Differences in Perceptions of COVID-19 Risks in a Fishing Community in Alaska, 2020-2021.

Bristol Bay in Alaska is home to the world's largest commercial salmon fishery. During an average fishing season, the population of the Bristol Bay region more than doubles as thousands of workers from out of state converge on the fishery. In the months leading up to the 2020 commercial fishery opening, as the COVID-19 pandemic exploded worldwide, great uncertainty existed about the health risks of opening the fishery. Bristol Bay residents had not yet experienced any cases of COVID-19, yet the livelihoods of most were closely tied to the commercial fishery opening. To better understand how COVID-19 risk perceptions affected decisions to participate in the fishery, we administered an online survey to community members and fishery participants. We collected standard socioeconomic data and posed questions to gauge risk perceptions related to COVID-19. We find that COVID-19 risk perceptions vary across race/ethnic groups by residency and income. People with below median income who are members of minority groups-notably, non-resident Hispanic workers and resident Alaska Native respondents-reported the highest risk perceptions related to COVID-19. This study highlights the important linkages among risk perceptions, socioeconomic characteristics, and employment decisions during an infectious disease outbreak.

Pesticide removal through wastewater and advanced treatment: full-scale sampling and bench-scale testing.

Dieldrin and DDx removal through wastewater treatment, ozonation, and microfiltration was assessed for a water reuse project for groundwater replenishment in Monterey, California, USA. Full-scale sampling was conducted at the wastewater treatment plant, and physical wastewater treatment processes, ozonation, and microfiltration were tested at the bench scale. Removals observed through wastewater treatment, ozonation, and microfiltration were 84%, 44% to 63%, and 97% to 98%, respectively, for dieldrin, and 93%, 36% to 48%, and 92% to 94% for DDx. These were sufficient to meet California Ocean Plan water quality objectives after wastewater treatment alone. Levels in the secondary effluent, ahead of ozonation, microfiltration, reverse osmosis and advanced oxidation in the advanced water purification facility, met drinking water standards. Removal of dieldrin and DDx through wastewater treatment occurred by physical treatment processes; removal through the full-scale wastewater treatment plant, which included biological and physical treatment processes, matched removal through the physical bench-scale wastewater treatment processes. Dieldrin and DDx removal correlated with removal of volatile suspended solids, suggesting that volatile suspended solids could be used as an indicator for pesticide removal through wastewater treatment. Dieldrin and DDx concentrations were highest in the solids contact process, where biomass is accumulated for carbon removal.

Narrative approach in understanding the drivers for resilience of military combat medics.

INTRODUCTION: Qualitative insights may demonstrate how combat medics (CM) deal with stressors and identify how resilience can potentially develop. Yet, qualitative research is scant in comparison to the many quantitative studies of health outcomes associated with military service. METHOD: Semistructured qualitative interviews were used to collect personal narratives of US Army CMs who had previously served in Iraq or Afghanistan. RESULTS: Thematic analysis revealed three key driving forces for how resilience develops in the context of combat and war. The first was patriotism, which captures loyalty and full commitment to the military and its missions. The second was commitment to their family, reflecting the balance of responsibility to family of origin with the obligation one feels towards their military family. The last driving force was faith, or the drive to reach towards the transcendent to provide a moral compass and develop empathy in the face of difficult situations. CONCLUSIONS: An individual's commitment to country, military family and faith strengthens their resilience, and this can be used to inform future research efforts as well as current clinical practice.

BioAssay Research Database (BARD): chemical biology and probe-development enabled by structured metadata and result types.

BARD, the BioAssay Research Database (https://bard.nih.gov/) is a public database and suite of tools developed to provide access to bioassay data produced by the NIH Molecular Libraries Program (MLP). Data from 631 MLP projects were migrated to a new structured vocabulary designed to capture bioassay data in a formalized manner, with particular emphasis placed on the description of assay protocols. New data can be submitted to BARD with a user-friendly set of tools that assist in the creation of appropriately formatted datasets and assay definitions. Data published through the BARD application program interface (API) can be accessed by researchers using web-based query tools or a desktop client. Third-party developers wishing to create new tools can use the API to produce stand-alone tools or new plug-ins that can be integrated into BARD. The entire BARD suite of tools therefore supports three classes of researcher: those who wish to publish data, those who wish to mine data for testable hypotheses, and those in the developer community who wish to build tools that leverage this carefully curated chemical biology resource.

Offspring-sex modifies the association between early-pregnancy adiposity and 2-year-old total physical activity - The Glowing Study.

Background: Rodent models suggest that in utero exposure to under and overnutrition programs offspring physical activity (PA) behaviors. Such nexus has not been established in humans. This study evaluated the association of early pregnancy maternal adiposity with offspring PA at age 2 years (2-yo-PA) taking into consideration prenatal and postnatal factors. Methods: Women (n=153) were enrolled early in pregnancy (<10 weeks). At enrollment, maternal adiposity [air displacement plethysmography, fat mass index (FMI, kg/m2)] and PA (accelerometers, activity counts) were measured, and age, race, and education self-reported. Gestational weight gain was measured at the research facility. Offspring birthweight and sex were self-reported. At age 2 years, parental feeding practices (child feeding questionnaire) were assessed, whereas anthropometrics (length and weight) and physical activity (accelerometers) were objectively measured. Offspring body mass index z-scores were calculated. Generalized linear regression analysis modeled the association of maternal FMI and 2-yo-PA [average activity counts (AC)4/day]. Results: There was an interaction between maternal FMI and offspring sex in association with 2-yo-PA (ß= -1.03, p= 0.030). Specifically, 2-yo-PA was lower in girls compared to boys when maternal FMI was ≥7 kg/m2. Maternal PA early in pregnancy positively associated with 2-yo-PA (ß= 0.21, p= 0.005). In addition, children born to women with college education tended to be more active compared to children born to women without college education (ß= 3.46, p= 0.059). Conclusions: Sexual dimorphism was observed in the associations of maternal adiposity with 2-yo-PA, with girls being less active compared to boys only when maternal FMI was ≥7 kg/m2.

Prioritizing conservation actions in urbanizing landscapes.

Urbanization-driven landscape changes are harmful to many species. Negative effects can be mitigated through habitat preservation and restoration, but it is often difficult to prioritize these conservation actions. This is due, in part, to the scarcity of species response data, which limit the predictive accuracy of modeling to estimate critical thresholds for biological decline and recovery. To address these challenges, we quantify effort required for restoration, in combination with a clear conservation objective and associated metric (e.g., habitat for focal organisms). We develop and apply this framework to coho salmon (Oncorhynchus kisutch), a highly migratory and culturally iconic species in western North America that is particularly sensitive to urbanization. We examine how uncertainty in biological parameters may alter locations prioritized for conservation action and compare this to the effect of shifting to a different conservation metric (e.g., a different focal salmon species). Our approach prioritized suburban areas (those with intermediate urbanization effects) for preservation and restoration action to benefit coho. We found that prioritization was most sensitive to the selected metric, rather than the level of uncertainty or critical threshold values. Our analyses highlight the importance of identifying metrics that are well-aligned with intended outcomes.

The Caries Management System: an evidence-based preventive strategy for dental practitioners. Application for adults.

In the absence of effective caries preventive methods, operative care became established as the means for caries control in general practice. Water fluoridation resulted in a declining caries incidence which decreased further following the advent of fluoridated toothpaste. The challenge today is to develop a non-invasive model of practice that will sustain a low level of primary caries experience in the younger generation and reduce risk of caries experience in the older generations. The Caries Management System is a ten step non-invasive strategy to arrest and remineralize early lesions. The governing principle of this system is that caries management must include consideration of the patient at risk, the status of each lesion, patient management, clinical management and monitoring. Both dental caries risk and treatment are managed according to a set of protocols that are applied at various steps throughout patient consultation and treatment. The anticipated outcome of implementing the Caries Management System in general dental practice is reduction in caries incidence and increased patient satisfaction. Since the attainment and maintenance of oral health is determined mainly by controlling both caries and periodontal disease, the implementation of the Caries Management System in general practice will promote both outcomes.

Indirect Reciprocity, Resource Sharing, and Environmental Risk: Evidence from Field Experiments in Siberia.

Integrating information from existing research, qualitative ethnographic interviews, and participant observation, we designed a field experiment that introduces idiosyncratic environmental risk and a voluntary sharing decision into a standard public goods game. Conducted with subsistence resource users in rural villages on the Kamchatka Peninsula in Northeast Siberia, we find evidence consistent with a model of indirect reciprocity and local social norms of helping the needy. When participants are allowed to develop reputations in the experiments, as is the case in most small-scale societies, we find that sharing is increasingly directed toward individuals experiencing hardship, good reputations increase aid, and the pooling of resources through voluntary sharing becomes more effective. We also find high levels of voluntary sharing without a strong commitment device; however, this form of cooperation does not increase contributions to the public good. Our results are consistent with previous experiments and theoretical models, suggesting strategic risks tied to rewards, punishments, and reputations are important. However, unlike studies that focus solely on strategic risks, we find the effects of rewards, punishments, and reputations are altered by the presence of environmental factors. Unexpected changes in resource abundance increase interdependence and may alter the costs and benefits of cooperation, relative to defection. We suggest environmental factors that increase interdependence are critically important to consider when developing and testing theories of cooperation.

Isolation of cardiac myofibrils and myosin light chains with in vivo levels of light chain phosphorylation.

Conditions are described for the preparation of functional myofibrils and myosin light chains from freeze-clamped beating hearts with the state of light chain phosphorylation chemically 'frozen' during the extraction procedure. Myofibrils were shown to be functionally intact by measurement of Ca2+ binding and ATPase activity. Highly purified cardiac myosin light chains could be routinely isolated from myofibrillar preparations using ethanol fractionation together with ion-exchange chromatography. Analysis of light chains for covalent phosphate indicated that basal levels of phosphorylation of the 18--20 000 dalton light chain of myosin in rabbit hearts beating in situ or in a perfusion apparatus were 0.3--0.4 mol/mol. Covalent phosphate content of the light chain fraction did not change during perfusion of hearts with 10 microM epinephrine.

A comparison of protocols for the optimisation of detection of bacteria using a surface acoustic wave (SAW) biosensor.

A dual channel surface acoustic wave (SAW) device has been used as a biosensor to detect two different microorganisms, Legionella and Escherichia coli, simultaneously. A series of experiments was conducted to optimise the use of the SAW for bacterial detection using a novel protocol of coating bacteria on the sensor surface prior to addition of the antibody. Results were compared with an experiment in which a conventional protocol was utilised, where antibody was coated on the sensor surface prior to exposure to bacteria. The concentration of bacteria that attached to the surface of the SAW device was related to the antibody that specifically bound to it and therefore to frequency in a dose dependent fashion. Unlike conventional microbiological techniques quantitative results can be obtained for Legionella and E. coli down to 10(6) cells per ml within 3 h. In addition E. coli was detected down to 10(5) cells per ml in a modified protocol using sheep IgG as a blocking agent.

Legal aspects of psychopharmacology.

Pharmacologic treatments useful in managing violent patients are reviewed. General principles of treatment and techniques for intervening in emergency situations are discussed first, followed by more specific recommendations for treating individuals with personality disorders, thought disorders, organic disorders, affective disorders and psychosexual disorders. The authors emphasize that medication alone almost never provides adequate treatment for such individuals and must be used in conjunction with other therapeutic modalities such as family, group, and individual psychotherapies.

Isolation and amino acid sequence of a new long-chain neurotoxin with two chromatographic isoforms (Aa el and Ae e2) from the venom of the Australian death adder (Acanthophis antarcticus).

The amino acid sequence of a previously undescribed toxin from Australian death adder venom (Acanthophis antarcticus) has been elucidated. It appears to exist in two forms which are separated by reverse-phase high-performance liquid chromatography, but which have the same sequence and mol. wt. It has 79 amino acid residues and is therefore longer than other long postsynaptic neurotoxins. It shows homology with the conserved regions of the other long postsynaptic neurotoxins except for three unique substitutions of conserved residues, which are Arg-29 instead of Trp or Phe, Leu-33 instead of Arg and Thr-43 instead of Ala.

Health care rationing in the aged: ethical and clinical perspectives.

This article provides an ethical analysis of the question of whether aged patients' access to health care should be less than, the same or greater than, the access younger patients enjoy, when economic resources are limited. This topic is being urgently considered in the US because managed care is becoming more common and brings with it new challenges to traditional medical ethics, and because the prevalence of the aged is increasing as is the number of patients with Alzheimer's disease (AD). It is also critical throughout the world because new findings suggest that the progression of AD may be retarded or even reversed by providing patients with enriched interpersonal environments. If these findings are valid, it would be inhumane to not consider providing these resources to patients with AD, since these gains would be so meaningful and substantial. Deontological and consequential values influencing this question are presented and evaluated. The theories of Veatch, Callahan and Daniels in regard to allocating health care to the aged are discussed. It is argued that 2 subgroups of aged patients, the isolated and demented, are among the patients worst off because the capacity to enjoy meaningful relationships with others supercedes all others and both groups of patients have lost this capacity. We assert that, on the basis of the principle of justice according to need, these 2 groups of patients' exceptional needs should be prioritised. We then raise the question of whether the majority of the population would be willing to provide these isolated and demented aged patients this care if the new findings proved valid. We conclude that, in light of many people's fear of growing old and dying, and some peoples bias against the aged (particularly in the US), willingness to provide the necessary resources is open to debate. Finally, we provide specific examples of the kinds of interventions which might be optimal for each group of patients. For patients who are cognitively unimpaired, this might be providing home care so that they could remain closer to and in contact with their loved ones. For patients who are cognitively impaired, this might be providing interpersonal support when these patients begin to lose control, rather than applying restraints or using psychotropic medication.

Ethical issues regarding mixed agency of military physicians.

Military physicians' obligations to the military may compete with or even override their obligations to patients, especially during combat. Doctor/patient trust may be impaired when the soldier/patient's interests conflict with those of the military and the physician's loyalty is uncertain, and when the military physician treats civilians in occupied territories during mass casualties or, in part, for political gain. When the military physician is asked to perform research which could potentially be utilized for offensive purposes, obligations to the medical profession or to humanity may take precedence over his obligations to the military.

KIE: The author, who is a faculty member at the Uniformed Services University of the Health Sciences, likens the conflict that all physicians face between their obligations to individual patients and their obligations to society to the issues of divided loyalties faced by military physicians. He maintains that the value priorities developed in military medicine can be extrapolated to civilian settings. Howe develops these ethical paradigms from considerations of triage and treatment of soldiers, prisoners, and civilians; confidentiality in the physician patient relationship; and the physician's role in weapons-related research and in experimentation on a coerced population.

Tooth staining effects of an alexidine mouthwash.

The primary purpose of this study was to determine the amount of tooth staining produced by an alexidine mouthrinse. One hundred and eighty subjects rinsed twice daily for 1 month with either 15 ml of alexidine (0.035%) or a placebo solution. Prior to the study, the subjects were classified according to their smoking, coffee and tea drinking habits and these factors were subsequently considered in the analysis of the stain scores. Additionally, the effects on staining of a prior prophylaxis and the use of a fluoridated toothpaste during the study were determined. Upon termination of the study, subjects utilizing the active mouthrinse manifested a greater degree of staining than placebo users. The amount and intensity of the stain due to alexidine were not influenced (increased) by smoking, tea or coffee drinking habits. A prior prophylaxis did not reduce the staining propensity of alexidine users. The method of scoring developed can be used to assess the degree of tooth staining induced by antiplaque agents.

The effect of an alexidine mouthwash on plaque and gingivitis.

A clinical study was conducted on the effects of an alexidine or placebo oral rinse on plaque and gingivitis. Forty-two male subjects rinsed for 54 days while continuing toothbrushing. This was followed by 4 days of mouthrinsing only. The alexidine mouthrinse significantly reduced the plaque index when used in conjunction with toothbrushing and also when brushing was discontinued. The gingivitis results were inconclusive.

Histologic changes in the adrenal cortex from young rats following spaceflight.

BACKGROUND: Potential stresses associated with spaceflight include microgravity, acceleration and deceleration forces, a crowded environment and re-adaptation to normal gravity after landing. HYPOTHESIS: We hypothesized that spaceflight would result in histological changes in the adrenal glands of young rats. METHODS: Six week old male rats were group-housed in an Animal Enclosure Module (AEM) for a 17 d shuttle flight (STS-78). Ground-based controls included a baseline group, an AEM-housed group and a vivarium group. Adrenal glands were collected from 4-6 hours after flight, fixed, embedded in plastic and sections prepared for light microscopy. RESULTS: The adrenals from the baseline and vivarium groups had normal histological features. Some changes in the adrenal cortices from the ground-based AEM group included greater parenchymal cord-like formation. The adrenal weights and width of the zona fasciculata were greater in the flight group than the controls. There were also increased parenchymal cord-like formation with better demarcation of the vascular sinusoids in the zona reticularis and zona fasciculata, greater depletion of cytoplasmic lipid vacuoles, and an increased nuclear volume of the cells in the zona fasciculata when compared with the controls. CONCLUSIONS: The adrenal changes in the ground-based AEM animals may be attributed to the confined space in the AEM. The adrenal enlargement and the histological changes observed in the flight animals may be attributed to spaceflight and possibly re-entry in addition to possible confinement stress in the AEM.

Failing Siracusa: governments' obligations to find the least restrictive options for tuberculosis control.

One of the world's leading causes of death, tuberculosis (TB) remains a stigmatized and feared disease. Prevention, diagnosis, and adherence to TB treatment remain a challenge for many people, including migrants, those with alcohol and drug dependency, sex workers, people living with the human immunodeficiency virus, and individuals with disabilities. Low levels of TB treatment literacy and ignorance of transmission risks are common, and-along with inadequate funding for treatment support-contribute to patients' non-adherence to treatment. Recent cases involving the detention of individuals with TB in Kenyan and Canadian correctional facilities illustrate the circumstances under which individuals interrupt treatment and how health authorities seek restrictive measures to oversee and compel treatment. The legitimacy of restrictive measures is often defended by international public health authorities in relation to the non-binding Siracusa Principles. Yet in practice, as illustrated by examples from Kenya and Canada, government authorities and local laws sometimes do not fully meet, or entirely disregard, the requirements in the Siracusa Principles that restrictions on rights in the name of public health be strictly necessary and the least intrusive available to reach their objective. In addition, more specific standards are required at the international level to guide states' development and use of rights-restricting measures to address TB.

La tuberculose (TB), une des principales causes de décès dans le monde, reste une maladie stigmatisée et redoutée. La prévention, le diagnostic et l'adhésion au traitement de la TB restent un défi pour de nombreuses personnes, notamment les migrants, les sujets dépendants à l'alcool et aux drogues, les travailleurs du sexe, les sujets atteints par le virus de l'immunodéficience humaine et les individus atteints d'invalidité. Le faible taux de connaissance du traitement de la TB et l'ignorance des risques de transmission sont courants et contribuent, en plus d'un financement inadéquat pour le soutien au traitement, à la non-adhésion des patients au traitement. Des cas récents impliquant la détention d'individus atteints de TB dans les services correctionnels du Kenya et du Canada illustrent les circonstances dans lesquelles les individus interrompent le traitement et celles où les autorités de santé recourent à des mesures restrictives pour surveiller et imposer le traitement. La légitimité des mesures restrictives est souvent défendue par les autorités internationales de santé publique en lien avec les Principes non-contraignants de Syracuse. En pratique, comme l'illustrent les exemples du Kenya et du Canada, parfois les autorités gouvernementales et les lois locales ne répondent pas complètement, voire méconnaissent totalement les exigences des Principes de Syracuse selon lesquels les restrictions appliquées aux droits au nom de la santé publique doivent être strictement nécessaires et le moins intrusives possible pour atteindre leur objectif. En outre, des standards plus spécifiques s'imposent au niveau international pour orienter au niveau des Etats l'élaboration et l'utilisation de mesures restreignant les droits pour faire face à la TB.

La tuberculosis (TB), una de las principales causas de muerte en el mundo, representa aun una enfermedad estigmatizada y temida. La prevención y el diagnóstico de la TB y el cumplimiento con el tratamiento antituberculoso representan todavía un reto en muchas poblaciones, sobre todo en los inmigrantes, las personas con dependencia al alcohol o las drogas, los trabajadores del sexo, las personas aquejadas de infección por el virus de la inmunodeficiencia humana y las personas discapacitadas. Es frecuente la carencia de conocimientos en materia de tratamiento y se suelen ignorar los riesgos de transmisión, lo cual, aunado a la escasez de financiamiento destinado al apoyo del tratamiento, favorece el incumplimiento terapéutico de los pacientes. Los casos recientes de detención de personas con TB en centros correccionales en Kenia y Canadá constituyen un ejemplo de circunstancias en las cuales los pacientes interrumpen el tratamiento y las autoridades sanitarias ejercen medidas restrictivas con el fin de supervisar el tratamiento y forzar su continuación. Con frecuencia, las autoridades internacionales de salud pública defienden la legitimidad de las medidas restrictivas, en nombre de los Principios de Siracusa, los cuales no presentan un carácter vinculante. Sin embargo en la práctica, como lo pone de manifiesto el ejemplo de Kenia y Canadá, las autoridades gubernamentales y las legislaciones locales en ocasiones no cumplen a cabalidad las exigencias de los Principios de Siracusa o los desacatan totalmente; según estos principios, solo se pueden restringir los derechos en nombre de la salud pública cuando es estrictamente necesario y las restricciones aplicadas deben ser las menos intrusivas existentes que permitan lograr los objetivos. Además, se precisan normas más específicas a escala internacional, que orienten a los estados en la formulación y la ejecución de las medidas de restricción de los derechos encaminadas a luchar contra la TB.

Progestin suppression of miR-29 potentiates dedifferentiation of breast cancer cells via KLF4.

The female hormone progesterone (P4) promotes the expansion of stem-like cancer cells in estrogen receptor (ER)- and progesterone receptor (PR)-positive breast tumors. The expanded tumor cells lose expression of ER and PR, express the tumor-initiating marker CD44, the progenitor marker cytokeratin 5 (CK5) and are more resistant to standard endocrine and chemotherapies. The mechanisms underlying this hormone-stimulated reprogramming have remained largely unknown. In the present study, we investigated the role of microRNAs in progestin-mediated expansion of this dedifferentiated tumor cell population. We demonstrate that P4 rapidly downregulates miR-29 family members, particularly in the CD44(+) cell population. Downregulation of miR-29 members potentiates the expansion of CK5(+) and CD44(+) cells in response to progestins, and results in increased stem-like properties in vitro and in vivo. We demonstrate that miR-29 directly targets Krüppel-like factor 4 (KLF4), a transcription factor required for the reprogramming of differentiated cells to pluripotent stem cells, and for the maintenance of breast cancer stem cells. These results reveal a novel mechanism, whereby progestins increase the stem cell-like population in hormone-responsive breast cancers, by decreasing miR-29 to augment PR-mediated upregulation of KLF4. Elucidating the mechanisms whereby hormones mediate the expansion of stem-like cells furthers our understanding of the progression of hormone-responsive breast cancers.

Dental students' knowledge and perceptions of non-invasive dental caries management.

BACKGROUND: An evidence-based, risk-specific, and non-invasive modality for caries management was implemented in the University of Sydney dentistry curriculum. This study reviews its impact on student learning outcomes and their perceptions of the efficacy of a risk-based caries management. METHODS: One hundred and nine Year 3 and Year 4 students were invited to complete a questionnaire to assess their understanding of the protocols and their perceptions of both the education process and value of the non-invasive treatment modality. RESULTS: A response rate of 93% Year 3 and 46% Year 4 students was obtained. They correctly identified high and low risk cases but Year 3 students were inclined to misclassify medium risk cases. Most understood correctly that enamel lesions should be arrested and remineralized but were often more radical in dealing with dentine lesions. Students who believed the protocols were useful and who spent more time on preventive care were less likely to restore enamel and dentine lesions. CONCLUSIONS: A modest level of knowledge concerning application of the non-invasive caries management system to paper-based clinical case studies was demonstrated. Protocol misinterpretation may reflect inconsistent instruction by some clinical tutors. It is hoped that the promulgation of evidence-based dentistry will overcome these barriers in future.