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BACKGROUND: Studies across multiple countries reveal that depression and sleep disorders can lead to cognitive decline. This study aims to speculate on the effect of different sources of indoor air pollution on cognition and to explore the mediation effect of depression and sleep disorders on cognition when exposed to indoor air pollution. We hypothesize that an older adult experiences higher cognitive decline from indoor pollution when mediated by depression and sleep disorders. METHODS: We use data from Longitudinal Aging Study in India (LASI), 2017-2018, and employ a multiple mediation model to understand the relationship between indoor air pollution and cognition through sleep disorders and depression while adjusting for possible confounders. Sensitivity analysis was applied to see the effect of different sources of indoor pollution (cooking fuel, indoor smoke products, and secondhand smoke) on cognitive performance. RESULTS: The effect of three sources of indoor pollutants on cognition increased when combined, indicating stronger cognitive decline. Unclean cooking practices, indoor smoke (from incense sticks and mosquito coils), and secondhand smoke were strongly associated with sleep disorders and depression among older adults. Indoor air pollution was negatively associated with cognitive health (ß= -0.38) while positively associated with depression (ß= 0.18) and sleep disorders (ß= 0.038) acting as mediators. Sensitivity analysis explained 45% variability while adjusting for confounders. CONCLUSION: The study lays a foundation for future investigations into the nexus of indoor pollution and mental health. It is essential to formulate policies to reduce exposure to varying sources of indoor air pollutants and improve screening for mental health services as a public health priority.
Subject(s)
Air Pollution, Indoor , Sleep Wake Disorders , Tobacco Smoke Pollution , Humans , Aged , Air Pollution, Indoor/adverse effects , Depression/diagnosis , Depression/epidemiology , Cognition , Sleep Wake Disorders/diagnosis , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/etiology , India/epidemiologyABSTRACT
Disaster experiences and explorations of preparedness among Asian, Pacific Islander, and Desi Americans (APIDA) in the United States are often overlooked owing to their relatively smaller population share. APIDA are not homogenous, and their disaster experiences warrant further examination. This paper does so by investigating disaster preparedness using disaggregated information about APIDA. The study utilises nationally representative data from the 2017 American Housing Survey, analysing sociodemographic covariates. The disaster preparedness score among APIDA communities was approximately 4.81 on a zero to nine scale. APIDA renters and non-US citizens were less prepared than homeowners and US citizens. Among subgroups, Korean, Chinese, and Vietnamese respondents who were non-US citizens were less prepared than those who were US citizens. Marital status was significantly and positively associated with preparedness among Indians, Japanese, Vietnamese, and multiracial respondents. The findings underscore the importance of data disaggregation and tailored preparedness information and resources to address specific challenges APIDA communities face instead of a one-size-fits-all approach.
ABSTRACT
In this paper, we report a power management system for autonomous and real-time monitoring of the neurotransmitter L-glutamate (L-Glu). A low-power, low-noise, and high-gain recording module was designed to acquire signal from an implantable flexible L-Glu sensor fabricated by micro-electro-mechanical system (MEMS)-based processes. The wearable recording module was wirelessly powered through inductive coupling transmitter antennas. Lateral and angular misalignments of the receiver antennas were resolved by using a multi-transmitter antenna configuration. The effective coverage, over which the recording module functioned properly, was improved with the use of in-phase transmitter antennas. Experimental results showed that the recording system was capable of operating continuously at distances of 4 cm, 7 cm and 10 cm. The wireless power management system reduced the weight of the recording module, eliminated human intervention and enabled animal experimentation for extended durations.
Subject(s)
Biosensing Techniques/instrumentation , Neurotransmitter Agents/analysis , Wireless Technology/instrumentation , Animals , Computer Simulation , Electricity , Electrodes , Glutamic Acid/analysis , RatsABSTRACT
Flexible iridium oxide (IrOx)-based micro-electrodes were fabricated on flexible polyimide substrates using a sol-gel deposition process for utilization as integrated pseudo-reference electrodes for bio-electrochemical sensing applications. The fabrication method yields reliable miniature on-probe IrOx electrodes with long lifetime, high stability and repeatability. Such sensors can be used for long-term measurements. Various dimensions of sol-gel iridium oxide electrodes including 1 mm × 1 mm, 500 µm × 500 µm, and 100 µm × 100 µm were fabricated. Sensor longevity and pH dependence were investigated by immersing the electrodes in hydrochloric acid, fetal bovine serum (FBS), and sodium hydroxide solutions for 30 days. Less pH dependent responses, compared to IrOx electrodes fabricated by electrochemical deposition processes, were measured at 58.8 ± 0.4 mV/pH, 53.8 ± 1.3 mV/pH and 48 ± 0.6 mV/pH, respectively. The on-probe IrOx pseudo-reference electrodes were utilized for dopamine sensing. The baseline responses of the sensors were higher than the one using an external Ag/AgCl reference electrode. Using IrOx reference electrodes integrated on the same probe with working electrodes eliminated the use of cytotoxic Ag/AgCl reference electrode without loss in sensitivity. This enables employing such sensors in long-term recording of concentrations of neurotransmitters in central nervous systems of animals and humans.
Subject(s)
Biosensing Techniques , Iridium/chemistry , Microelectrodes , Neurotransmitter Agents/isolation & purification , Animals , Cattle , Central Nervous System/physiology , Electrochemistry/instrumentation , Humans , Serum/chemistryABSTRACT
The world's population is aging while the Earth's climate is warming. The climate change crisis poses threats to our aging population and requires concerted action. Steps to address these threats present opportunities for improving livability for people of all ages while addressing the underlying drivers of climate change. Yet prominent action frameworks such as the World Health Organization's (WHO) Global Network of Age-Friendly Cities and Communities do not explicitly include climate resilience and sustainability as essential elements of age-friendly communities. In this essay, we argue for the creation of a cross-cutting and interdependent sustainability and climate resilience domain to complement the existing interconnected WHO age-friendly domains of community and healthcare, communication and information, housing, civic participation and employment, outdoor spaces and buildings, social participation, respect and social inclusion, and transportation. These domains drive the community engagement, planning, action, and evaluation required by the communities who join the Global Network for Age-Friendly Cities and Communities. The age-friendly network currently includes 1,445 communities, across 51 countries. We discuss how the alignment of age-friendly and climate resilience networks strengthens local action and global advocacy through a shared vision for an age-friendly and climate resilient future.
Subject(s)
Residence Characteristics , Resilience, Psychological , Humans , Aged , Housing , Aging , Social ParticipationABSTRACT
Nita S. NairBackground Radiotherapy (RT) is an important modality in the management of breast cancers (BC). Large randomized trials have suggested that prophylactic regional nodal irradiation inclusive of internal mammary lymph nodes (IMLN) reduces BC-related mortality. However, the adoption of IMLN-RT has been variable due to relative benefits and toxicity concerns. Methods A survey was emailed to radiation oncologists (ROs) across the country wherein they were asked about their practice regarding IMLN-RT in BC. Results We received 128 responses, which included radiation oncologists across both private institutions (PIs) and government institutions (GIs). Fifty-six (43.8%) routinely offer prophylactic(p) IMLN-RT and an additional 15 (11.71%) suggested they would have offered it in the absence of logistic constraints. Almost all, 121 (94.5%) radiate the IMLN in case of radiologically positive lymph nodes (LNs). Fifty-six ROs (43.8%) offered prophylactic IMLN-RT in node-negative disease. Among those who did not offer IMLN-RT, most (84.72%) felt the clinical evidence was equivocal. Of the 56 who offered pIMLN-RT, 34/56 (60.71%) offered to locally advanced tumors, 20/56 (35.71%) offered to all inner and central tumors (ICQT), 29/56 (51.78%) to > 4 axillary LN-positive and 9/56 (16.07%) to any axillary LN-positive. The majority, i.e., 36/56 (64.28%) radiated upper three intercostal spaces, 9 (16.07%) radiated upper five intercostal spaces, and 6 (10.9%) decided based on tumor location, while 5 (9%) irradiated one space below the involved space. Overall, simulation-based planning was undertaken in 99% of PIs as opposed to 89% of GIs ( p = 0.03). The majority of ROs, i.e., 92 (72.4%) preferred IMRT to IMLN-RT. In addition, the surgical approach to IMLN was practiced by surgeons at 18 (14%) centers, of which 13 (72.22%) operated the IMLN when radiologically evident. The IMLN dissection was preferentially performed for second and third intercostal spaces as suggested in 10 (55.55%) responses, while 8 (44.44%) performed thoracoscopic dissection of the IMLN chain. The distribution of prophylactic, definitive IMLN-RT, and IMLN dissection did not differ significantly between GI and PI ( p = NS). Conclusion pIMLN-RT is still not the standard protocol in most centers citing equivocal evidence in the literature. Logistics, though different in GIs and PIs, did not impact the decision of pIMLN-RT. Further efforts would be required to standardize practice in IMLN across India.
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An estimated 6 million children under the age of five in Nigeria (out of nearly 31 million) risk not reaching their full developmental potential. The dearth of context-relevant measures poses a challenge to the planning and implementation of effective interventions. This study assesses the utility of the Early Childhood Development Index (ECDI) in Nigeria. We used the Multiple Indicator Cluster Surveys to track progress among 3- to 4-year-old children (n = 11,073); 3-year-old, 51%; female, 49%. Using random calibration samples, the results from psychometric tests indicate that while over half of the children were on track in their development based on the ECDI, the instrument had low to average internal consistency and weak face validity, suggesting an inadequacy in capturing ECD information of value. At the outset of the launch of the new ECDI2030, the results of this study point to the need for continued discourse and advocacy for the use of culturally appropriate measures of child development, and a child-centered community engagement approach. This is essential in ensuring accountability and responsive interventions for the children served and their families.
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Background: Primary hyperparathyroidism (PHPT) is a common endocrine condition but rare in the pediatric and adolescent populations. The presentations can be unique, accounting for significant morbidity in the case of untimely detection. Aim: To study surgically treated pediatric PHPT retrospectively. Methods: Surgically treated children of PHPT up to 20 years of age between 2010 to 2022 were analyzed. All of them were operated on by an endocrine surgeon and team. Results: There was a total of 712 parathyroidectomies over 12 years, out of which there were 52 children (7.3%) had PHPT at less than 20 years of age. This group included 32 male children. The mean age was 16.1 years, including 7 cases of neonatal severe HPT. Multiple Endocrine Neoplasia type 1 was confirmed in 12 children. Presentations were more severe like bone pain (35.13%), renal stones (27.02%), incidental asymptomatic detection (18.9%), failure to thrive (10.8%), and pancreatitis (8.1%) as compared to adults. Mean serum calcium was 12.9 mg/dl (highest-14.1, N-8.8-10.8 mg/dl), mean parathormone levels were 386.91 pg/ml (N-10-65) and vitamin D levels ranged from 2.9-22.8 ng/ml. Localization was done with ultrasound and 99mTc- SESTAMIBI scans. Mean serum calcium levels in NSPHPT were 28.6 mg/dl (N-8.8-10.8 mg/dl). There were a total of 45 cases (6.32%) of PHPT less than 20 years of age, excluding the cases of NSPHPT. All children underwent parathyroidectomy, with 14 cases having an additional thymectomy, 2 cases with thyroidectomy, and a single case of hemithyroidectomy. The cure rate was 97.3%, while one baby with NSPHPT had persistent disease (postop PTH-110 pg/ml). The uniglandular disease was seen in 54.05% and the rest had a multiglandular disease. Adults accounted for 559/660 cases with 80% uniglandular disease. All cases had a postoperative histopathological confirmation with an average follow-up of 1 year. Conclusion: Childhood PHPT has a few features same as the adult population. Symptomatic presentations like adults, though pancreatitis and fatigue were more commonly seen as compared to bone pain. Calcium, phosphorus, and parathormone levels were comparable. Uniglandular involvement was seen just like the adult population. There are a few others that make them a distinct subtype like their symptoms of bone pain and being more common among boys. One-fourth of them had MEN1. Fewer cases in this age group make them unique.
ABSTRACT
BACKGROUND: Chronic GERD affects approximately 15% of adults in the United States and is one of the most prevalent clinical conditions involving the GI tract. The commercial tools for monitoring GERD include multichannel intraluminal impedance (MII) probes and pH-sensing capsules. However, MII probes cause discomfort, which alters patients' regular activities, whereas the pH-sensing capsule lacks the ability to detect weak or nonacid episodes, misses reflux episodes with similar pH values, and has a limited sampling rate and battery life. OBJECTIVE: To develop and test an implantable batteryless dual-sensor capsule that can be used to diagnose and monitor GERD. DESIGN: The implanted capsule is wirelessly powered by an external device. Simulated reflux episodes were created in 3 live porcine models. Impedance and pH data were continuously measured and recorded. INTERVENTION: The implant capsule was placed in the esophagus along with a commercial pH-sensing capsule for comparison. MAIN OUTCOME MEASUREMENTS: Precise impedance and pH readouts were obtained and compared with those from a commercial pH-sensing capsule. RESULTS: The wireless energy supplied by the external unit was strong enough to power the implant. The pH sensor accurately measured pH levels and the impedance sensor precisely located the reflux episodes. LIMITATION: Simulated reflux events in a pig model. CONCLUSION: Our wireless sensors are reliable in operation and provide accurate assessment of simulated reflux episodes. The entire device can potentially be used to diagnose and monitor GERD.
Subject(s)
Esophageal pH Monitoring/instrumentation , Gastroesophageal Reflux/diagnosis , Implants, Experimental , Animals , Equipment Design , Female , SwineABSTRACT
BACKGROUND: Although overall air quality has improved in the United States, air pollution remains unevenly distributed across neighborhoods, producing disproportionate environmental burdens for minoritized and socioeconomically disadvantaged residents for whom greater exposure to other structurally rooted neighborhood stressors is also more frequent. These interrelated dynamics and layered vulnerabilities each have well-documented associations with physical and psychological health outcomes; however, much remains unknown about the joint effects of environmental hazards and neighborhood socioeconomic factors on self-reported health status. OBJECTIVES: We examined the nexus of air pollution exposure, neighborhood socioeconomic disadvantage, and self-rated health (SRH) among adults in the United States. METHODS: This observational study used individual-level data from the Panel Study of Income Dynamics merged with contextual information, including neighborhood socioeconomic and air pollution data at the census tract and census block levels, spanning the period of 1999-2015. We estimated ordinary least squares regression models predicting SRH by 10-y average exposures to fine particulate matter [particles ≤2.5µm in aerodynamic diameter (PM2.5)] and neighborhood socioeconomic disadvantage while controlling for individual-level correlates of health. We also investigated the interaction effects of air pollution and neighborhood socioeconomic disadvantage on SRH. RESULTS: On average, respondents in our sample rated their health as 3.41 on a scale of 1 to 5. Respondents in neighborhoods with higher 10-y average PM2.5 concentrations or socioeconomic disadvantage rated their health more negatively after controlling for covariates [ß=-0.024 (95% CI: -0.034, -0.014); ß=-0.107 (95% CI: -0.163, -0.052), respectively]. We also found that the deleterious associations of PM2.5 exposure with SRH were weaker in the context of greater neighborhood socioeconomic disadvantage (ß=0.007; 95% CI: 0.002, 0.011). DISCUSSION: Study results indicate that the effects of air pollution on SRH may be less salient in socioeconomically disadvantaged neighborhoods compared with more advantaged areas, perhaps owing to the presence of other more proximate structurally rooted health risks and vulnerabilities in disinvested areas (e.g., lack of economic resources, health access, healthy food options). This intersection may further underscore the importance of meaningful involvement and political power building among community stakeholders on issues concerning the nexus of environmental and socioeconomic justice, particularly in structurally marginalized communities. https://doi.org/10.1289/EHP11268.
Subject(s)
Air Pollutants , Air Pollution , Humans , Adult , United States , Air Pollution/analysis , Particulate Matter/analysis , Residence Characteristics , Income , Neighborhood Characteristics , Air Pollutants/analysis , Environmental Exposure/analysisABSTRACT
The parathyroid glands are situated in close proximity to the thyroid gland. They have an important endocrine function maintaining calcium and phosphate homeostasis in the body by the secretion of parathormone (PTH), which is responsible for this function. The parathyroid glands are commonly damaged during thyroid surgeries. This could lead to transient or permanent hypoparathyroidism in 30% of cases. Preservation of the parathyroid glands, is an important and integral part of thyroidectomy and other surgical interventions in the neck. The main principle underlying this is a thorough understanding of parathyroid anatomy in relation to the thyroid gland and other important structures in the area. There can also be significant variation in the anatomical location of the glands. Various techniques and methods have been described for parathyroid preservation. They include intraoperative identification utilizing indocyanine green (ICG) fluorescence, carbon nanoparticles, loupes, and microscopes. The techniques of surgery (meticulous capsular dissection), expertise, central compartment neck dissection, preoperative vitamin D deficiency, extent and type of thyroidectomy are the risk factors associated with damaged thyroids, inadvertent parathyroidectomy and subsequent hypoparathyroidism. Parathyroid Autotransplantation is a treatment option for inadvertent parathyroidectomy. Ultimately, the best way to assure normal parathyroid function is to preserve them in situ intraoperatively undamaged.
Subject(s)
Hypoparathyroidism , Parathyroid Glands , Humans , Parathyroid Glands/transplantation , Thyroid Gland/surgery , Hypoparathyroidism/etiology , Thyroidectomy/adverse effects , Thyroidectomy/methods , NeckABSTRACT
Little is known about the impact of child welfare system-level factors on child mortality as an outcome within foster care. Using data from the Adoption and Foster Care Analysis and Reporting System, 2009-2018, we examined the associations between county-level sociodemographic, foster care performance, and judicial reform characteristics with all-cause mortality rates. Results of random effects negative binomial regression analyses showed that higher proportions of younger children (<1 year: IRR = 1.06, 95% CI [1.02, 1.11]; 5-9 years: IRR = 1.05, 95% CI [1.01, 1.09]); children of color (i.e., non-Hispanic Asian: IRR = 1.07, 95% CI [1.01, 1.13]; multiracial: IRR = 1.03, 95% CI [1.01, 1.04]; non-Hispanic Black: IRR = 1.02, 95% CI [1.01, 1.02]; Hispanic: IRR = 1.01, 95% CI [1.01, 1.02]); and male children (IRR = 1.10, 95% CI [1.05, 1.15]) were associated with higher mortality risks at the county level. Current class action lawsuits (IRR = 0.79, 95% CI [0.63, 0.99]) and active consent decrees (IRR = 0.77, 95% CI [0.63, 0.94]) were associated with lower mortality risks. None of the foster care performance characteristics (e.g., foster care entry, placement stability, permanency) were associated with mortality risks. These findings have implications for addressing health disparities and reforming foster care systems through programmatic and policy efforts.
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BACKGROUND: Gastric electric stimulation (GES) at a high-frequency, low-energy setting is an option for treating refractory gastroparesis. The currently available commercial stimulator, the Enterra neurostimulator (Medtronic Inc, Minneapolis, MN), however, requires surgical implantation and is powered by a nonrechargeable battery. OBJECTIVE: To develop and test a miniature wireless GES device for endoscopic implantation in an experimental model. DESIGN: In-vivo gastric signals were recorded and measured in a nonsurvival swine model (n = 2; 110-lb animals). INTERVENTION: An endoscopically placed, wireless GES device was inserted into the stomach through an overtube; the two GES electrodes were endoscopically attached to the gastric mucosa and secured with endoclips to permit stimulation. MAIN OUTCOME MEASUREMENTS: Stable electrogastrogram measures were observed during GES stimulation. RESULTS: Electrogastrogram recordings demonstrated that gastric slow waves became more regular and of constant amplitudes when stomach tissues were stimulated, in comparison with no stimulation. The frequency-to-amplitude ratio also changed significantly with stimulation. LIMITATION: Nonsurvival pig studies. CONCLUSION: Gastric electric stimulation is feasible by our endoscopically implanted, wireless GES device.
Subject(s)
Electric Stimulation Therapy/instrumentation , Gastric Mucosa/physiology , Wireless Technology , Animals , Gastroparesis/physiopathology , Gastroparesis/therapy , Gastroscopy , Prosthesis Implantation , Signal Processing, Computer-Assisted , Stomach/physiology , SwineABSTRACT
Overcoming the global concern of antibiotic resistance is one of the biggest challenges faced by scientists today, and the key to tackling this issue of emerging infectious diseases is the development of next-generation antimicrobials. The rapid emergence of multi-drug resistant microbes, superbugs and mutated strains of viruses has fuelled the search for new and alternative antimicrobial agents with broad-spectrum biocidal activity. Biomaterials, ranging from macroscopic polymers, proteins, and peptides to nanoscale materials such as nanoparticles, nanotubes and nanosheets have emerged as effective antimicrobials. An extensive body of research has established the antibacterial and antiviral efficiencies of different types of biomaterials. What make these materials unique are the different modes through which they interact and exert their antimicrobial activity. This review provides a comprehensive and detailed overview of the diverse modes of interaction between biomaterials and bacteria and viruses, and sheds light on how different biomaterials influence and modulate antimicrobial mechanisms to achieve a high degree of therapeutic efficacy without resistance generation.
Subject(s)
Anti-Infective Agents , Nanoparticles , Anti-Bacterial Agents/pharmacology , Anti-Infective Agents/pharmacology , Bacteria , Biocompatible Materials/pharmacologyABSTRACT
Although climate change poses a threat to health and well-being globally, a regional approach to addressing climate-related health equity may be more suitable, appropriate, and appealing to under-resourced communities and countries. In support of this argument, this commentary describes an approach by a network of researchers, practitioners, and policymakers dedicated to promoting climate-related health equity in Small Island Developing States and low- and middle-income countries in the Pacific. We identify three primary sets of needs related to developing a regional capacity to address physical and mental health disparities through research, training, and assistance in policy and practice implementation: (1) limited healthcare facilities and qualified medical and mental health providers; (2) addressing the social impacts related to the cooccurrence of natural hazards, disease outbreaks, and complex emergencies; and (3) building the response capacity and resilience to climate-related extreme weather events and natural hazards.
Subject(s)
Health Equity , Climate Change , Humans , Income , Mental Health , PolicyABSTRACT
BACKGROUND: Fluorescent in situ hybridization (FISH) equivocal results for Her-2/neu still pose a diagnostic dilemma in oncology practice. In this study, we evaluate if Her-2/neu mRNA expression is an alternative to FISH for detecting Her-2/neu positivity. PATIENTS AND METHODS: Archival paraffin blocks of 54 breast cancer patients were analyzed for Her-2/neu status using immunohistochemistry (IHC), FISH, and Her-2/neu gene expression using mRNA. RESULTS: There was a 100% positive agreement and 64.7% negative agreement of Her-2/neu mRNA expression with respect to the reference standard (FISH), with the kappa value for agreement being 0.36. mRNA levels correlated positively and strongly with FISH ratio and IHC positivity. For Her-2/neu mRNA expression, Her-2/neu copy number was a significant predictor indicating that mRNA expression is independent of polysomy status. CONCLUSIONS: Her-2/neu mRNA expression may help tide over ambiguity posed by polysomy and FISH equivocal samples.
Subject(s)
Biomarkers, Tumor/genetics , Breast Neoplasms/diagnosis , Breast Neoplasms/genetics , Chromosomes, Human, Pair 17/genetics , Genes, erbB-2/genetics , In Situ Hybridization, Fluorescence/methods , Polymerase Chain Reaction/methods , Breast Neoplasms/therapy , Female , Genetic Predisposition to Disease/genetics , Humans , Molecular Diagnostic Techniques/methods , Reproducibility of Results , Sensitivity and Specificity , Up-Regulation/geneticsABSTRACT
Race, ethnicity, and racism (RER) are interconnected with the critical problems tackled in the Grand Challenges for Social Work (GCSW). Yet, the extent to which the GCSW discuss the central role of RER is less clear. This article investigates how the GCSW integrate RER in their discourse. Using content analysis, authors examined all 21 concept papers that comprise the 12 initial GCSW to determine their attention to RER. Authors assessed whether each paper made any reference to race or ethnicity, whether race or ethnicity was considered as a primary theme, and whether racism was mentioned. Nine GCSW had at least one paper that mentioned race or ethnicity; seven had at least one paper that treated race and ethnicity as a major construct. Five GCSW contained at least one paper that discussed racism's impacts on their topical interests. None of the papers analyzed in the study defined or specified their conceptualization of racism. The GCSW are strategically positioned to widen and deepen social work's focus on RER, and the recent adoption of the 13th GCSW to "Eliminate racism" is an important first step. Authors encourage the social work field to embrace a more explicit, renewed, and continued commitment to eradicating systemic racism.
Subject(s)
Ethnicity , Racism , Humans , Social WorkABSTRACT
Natural disasters affect about 200 million people annually. Heightened intimate partner violence (IPV) is a gendered impact of these disruptive events. This study examines prevalence and correlates of IPV in four Indian states-TamilNadu, Kerala, AndhraPradesh, and Karnataka-before and after the Indian Ocean tsunami of 2004. Drawing on three waves of National Family Health Surveys of India-six years before, immediately after, and a decade after disaster, this paper evaluates if TamilNadu and Kerala (severely affected) exhibited higher prevalence of IPV than AndhraPradesh (moderately affected) and Karnataka (not directly affected). Logistic regression analyses determine association between IPV, state of residence (proxy for experience of disaster), and other covariates. To test hypotheses guided by vulnerability theory, IPV was regressed on socio-economic and demographic predictors for states across waves. IPV increased by 48% between 2005 and 2015. Increase in physical (61%) and sexual (232%) violence was highest in TamilNadu; emotional violence increased by 122% in Karnataka. State of residence was associated with IPV in the aftermath of disaster. In 2005, compared to Karnataka, odds of IPV were 98% higher in TamilNadu and 41% higher in Kerala. A decade after, odds were two times higher in TamilNadu than in Karnataka. Belonging to disadvantaged groups predicted higher odds of IPV in the year after disaster. Higher socio-economic status predicted lower odds of IPV, except in Kerala. Data point to ways in which socio-economic and demographic vulnerabilities factor into risk of IPV after disaster. Demographic factors of religion and caste appear to lose significance over time, but socio-economic factors continue to matter. Disaster response strategies seldom work without tackling long-standing inequities. Appropriate support systems for women and minorities in non-disaster situations are critical to ensure their conditions are not exacerbated.
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Adrenocortical carcinomas (ACCs) are rare malignancies with an incidence of one to two per million per year. Aldosterone-producing ACCs (APACs) are extremely rare with an incidence less than 1%. We describe a rare case of APAC, presenting with episodic lower-limb weakness and hypertension. Our patient was found to have serum aldosterone levels of 20.8 ng/dL (2.5-15.2) with persistent hypokalaemia and a 9.7×8.3×7.7 cm right adrenal mass, which was suspicious of malignancy on evaluation. He underwent a complete surgical resection which confirmed the diagnosis of ACC and normalised his aldosterone and potassium levels. He was then subjected to postoperative chemotherapy. Postoperative adjuvant chemotherapy with mitotane has a role in preventing recurrence.
Subject(s)
Adrenal Cortex Neoplasms , Adrenalectomy/methods , Adrenocortical Carcinoma , Aldosterone/blood , Hypertension , Hypokalemic Periodic Paralysis , Adrenal Cortex/diagnostic imaging , Adrenal Cortex/pathology , Adrenal Cortex Neoplasms/metabolism , Adrenal Cortex Neoplasms/pathology , Adrenal Cortex Neoplasms/physiopathology , Adrenocortical Carcinoma/metabolism , Adrenocortical Carcinoma/pathology , Adrenocortical Carcinoma/physiopathology , Adult , Chemotherapy, Adjuvant/methods , Diagnosis, Differential , Humans , Hypertension/diagnosis , Hypertension/etiology , Hypokalemic Periodic Paralysis/diagnosis , Hypokalemic Periodic Paralysis/etiology , Male , Potassium/blood , Tomography, X-Ray Computed/methods , Treatment OutcomeABSTRACT
Goal: Artificially engineering the tumor microenvironment in vitro as a vital tool for understanding the mechanism of tumor progression. In this study, we developed three-dimensional cell scaffold systems with different topographical features and mechanical properties but similar surface chemistry. The cell behavior was modulated by the topography and mechanical properties of the scaffold. Methods: Adenocarcinoma (MCF7), triple-negative (MDA-MB-231) and premalignant (MCF10AneoT) breast cancer cells were seeded on the scaffold systems. The cell viability, cell-cell interaction and cell-matrix interactions were analyzed. The preferential growth and alignment of specific population of cells were demonstrated. Results: Among the different scaffolds, triple-negative breast cancer cells preferred honeycomb scaffolds while adenocarcinoma cells favored mesh scaffolds and premalignant cells preferred the aligned scaffolds. Conclusions: The 3D model system developed here can be used to support growth of only specific cell populations or for the growth of tumors. This model can be used for understanding the topographical and mechanical features affecting tumorigenesis, cancer cell growth and migration behavior of malignant and metastatic cancer cells.