Effect of the NFL's Super Bowl on emergency department visits for assault-related injuries.

PURPOSE: Through its associations with mass gatherings, alcohol consumption, emotional cues, and gambling, the Super Bowl (SB) has been implicated in increased rates of interpersonal violence and assaults. This study endeavors to investigate the relationship between assault-related injuries, especially intimate partner violence (IPV) and SB. METHOD: A retrospective review of prospectively collected data from the National Electronic Injury Surveillance System (NEISS) spanning 2005 to 2017 was conducted. Assault-related injuries were examined in relation to (1) the 4-day Super Bowl weekend (Friday-Monday), (2) Super Bowl Sunday, and (3) the Super Bowl week (Friday-Thursday) for all years, following the loss of the projected winning team (underdog victories), and losses despite a significant point spread favoring one team (upset losses). National estimates of injuries and associated variables were derived using the SUDAAN software. RESULTS: While there were no significant differences in the overall number of assaults or assault types during the SB weekend (5.6% vs 5.5%; p = 0.31), relative decreases were observed for altercations (21.1% vs 24.8%; p < 0.01), sexual assault (3.4% vs 4.0%; p < 0.01), and IPV (8.3% vs 12.5%; p < 0.01) on the Friday preceding SB, and robbery incidents on SB Sunday (2.1% vs 3.5%; p = 0.01). No changes in the incidence of assault-related injuries were found based on the favored or underdog status of the teams, including upset losses. CONCLUSION: Contrary to expectations, SB was not associated with increased assault-related injuries. This study underscores the need for year-round structural changes in addressing violence rather than relying solely on heightened awareness during specific events.

Trauma and female reproductive health across the lifecourse: motivating a research agenda for the future of women's health.

The aetiology behind many female reproductive disorders is poorly studied and incompletely understood despite the prevalence of such conditions and substantial burden they impose on women's lives. In light of evidence demonstrating a higher incidence of trauma exposure in women with many such disorders, we present a set of interlinked working hypotheses proposing relationships between traumatic events and reproductive and mental health that can define a research agenda to better understand reproductive outcomes from a trauma-informed perspective across the lifecourse. Additionally, we note the potential for racism to act as a traumatic experience, highlight the importance of considering the interaction between mental and reproductive health concerns, and propose several neuroendocrinological mechanisms by which traumatic experiences might increase the risk of adverse health outcomes in these domains. Finally, we emphasize the need for future primary research investigating the proposed pathways between traumatic experiences and adverse female reproductive outcomes.

Assault-related anoxia and neck injuries in US emergency departments.

BACKGROUND: Early identification of non-fatal strangulation in the context of intimate partner violence (IPV) is crucial due to its severe physical and psychological consequences for the individual experiencing it. This study investigates the under-reported and underestimated burden of IPV-related non-fatal strangulation by analysing assault-related injuries leading to anoxia and neck injuries. METHODS: An IRB-exempt, retrospective review of prospectively collected data were performed using the National Electronic Injury Surveillance System All Injury Programme data from 2005 to 2019 for all assaults resulting in anoxia and neck injuries. The type and mechanism of assault injuries resulting in anoxia (excluding drowning, poisoning and aspiration), anatomical location of assault-related neck injuries and neck injury diagnosis by morphology, were analysed using statistical methods accounting for the weighted stratified nature of the data. RESULTS: Out of a total of 24 493 518 assault-related injuries, 11.6% (N=2 842 862) resulted from IPV (defined as perpetrators being spouses/partners). Among 22 764 cases of assault-related anoxia, IPV accounted for 40.4%. Inhalation and suffocation were the dominant mechanisms (60.8%) of anoxia, with IPV contributing to 41.9% of such cases. Neck injuries represented only 3.0% of all assault-related injuries, with IPV accounting for 21% of all neck injuries and 31.9% of neck contusions. CONCLUSIONS: The study reveals a significant burden of IPV-related anoxia and neck injuries, highlighting the importance of recognising IPV-related strangulation. Comprehensive screening for IPV should be conducted in patients with unexplained neck injuries, and all IPV patients should be screened for strangulation events.

Short-wavelength optoacoustic spectroscopy based on water muting.

Infrared (IR) optoacoustic spectroscopy can separate a multitude of molecules based on their absorption spectra. However, the technique is limited when measuring target molecules in aqueous solution by strong water absorption at IR wavelengths, which reduces detection sensitivity. Based on the dependence of optoacoustic signal on the temperature of the probed medium, we introduce cooled IR optoacoustic spectroscopy (CIROAS) to mute water contributions in optoacoustic spectroscopy. We showcase that spectral measurements of proteins, lipids, and glucose in the short-wavelength IR region, performed at 4 °C, lead to marked sensitivity improvements over conventional optoacoustic or IR spectroscopy. We elaborate on the dependence of optoacoustic signals on water temperature and demonstrate polarity changes in the recorded signal at temperatures below 4 °C. We further elucidate the dependence of the optoacoustic signal and the muting temperature on sample concentration and demonstrate that changes in these dependences enable quantification of the solute concentration. We discuss how CIROAS may enhance abilities for molecular sensing in the IR.

Holiday effect on injuries sustained by assault victims seen in US emergency departments.

PURPOSE: There has been a limited and inconsistent analysis of assault-related injury patterns associated with holidays. We investigated the temporal variation in assault-related injuries presenting to US emergency departments (ED) around holidays. METHODS: We examined data from the National Electronic Injury Surveillance System Database between 2005 and 2017 for six categories of assault-related injuries: altercation, sexual assault, robbery, intimate partner violence (IPV), other specified, and unknown. Differences between holiday and non-holiday periods were analyzed for each assault type. RESULTS: There was a significant difference in overall assault-related injury visits between holiday and non-holiday periods (p < 0.00001). Of over 21 million assault-related injury visits, 14.9% occurred during holiday periods and 85% during non-holiday periods. The difference between the daily number of assault-related ED visits was also significantly higher during the holiday period than baseline non-holiday period (p < 0.00001). Altercations and IPV were significantly higher than baseline for New Year's Eve (highest), St. Patrick's Day, July 4th, and Labor Day. IPV also remained significantly higher than baseline during Thanksgiving and Christmas. Sexual assaults were significantly higher than baseline during the New Year's Eve period but lower than baseline during Christmas and Easter. CONCLUSIONS: Holidays are associated with increase in several assault-related injuries. The information can help allocate healthcare resources and guide prevention strategies.

"Because the resources aren't there, then we fail. We fail as a society": A Qualitative Analysis of Human Trafficking Provider Perceptions of Child Welfare Involvement among Trafficked Mothers.

BACKGROUND: Little is understood about child welfare involvement (CWI) in cases where the birth mother has experienced human trafficking. OBJECTIVES: The aim of this study was to explore provider perceptions of the impact of CWI for the trafficked mother. METHODS: Participants were selected among providers caring for trafficked birth mothers. Semi-structured interviews were conducted with providers and qualitative content analysis was conducted. RESULTS: Interviewees reported reasons for CWI, positive and negative impacts of CWI and provided recommendations for systems improvement. CONCLUSION FOR PRACTICE: Recommendations from this exploratory study include mechanisms to support trafficked mothers, train hospital social workers, and systems change. During the prenatal period, strategies to support the trafficked mother may include addressing gaps in social determinants of health, ensuring appropriate medical and mental health care, early screening and referral to substance use treatment services, enhancing community support, and working to develop safety plans for survivors and their families. Enhanced engagement of social workers and all providers to improve understanding of the unique complexity of trafficked mothers is needed. Education should include an understanding that judgement of a caretaker's ability to parent should be current and holistic and not reflexive based on history in the electronic medical record. An exploration of the child welfare system itself should also be undertaken to identify and modify discriminatory laws and policies. Finally, efforts to address social determinants of health in the community and enhance the trauma-informed nature of child welfare referrals could improve the lives of trafficked mothers.

Model resolution matrix based deconvolution improves over non-quadratic penalization in frequency-domain photoacoustic tomography.

Frequency domain photoacoustic tomography is becoming more attractive due to low-cost and compact light-sources being used; however, frequency-domain implementation suffers from lower signal to noise compared to time-domain implementation. In this work, we have developed a non-quadratic based penalization framework for frequency-domain photoacoustic imaging, and further proposed a two-step model-resolution matrix based deconvolution approach to improve the reconstruction image quality. The model-resolution matrix was developed in the context of different penalty functions like l2-norm, l1-norm, Cauchy, and Geman-McClure. These model-resolution matrices were then used to perform the deconvolution operation using split augmented Lagrangian shrinkage thresholding algorithm in both full-view and limited-view configurations. The results indicated that the two-step approach outperformed the different penalty function (prior constraint) based reconstruction, with an improvement of about 20% in terms of peak signal to noise ratio and 30% in terms of structural similarity index measure. The improved image quality provided using these algorithms will have a direct impact on realizing practical frequency-domain implementation in both limited-view and full-view configurations.

Quantifying dynamic range in red blood cell energetics: Evidence of progressive energy failure during storage.

BACKGROUND: During storage, red blood cells (RBCs) undergo significant biochemical and morphologic changes, referred to collectively as the "storage lesion". It was hypothesized that these defects may arise from disrupted oxygen-based regulation of RBC energy metabolism, with resultant depowering of intrinsic antioxidant systems. STUDY DESIGN AND METHODS: As a function of storage duration, the dynamic range in RBC metabolic response to three models of biochemical oxidant stress (methylene blue, hypoxanthine/xanthine oxidase, and diamide) was assessed, comparing glycolytic flux by NMR and UHPLC-MS methodologies. Blood was processed/stored under standard conditions (AS-1 additive solution) with leukoreduction. Over a 6-week period, RBC metabolic and antioxidant status were assessed at baseline and following exposure to the three biochemical oxidant models. Comparison was made of glycolytic flux (1 H-NMR tracking of [2-13 C]-glucose and metabolomic phenotyping with [1,2,3-13 C3 ] glucose), reducing equivalent (NADPH/NADP+ ) recycling, and thiol-based (GSH/GSSG) antioxidant status. RESULTS: As a function of storage duration, we observed the following: (1) a reduction in baseline hexose monophosphate pathway (HMP) flux, the sole pathway responsible for the regeneration of the essential reducing equivalent NADPH; with (2) diminished stress-based dynamic range in both overall glycolytic as well as proportional HMP flux. In addition, progressive with storage duration, RBCs showed (3) constraint in reducing equivalent (NADPH) recycling capacity, (4) loss of thiol based (GSH) recycling capacity, and (5) dysregulation of metabolon assembly at the cytoplasmic domain of Band 3 membrane protein (cdB3). CONCLUSION: Blood storage disturbs normal RBC metabolic control, depowering antioxidant capacity and enhancing vulnerability to oxidative injury.

Humanized cereblon mice revealed two distinct therapeutic pathways of immunomodulatory drugs.

Immunomodulatory drugs (IMiDs), including thalidomide derivatives such as lenalidomide and pomalidomide, offer therapeutic benefit in several hematopoietic malignancies and autoimmune/inflammatory diseases. However, it is difficult to study the IMiD mechanism of action in murine disease models because murine cereblon (CRBN), the substrate receptor for IMiD action, is resistant to some of IMiDs therapeutic effects. To overcome this difficulty, we generated humanized cereblon (CRBNI391V) mice thereby providing an animal model to unravel complex mechanisms of action in a murine physiological setup. In our current study, we investigated the degradative effect toward IKZF1 and CK-1α, a target substrate of IMiDs. Unlike WT mice which were resistant to lenalidomide and pomalidomide, T lymphocytes from CRBNI391V mice responded with a higher degree of IKZF1 and CK-1α protein degradation. Furthermore, IMiDs resulted in an increase in IL-2 among CRBNI391V mice but not in the WT group. We have also tested a thalidomide derivative, FPFT-2216, which showed an inhibitory effect toward IKZF1 protein level. As opposed to pomalidomide, FPFT-2216 and lenalidomide degrades CK-1α. Additionally, we assessed the potential therapeutic effects of IMiDs in dextran sodium sulfate (DSS)-induced colitis. In both WT and humanized mice, lenalidomide showed a significant therapeutic effect in the DSS model of colitis, while the effect of pomalidomide was less pronounced. Thus, while IMiDs' degradative effect on IKZF1 and CK-1α, and up-regulation of IL-2, is dependent on CRBN, the therapeutic benefit of IMiDs in a mouse model of inflammatory bowel disease occurs through a CRBN-IMiD binding region independent pathway.

Targeting Elastase for Molecular Imaging of Early Atherosclerotic Lesions.

OBJECTIVE: Neutrophils accumulate in early atherosclerotic lesions and promote lesion growth. In this study, we evaluated an elastase-specific near-infrared imaging agent for molecular imaging using hybrid fluorescence molecular tomography/x-ray computed tomography. APPROACH AND RESULTS: Murine neutrophils were isolated from bone marrow and incubated with the neutrophil-targeted near-infrared imaging agent Neutrophil Elastase 680 FAST for proof of principle experiments, verifying that the elastase-targeted fluorescent agent is specifically cleaved and activated by neutrophil content after lysis or cell stimulation. For in vivo experiments, low-density lipoprotein receptor-deficient mice were placed on a Western-type diet and imaged after 4, 8, and 12 weeks by fluorescence molecular tomography/x-ray computed tomography. Although this agent remains silent on injection, it produces fluorescent signal after cleavage by neutrophil elastase. After hybrid fluorescence molecular tomography/x-ray computed tomography imaging, mice were euthanized for whole-body cryosectioning and histological analyses. The in vivo fluorescent signal in the area of the aortic arch was highest after 4 weeks of high-fat diet feeding and decreased at 8 and 12 weeks. Ex vivo whole-body cryoslicing confirmed the fluorescent signal to locate to the aortic arch and to originate from the atherosclerotic arterial wall. Histological analysis demonstrated the presence of neutrophils in atherosclerotic lesions. CONCLUSIONS: This study provides evidence that elastase-targeted imaging can be used for in vivo detection of early atherosclerosis. This imaging approach may harbor potential in the clinical setting for earlier diagnosis and treatment of atherosclerosis.

Three-dimensional optoacoustic reconstruction using fast sparse representation.

Optoacoustic tomography based on insufficient spatial sampling of ultrasound waves leads to loss of contrast and artifacts on the reconstructed images. Compared to reconstructions based on L2-norm regularization, sparsity-based reconstructions may improve contrast and reduce image artifacts but at a high computational cost, which has so far limited their use to 2D optoacoustic tomography. Here we propose a fast, sparsity-based reconstruction algorithm for 3D optoacoustic tomography, based on gradient descent with Barzilai-Borwein line search (L1-GDBB). Using simulations and experiments, we show that the L1-GDBB offers fourfold faster reconstruction than the previously reported L1-norm regularized reconstruction based on gradient descent with backtracking line search. Moreover, the new algorithm provides higher-quality images with fewer artifacts than the L2-norm regularized reconstruction and the back-projection reconstruction.

Toward real-time availability of 3D temperature maps created with temporally constrained reconstruction.

PURPOSE: To extend the previously developed temporally constrained reconstruction (TCR) algorithm to allow for real-time availability of three-dimensional (3D) temperature maps capable of monitoring MR-guided high intensity focused ultrasound applications. METHODS: A real-time TCR (RT-TCR) algorithm is developed that only uses current and previously acquired undersampled k-space data from a 3D segmented EPI pulse sequence, with the image reconstruction done in a graphics processing unit implementation to overcome computation burden. Simulated and experimental data sets of HIFU heating are used to evaluate the performance of the RT-TCR algorithm. RESULTS: The simulation studies demonstrate that the RT-TCR algorithm has subsecond reconstruction time and can accurately measure HIFU-induced temperature rises of 20°C in 15 s for 3D volumes of 16 slices (RMSE = 0.1°C), 24 slices (RMSE = 0.2°C), and 32 slices (RMSE = 0.3°C). Experimental results in ex vivo porcine muscle demonstrate that the RT-TCR approach can reconstruct temperature maps with 192 × 162 × 66 mm 3D volume coverage, 1.5 × 1.5 × 3.0 mm resolution, and 1.2-s scan time with an accuracy of ±0.5°C. CONCLUSION: The RT-TCR algorithm offers an approach to obtaining large coverage 3D temperature maps in real-time for monitoring MR-guided high intensity focused ultrasound treatments.

Antepartum Intimate Partner Violence: Development of a Risk Prediction Model.

Objectives: To explore socio-behavioral, clinical, and imaging findings associated with antepartum intimate partner violence (IPV) and aid in risk stratification of at-risk individuals. Methods: We analyzed electronic medical records during indexed pregnancies for 108 pregnant patients who self-reported antepartum IPV (cases) and 106 age-matched pregnant patients who did not self-report antepartum IPV (controls). Sociodemographic, clinical, and radiology data were analyzed via chi-squared and Fisher's exact tests with p < 0.05 as the threshold for significance. Stepwise logistic regression was applied to derive a risk prediction model. Results: The proportion of cases reporting emotional IPV (76% vs. 52%) and/or physical IPV (45% vs. 31%) during pregnancy significantly increased from prior to pregnancy. Cases were significantly more likely to report prepregnancy substance use (odds ratio [OR] = 2.60; 95% confidence interval [CI]: 1.13-5.98), sexually transmitted infections (OR = 3.48; 95%CI: 1.64-7.37), abortion (OR = 3.17; 95%CI: 1.79, 5.59), and preterm birth (OR = 5.97; 95%CI: 1.69-21.15). During pregnancy, cases were more likely to report unstable housing (OR = 5.26; 95%CI: 2.67-10.36), multigravidity (OR = 2.83; 95%CI: 1.44-5.58), multiparity (OR = 3.75; 95%CI: 1.72-8.20), anxiety (OR = 3.35; 95%CI: 1.85-6.08), depression (OR = 5.58; 95%CI: 3.07-10.16), substance use (OR = 2.92; 95%CI: 1.28-6.65), urinary tract infection (UTI) (OR = 3.26; 95%CI: 1.14-9.32), intrauterine growth restriction (OR = 10.71; 95%CI: 1.35-85.25), and cesarean delivery (OR = 2.25; 95%CI: 1.26-4.02). Cases had significantly more OBGYN abnormalities on imaging and canceled more radiological studies (OR = 5.31). Logistic regression found housing status, sexually transmitted infection history, preterm delivery history, abortion history, depression, and antepartum UTI predictive of antepartum IPV. The risk prediction model achieved good calibration with an area under the curve of 0.79. Conclusions: This study identifies significant disparities among patients experiencing antepartum IPV, and our proposed risk prediction model can inform risk assessment in this setting.

Injury patterns and demographics in older adult abuse and falls: A comparative study in emergency department settings.

BACKGROUND: Falls and interpersonal violence pose significant threats to older adults, leading to injuries, hospitalizations, and emergency department (ED) visits. This study investigates the demographics and injury patterns in older adults (aged 60 and above) who sought ED care due to assaults, comparing them with those who experienced falls to gain a deeper understanding of older adult abuse patterns. METHOD: This study utilizes data from the National Electronic Injury Surveillance System (NEISS) All Injury Program (2005-2019) to examine injuries among older adults aged 60 years and above. Participants were categorized into two groups: older adult abuse and injuries due to falls. The differences between the groups by demographics, injury locations, patterns, and temporal trends were analyzed using statistical methods accounting for the weighted stratified nature of the data. Cosinor analysis and Joinpoint regression were used for temporal analysis. RESULTS: Over 15 years, there were an estimated 307,237 ED visits for older adult abuse and 39,477,217 for falls. Older adults experiencing abuse were younger and had lower hospital admission rates compared to fall patients. Injuries associated with abuse included contusions/abrasions, penetrating injuries, and fractures to the head/neck, fingers, toes, ribs, and lower extremities. In contrast, fall patients had higher admission rates, with more fractures, including cervical spine and hip fractures. Temporal patterns showed a higher rate of assaults during the summer, whereas abuse demonstrated bimodal peaks in the summer and fall. CONCLUSIONS: Injuries associated with abuse such as facial, upper trunk, and upper extremity fractures should raise suspicion even in the absence of severe symptoms. These findings emphasize the importance of early identification to connect older adults with support resources, as patients experiencing abuse often get discharged from the ED.

Data-resolution based optimal choice of minimum required measurements for image-guided diffuse optical tomography.

Image-guided diffuse optical tomography has the advantage of reducing the total number of optical parameters being reconstructed to the number of distinct tissue types identified by the traditional imaging modality, converting the optical image-reconstruction problem from underdetermined in nature to overdetermined. In such cases, the minimum required measurements might be far less compared to those of the traditional diffuse optical imaging. An approach to choose these optimally based on a data-resolution matrix is proposed, and it is shown that such a choice does not compromise the reconstruction performance.

Maternal Health Concerns for Pregnant Labor-Trafficked People: A Scoping Review.

We set out to map the (1) living/occupational hazards, (2) health outcomes, and (3) barriers to care that exist for pregnant labor-trafficked people. Eight databases were systematically searched based on inclusion criteria. Five papers were eligible for inclusion. Data on study characteristics, social determinants, hazardous exposures, health outcomes, and barriers to care were extracted and synthesized. Common risk factors and occupational/living hazards were identified. Both were thematically connected with barriers to care and a host of adverse health outcomes. More importantly, a significant gap was discovered with no disaggregated quantitative data on the experience of pregnancy among labor-trafficked people. The interaction of risk factors, occupational/living hazards, and barriers to care experienced by pregnant labor-trafficked people may influence their susceptibility to adverse health outcomes. We need population-based studies, informed by those with lived experience of labor trafficking to examine the experience of pregnancy for labor-trafficked people to improve intervention and support efforts for this population.

"Praying for freedom": a story of labor trafficking during pregnancy.

Given the scant literature and data that exist on labor trafficking in general, obstetricians and gynecologists have very limited awareness of the effect of pregnancy on individuals affected by labor trafficking. Labor trafficking is the use of force, fraud, or coercion to compel an individual to provide a service. Our current understanding of this topic lacks the narratives of survivors who have lived experiences with this intersection. This study presented the story of a labor-trafficked person navigating the healthcare system throughout her pregnancy to shed light on an important presentation of labor trafficking in women's healthcare settings. The insufficient attention afforded to and the stereotypical views of labor trafficking do not often include the experiences of pregnant women. Therefore, presenting examples of labor trafficking, such as in this case study, are important to combat implicit structural and institutional biases that interfere with survivor identification. In addition to sharing one survivor's story, this article presents a trauma-informed approach to setting up socioculturally sensitive, developmentally appropriate, and inherently empowering conversations within healthcare settings to assess for exploitation and connect victims to resources. This case and framework are very important for obstetrician-gynecologists as they are uniquely positioned to screen and care for pregnant labor-trafficked people. Given the well-described "dual exploitation" of those experiencing intimate partner abuse and trafficking, clinical settings that focus on women's health and reproductive healthcare are important touchpoints for the identification, resource coordination, and management of pregnant-trafficked people.

Labor trafficking in marijuana production: a hidden epidemic in the shadows of the cannabis industry.

Labor trafficking in marijuana production remains a concealed epidemic within the expanding cannabis industry. This abstract brings attention to the systemic exploitation of vulnerable individuals engaged in cultivating, harvesting, and processing cannabis. It explores the factors contributing to labor trafficking, including demand for cheap labor, inadequate regulation, and the vulnerability of the workforce. By compiling published cases, both in peer-reviewed literature and the media, this perspective piece investigates the extent of health issues experienced by labor-trafficked victims. These include chronic pain from repetitive tasks, respiratory problems due to exposure to pesticides and other toxic substances, musculoskeletal injuries, malnutrition, and mental health disorders stemming from trauma and extreme stress. Additionally, this perspective article examines the factors contributing to poor health outcomes of labor-trafficked victims, including hazardous working conditions, lack of access to healthcare, and physical and psychological abuse. Addressing the health challenges faced by labor-trafficked victims in the cannabis industry requires multidimensional solutions: awareness among healthcare providers, comprehensive medical services, and mental health support. Furthermore, collaborative efforts among government agencies, healthcare providers, labor organizations, and the cannabis industry are essential in preventing trafficking and addressing the health disparities faced by labor-trafficked victims.

Understanding Health Care Utilization and Occupational Exposures of Labor-Trafficked People.

OBJECTIVES: To describe health care utilization and occupational exposures during trafficking among foreign-born people labor-trafficked in the U.S. METHODS: Retrospective analysis of immigration files for health data among 114 labor-trafficked individuals. RESULTS: Mean age was 30. Files of 38% mentioned accessing medical services at least once, mostly via hospitals (73%-81%). Forty-three percent (43%) had U.S. citizen children-indicating their children and spouses interacted with social and medical systems during exploitation. Almost all (97%) had limited English proficiency, and 75% did not have legal immigration status. Employers/traffickers interfered with access to health care and forced victims to work while injured. Half (50%) had sick family members. Victims reported physical and sexual abuse, toxic and environmental occupational exposures, and sleep disturbances. CONCLUSIONS: This is the largest study to elucidate health concerns and care utilization patterns among labor-trafficked people. Concerted resources must be dedicated to understanding health needs and health systems intervention opportunities for labor-trafficked people.

A comparative analysis of serological parameters and oxidative stress in osteoarthritis and rheumatoid arthritis.

Progression of rheumatoid arthritis (RA) and osteoarthritis (OA) is associated with inflammation and oxidative stress. Previous studies have shown that there was no difference between RA and OA patients regarding the percentages of the different lymphocytes subsets reflecting the abnormalities in T cells and its subsets that may contribute to the pathogenesis of OA as in RA. Therefore, the present study was aimed to analyze that whether disease activity of OA is able to affect a few serological and biochemical parameters in the same way as RA does or differently. The study was done on 36 asymptomatic controls (25 women), 28 patients with OA (20 women), 36 patients with RA (22 women). Patients with OA were screened according to radiological and clinical finding of Kellgren and Lawrence grade and ACR criteria and assessed by VAS and WOMAC score. Patients with RA were selected who were fulfilling 4/5 symptoms of ACR criteria, and their DAS28-CRP, VAS score, and RF positivity were evaluated. Participants of the groups were matched for sex, age, weight, and height (body mass index). The BMI of all three groups was also found to be the same (P > 0.05). The mean level of LDL, cholesterol, MDA, CRP, and triglyceride was significantly (P < 0.05 or P < 0.01) higher in both OA and RA as compared to control. The mean level of total lipid, cholesterol, MDA, CRP, and triglyceride was found to be significantly (P < 0.05 or P < 0.01) higher in RA as compared to OA. The pre-treatment CRP level of both groups of patients showed significant and direct relation with total lipid (r = 0.27, P < 0.05) and cholesterol (r = 0.66, P < 0.01). Inverse relation was observed between uric acid and creatinine (r = -0.26, P < 0.05) and cholesterol and HDL (r = -0.34, P < 0.01). Our study shows the similar trend in lipid profile and other parameters studied in both patients with OA and patients with RA with more pronounced changes in RA.