crude dementia incidence rates using sIOSW (versus unweighted) were similar in Chinese, Filipinos, Pacific Islanders and Vietnamese, and higher in Japanese, Koreans, and South Asians. Unweighted and weighted age-standardized incidence rates differed for South Asians. Unweighted and weighted cumulative risk were similar for all groups. We estimated the first population-representative dementia incidence rates and cumulative risk in AANHPI ethnic groups. We encountered some estimation problems and weighted estimates were imprecise, highlighting challenges using weighting to extend inferences to target populations.

15.
Clin Gastroenterol Hepatol ; 22(3): 455-469.e7, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38081492

RESUMEN

Colorectal cancer (CRC) epidemiology is changing due to a birth cohort effect, first recognized by increasing incidence of early onset CRC (EOCRC, age <50 years). In this paper, we define "birth cohort CRC" as the observed phenomenon, among individuals born 1960 and later, of increasing CRC risk across successive birth cohorts, rising EOCRC incidence, increasing incidence among individuals aged 50 to 54 years, and flattening of prior decreasing incidence among individuals aged 55 to 74 years. We demonstrate birth cohort CRC is associated with unique features, including increasing rectal cancer (greater than colon) and distant (greater than local) stage CRC diagnosis, and increasing EOCRC across all racial/ethnic groups. We review potential risk factors, etiologies, and mechanisms for birth cohort CRC, using EOCRC as a starting point and describing importance of viewing these through the lens of birth cohort. We also outline implications of birth cohort CRC for epidemiologic and translational research, as well as current clinical practice. We postulate that recognition of birth cohort CRC as an entity-including and extending beyond rising EOCRC-can advance understanding of risk factors, etiologies, and mechanisms, and address the public health consequences of changing CRC epidemiology.


Asunto(s)
Neoplasias Colorrectales , Neoplasias del Recto , Humanos , Neoplasias Colorrectales/diagnóstico , Neoplasias Colorrectales/epidemiología , Cohorte de Nacimiento , Grupos Raciales , Factores de Riesgo
16.
Breast Cancer Res Treat ; 203(3): 533-542, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37897647

RESUMEN

PURPOSE: While breast cancer studies often aggregate Asian/Pacific Islander (API) women, as a single group or exclude them, this population is heterogeneous in terms of genetic background, environmental exposures, and health-related behaviors, potentially resulting in different cancer outcomes. Our purpose was to evaluate risks of contralateral breast cancer (CBC) among subgroups of API women with breast cancer. METHODS: We conducted a retrospective cohort study of women ages 18 + years diagnosed with stage I-III breast cancer between 2000 and 2016 in the Surveillance, Epidemiology and End Results registries. API subgroups included Chinese, Japanese, Filipina, Native Hawaiian, Korean, Vietnamese, Indian/Pakistani, and other API women. Asynchronous CBC was defined as breast cancer diagnosed in the opposite breast 12 + months after first primary unilateral breast cancer. Multivariable-adjusted subdistribution hazard ratios (SHR) and 95% confidence intervals (CI) were estimated and stratified by API subgroups. RESULTS: From a cohort of 44,362 API women with breast cancer, 25% were Filipina, 18% were Chinese, 14% were Japanese, and 8% were Indian/Pakistani. API women as an aggregate group had increased risk of CBC (SHR 1.15, 95% CI 1.08-1.22) compared to NHW women, among whom Chinese (SHR 1.23, 95% CI 1.08-1.40), Filipina (SHR 1.37, 95% CI 1.23-1.52), and Native Hawaiian (SHR 1.69, 95% CI 1.37-2.08) women had greater risks. CONCLUSION: Aggregating or excluding API patients from breast cancer studies ignores their heterogeneous health outcomes. To advance cancer health equity among API women, future research should examine inequities within the API population to design interventions that can adequately address their unique differences.


Asunto(s)
Neoplasias de la Mama , Femenino , Humanos , Asiático/estadística & datos numéricos , Neoplasias de la Mama/epidemiología , Neoplasias de la Mama/etnología , Neoplasias de la Mama/etiología , Hawaii , Nativos de Hawái y Otras Islas del Pacífico/estadística & datos numéricos , Estudios Retrospectivos , Estados Unidos/epidemiología , Adolescente , Adulto Joven , Adulto
17.
Cancer Causes Control ; 35(4): 635-645, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38001334

RESUMEN

PURPOSE: The incidence and mortality rates of colorectal cancer (CRC) remain consistently high in rural populations. Telehealth can improve screening uptake by overcoming individual and environmental disadvantages in rural communities. The present study aimed to characterize varying barriers to CRC screening between rural individuals with and without experience in using telehealth. METHOD: The cross-sectional study surveyed 250 adults aged 45-75 residing in rural U.S. states of Alaska, Idaho, Oregon, and Washington from June to September 2022. The associations between CRC screening and four sets of individual and environmental factors specific to rural populations (i.e., demographic characteristics, accessibility, patient-provider factors, and psychological factors) were assessed among respondents with and without past telehealth adoption. RESULT: Respondents with past telehealth use were more likely to screen if they were married, had a better health status, had experienced discrimination in health care, and had perceived susceptibility, screening efficacy, and cancer fear, but less likely to screen when they worried about privacy or had feelings of embarrassment, pain, and discomfort. Among respondents without past telehealth use, the odds of CRC screening decreased with busy schedules, travel burden, discrimination in health care, and lower perceived needs. CONCLUSION: Rural individuals with and without previous telehealth experience face different barriers to CRC screening. The finding suggests the potential efficacy of telehealth in mitigating critical barriers to CRC screening associated with social, health care, and built environments of rural communities.


Asunto(s)
Neoplasias Colorrectales , Telemedicina , Adulto , Humanos , Población Rural , Estudios Transversales , Detección Precoz del Cáncer/psicología , Neoplasias Colorrectales/diagnóstico , Neoplasias Colorrectales/epidemiología , Neoplasias Colorrectales/prevención & control , Washingtón/epidemiología
18.
Cancer Causes Control ; 35(5): 839-848, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38227176

RESUMEN

PURPOSE: Acute lymphoblastic leukemia (ALL) is a type of blood cancer that affects white blood cells. Here, we use data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, to estimate the burden and incidence rate changes in adolescents and young adults (AYA) ALL in the Western Pacific Region and to reveal potential risk factors of incidence- and mortality rates. METHODS: The GBD 2019 study data was stratified by sex, age, country, and territory. We calculated the Estimated annual percentage changes (estimated APC) in mortality and incidence rates for each of the 25 countries and territories of the western Pacific region from 1990 to 2019. RESULTS: This study found global AYA ALL incidence rates had increased while the mortality rates had decreased between 1990 and 2019. Moreover, healthcare access and quality (HAQ), and government per capita health spending were identified as country-level risk factors of AYA ALL incidence rates, while HAQ, male education, and sex were identified as mortality rate predictors in 25 Western Pacific Region countries. CONCLUSION: To address and reduce the burden of incidence and mortality among AYA, various regions around the world, particularly developing countries, could revise their AYA prevention and treatment strategies.


Asunto(s)
Carga Global de Enfermedades , Leucemia-Linfoma Linfoblástico de Células Precursoras , Humanos , Masculino , Adolescente , Femenino , Adulto Joven , Incidencia , Leucemia-Linfoma Linfoblástico de Células Precursoras/epidemiología , Leucemia-Linfoma Linfoblástico de Células Precursoras/mortalidad , Adulto , Factores de Riesgo , Costo de Enfermedad
19.
Mol Genet Metab ; 142(3): 108508, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38820906

RESUMEN

Short-chain enoyl-coA hydratase (SCEH) deficiency due to biallelic pathogenic ECHS1 variants was first reported in 2014 in association with Leigh syndrome (LS) and increased S-(2-carboxypropyl)cysteine excretion. It is potentially treatable with a valine-restricted, high-energy diet and emergency regimen. Recently, Simon et al. described four Samoan children harbouring a hypomorphic allele (c.489G > A, p.Pro163=) associated with reduced levels of normally-spliced mRNA. This synonymous variant, missed on standard genomic testing, is prevalent in the Samoan population (allele frequency 0.17). Patients with LS and one ECHS1 variant were identified in NZ and Australian genomic and clinical databases. ECHS1 sequence data were interrogated for the c.489G > A variant and clinical data were reviewed. Thirteen patients from 10 families were identified; all had Pacific ancestry including Samoan, Maori, Cook Island Maori, and Tokelauan. All developed bilateral globus pallidi lesions, excluding one pre-symptomatic infant. Symptom onset was in early childhood, and was triggered by illness or starvation in 9/13. Four of 13 had exercise-induced dyskinesia, 9/13 optic atrophy and 6/13 nystagmus. Urine S-(2-carboxypropyl)cysteine-carnitine and other SCEH-related metabolites were normal or mildly increased. Functional studies demonstrated skipping of exon four and markedly reduced ECHS1 protein. These data provide further support for the pathogenicity of this ECHS1 variant which is also prevalent in Maori, Cook Island Maori, and Tongan populations (allele frequency 0.14-0.24). It highlights the need to search for a second variant in apparent heterozygotes with an appropriate phenotype, and has implications for genetic counselling in family members who are heterozygous for the more severe ECHS1 alleles. SYNOPSIS: Short-chain enoyl-CoA hydratase deficiency is a frequent cause of Leigh-like disease in Maori and wider-Pacific populations, due to the high carrier frequency of a hypomorphic ECHS1 variant c.489G > A, p.[Pro163=, Phe139Valfs*65] that may be overlooked by standard genomic testing.


Asunto(s)
Enoil-CoA Hidratasa , Enfermedad de Leigh , Humanos , Enoil-CoA Hidratasa/genética , Enoil-CoA Hidratasa/deficiencia , Masculino , Femenino , Lactante , Australia/epidemiología , Enfermedad de Leigh/genética , Preescolar , Niño , Mutación , Nueva Zelanda , Alelos , Frecuencia de los Genes
20.
Appl Environ Microbiol ; 90(4): e0003224, 2024 04 17.
Artículo en Inglés | MEDLINE | ID: mdl-38551354

RESUMEN

Aerobic anoxygenic phototrophic (AAP) bacteria harvest light energy using bacteriochlorophyll-containing reaction centers to supplement their mostly heterotrophic metabolism. While their abundance and growth have been intensively studied in coastal environments, much less is known about their activity in oligotrophic open ocean regions. Therefore, we combined in situ sampling in the North Pacific Subtropical Gyre, north of O'ahu island, Hawaii, with two manipulation experiments. Infra-red epifluorescence microscopy documented that AAP bacteria represented approximately 2% of total bacteria in the euphotic zone with the maximum abundance in the upper 50 m. They conducted active photosynthetic electron transport with maximum rates up to 50 electrons per reaction center per second. The in situ decline of bacteriochlorophyll concentration over the daylight period, an estimate of loss rates due to predation, indicated that the AAP bacteria in the upper 50 m of the water column turned over at rates of 0.75-0.90 d-1. This corresponded well with the specific growth rate determined in dilution experiments where AAP bacteria grew at a rate 1.05 ± 0.09 d-1. An amendment of inorganic nitrogen to obtain N:P = 32 resulted in a more than 10 times increase in AAP abundance over 6 days. The presented data document that AAP bacteria are an active part of the bacterioplankton community in the oligotrophic North Pacific Subtropical Gyre and that their growth was mostly controlled by nitrogen availability and grazing pressure.IMPORTANCEMarine bacteria represent a complex assembly of species with different physiology, metabolism, and substrate preferences. We focus on a specific functional group of marine bacteria called aerobic anoxygenic phototrophs. These photoheterotrophic organisms require organic carbon substrates for growth, but they can also supplement their metabolic needs with light energy captured by bacteriochlorophyll. These bacteria have been intensively studied in coastal regions, but rather less is known about their distribution, growth, and mortality in the oligotrophic open ocean. Therefore, we conducted a suite of measurements in the North Pacific Subtropical Gyre to determine the distribution of these organisms in the water column and their growth and mortality rates. A nutrient amendment experiment showed that aerobic anoxygenic phototrophs were limited by inorganic nitrogen. Despite this, they grew more rapidly than average heterotrophic bacteria, but their growth was balanced by intense grazing pressure.


Asunto(s)
Bacterioclorofilas , Procesos Fototróficos , Bacterioclorofilas/metabolismo , Bacterias Aerobias , Agua/metabolismo , Nitrógeno/metabolismo , Agua de Mar/microbiología
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