Exploring cancer health disparities among formerly incarcerated African Americans

Incarcerated populations have a higher burden of chronic disease and elevated risk factors for cancer (BJS, 2012). In 2013, cancer (31%) and heart disease (26%) accounted for over half of all prisoner deaths. The Genomics Research Program of the National Cancer Institute’s Division of Cancer Control and Population Sciences (2016) identified incarcerated persons as an understudied population about which there is limited data regarding cancer risks and outcomes. A majority of studies on corrections populations focus on health issues associated with reduction of infectious diseases such as HIV, Tuberculosis, and Hepatitis. Scant research has been conducted on issues associated with cancer prevention and control among African Americans with a history of incarceration. This qualitative, participatory, pilot research study explores the domains of cancer health disparities among African American men and women who were formerly incarcerated in Illinois prisons. Four qualitative focus groups will be conducted. The primary purpose of the focus groups is to collect and qualitatively analyze preliminary data on the barriers to access, utilization and treatment of cancer. This presentation seeks to: (1) describe the need for enhanced access to cancer care and treatment, (2) advocate for the inclusion of best practices in cancer care in corrections systems and, (3) identify policy recommendations and initiatives aimed at reducing cancer disparities among incarcerated and formerly incarcerated persons

Factors influencing terrestriality in primates of the Americas and Madagascar

Among mammals, the order Primates is exceptional in having a high taxonomic richness in which the taxa are arboreal, semiterrestrial, or terrestrial. Although habitual terrestriality is pervasive among the apes and African and Asian monkeys (catarrhines), it is largely absent among monkeys of the Americas (platyrrhines), as well as galagos, lemurs, and lorises (strepsirrhines), which are mostly arboreal. Numerous ecological drivers and species-specific factors are suggested to set the conditions for an evolutionary shift from arboreality to terrestriality, and current environmental conditions may provide analogous scenarios to those transitional periods. Therefore, we investigated predominantly arboreal, diurnal primate genera from the Americas and Madagascar that lack fully terrestrial taxa, to determine whether ecological drivers (habitat canopy cover, predation risk, maximum temperature, precipitation, primate species richness, human population density, and distance to roads) or species-specific traits (bodymass, group size, and degree of frugivory) associate with increased terrestriality. We collated 150,961 observation hours across 2,227 months from 47 species at 20 sites in Madagascar and 48 sites in the Americas. Multiple factors were associated with ground use in these otherwise arboreal species, including increased temperature, a decrease in canopy cover, a dietary shift away from frugivory, and larger group size. These factors mostly explain intraspecific differences in terrestriality. As humanity modifies habitats and causes climate change, our results suggest that species already inhabiting hot, sparsely canopied sites, and exhibiting more generalized diets, are more likely to shift toward greater ground use

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

Factors influencing terrestriality in primates of the Americas and Madagascar

Among mammals, the order Primates is exceptional in having a high taxonomic richness in which the taxa are arboreal, semiterrestrial, or terrestrial. Although habitual terrestriality is pervasive among the apes and African and Asian monkeys (catarrhines), it is largely absent among monkeys of the Americas (platyrrhines), as well as galagos, lemurs, and lorises (strepsirrhines), which are mostly arboreal. Numerous ecological drivers and species-specific factors are suggested to set the conditions for an evolutionary shift from arboreality to terrestriality, and current environmental conditions may provide analogous scenarios to those transitional periods. Therefore, we investigated predominantly arboreal, diurnal primate genera from the Americas and Madagascar that lack fully terrestrial taxa, to determine whether ecological drivers (habitat canopy cover, predation risk, maximum temperature, precipitation, primate species richness, human population density, and distance to roads) or species-specific traits (body mass, group size, and degree of frugivory) associate with increased terrestriality. We collated 150,961 observation hours across 2,227 months from 47 species at 20 sites in Madagascar and 48 sites in the Americas. Multiple factors were associated with ground use in these otherwise arboreal species, including increased temperature, a decrease in canopy cover, a dietary shift away from frugivory, and larger group size. These factors mostly explain intraspecific differences in terrestriality. As humanity modifies habitats and causes climate change, our results suggest that species already inhabiting hot, sparsely canopied sites, and exhibiting more generalized diets, are more likely to shift toward greater ground use

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Latino College Students Attending Highly Selective Universities: The Role of Ethnic Identity

Latinos trail behind their non-Latino White peers in academic achievement from early childhood through higher education. While attention has been paid to improving Latinos high school completion and college enrollment rates, far less attention has been given to college completion. This study utilized quantitative data from the National Longitudinal Survey of Freshman (NLSF) to address two overarching research questions: (1) Is a culturally accepting/inclusive school climate related to positive academic outcomes? and (2) Does the effect of the cultural climate on student achievement vary by students’ ethnic identity? The sample was comprised of 917 Latino college students attending 28 selective universities from across the nation. The empirical research on these areas of interest has produced mixed results. This may be partially due to ethnic identity and academic outcomes being defined and measured differently from one study to another, making it difficult to make comparisons from one study to another. This study examined ethnic identity from a multi-dimensional perspective and examined academic achievement from a mainstream and Latino perspective (students’ ability to obtain a formal education while maintaining strong family/community ties). The cultural school climate was related to five outcomes (timely degree completion, increased academic aspirations and connectedness to family, community, and ethnic group). The effect of the cultural climate on student achievement was dependent on students’ ethnic identity for seven outcomes (i.e. grades earned, timely degree completion, degree completion (six years), increased aspirations, reduced aspirations, family connectedness, and feeling resented by one’s ethnic group). The majority of these students completed their degree and earned high grades, however, a sizeable amount reported their going to college made them feel less part of their family and reported feeling resented by members of their ethnic group. This study supports the need to develop targeted programs to serve a range of Latino students because depending on the outcome in question and/or students’ unique dimensions of ethnic identity, some students stand to benefit more from culturally inclusive learning environments than others. Also, this study shows schools can strengthen students’ relationships with family and their ethnic group while also nurturing their academic aspirations and timely completion

DIVERSIDADE GENÉTICA EM PINHÃO MANSO COM BASE EM MARCADORES ISSR

A utilização de espécies oleaginosas constitui uma alternativa à busca crescente por biocombustíveis, fazendo com que o pinhão manso venha ganhando destaque pela qualidade do seu óleo e rusticidade. Surge assim uma demanda pelo desenvolvimento de cultivares desta espécie e para isso o conhecimento de sua variabilidade genética é fundamental. Objetivou-se com o presente estudo avaliar a diversidade genética de 23 acessos de pinhão manso coletados em diferentes regiões do Brasil. Os DNAs dos acessos foram extraídos e analisados por meio de 12 iniciadores ISSR. A partir dos perfis eletroforéticos das bandas foi gerada a matriz de dissimilaridade genética, utilizada na elaboração do dendrograma e no agrupamento dos indivíduos, que também foi realizado segundo o método de Tocher.  O Índice de Coincidência foi calculado para verificar a existência de relação entre o agrupamento dos acessos e seu local de coleta. Um total de 44 bandas foram amplificadas, sendo 26 polimórficas (49,08%). As distâncias genéticas entre os genótipos variaram de 0,034 a 0,314. Os métodos de agrupamento permitiram a formação de grupos distintos, com um total de três grupos formados pelo Método de Tocher e sete pelo método UPGMA. Os acessos estudados apresentaram base genética estreita, o que poderá trazer dificuldades ao processo de melhoramento da cultura e levar a uma maior vulnerabilidade genética das novas cultivares lançadas.Palavras-chave: Jatropha curcas; marcadores moleculares; diversidade genética. GENETIC DIVERSITY IN THE PHYSIC NUT BASED ON ISSR MARKERS ABSTRACT: The use of oleaginous species is an alternative in the growing search for biofuels, where the physic nut (Jatropha curcas) stands out due to its robustness and the quality of its oil. The result is a demand to develop cultivars of this species, and for this, a knowledge of its genetic variability is fundamental. The aim of this study was to evaluate the genetic diversity of 23 accessions of jatropha collected in different regions of Brazil. The DNA of the accessions was extracted and analysed by means of 12 ISSR primers. A genetic dissimilarity matrix was generated from the electrophoretic profiles of the bands and used in elaborating the dendrogram and in grouping the individuals, which was also carried out as per the Tocher method. A Coincidence Index was calculated to check the existence of a relationship between the groups of accessions and their places of collection. A total of 44 bands were amplified, of which 26 were polymorphic (49.08%). The genetic distance between the genotypes ranged from 0.034 to 0.314. The clustering methods resulted in the formation of distinct groups, where three groups were formed by the Tocher Method and seven by the UPGMA. The accessions under study had a narrow genetic base, which could cause difficulties for the process of crop breeding, and lead to greater genetic vulnerability in the new cultivars.Keywords: Jatropha curcas; molecular markers; genetic diversity

DIVERSIDADE GENÉTICA EM PINHÃO MANSO COM BASE EM MARCADORES ISSR

A utilização de espécies oleaginosas constitui uma alternativa à busca crescente por biocombustíveis, fazendo com que o pinhão manso venha ganhando destaque pela qualidade do seu óleo e rusticidade. Surge assim uma demanda pelo desenvolvimento de cultivares desta espécie e para isso o conhecimento de sua variabilidade genética é fundamental. Objetivou-se com o presente estudo avaliar a diversidade genética de 23 acessos de pinhão manso coletados em diferentes regiões do Brasil. Os DNAs dos acessos foram extraídos e analisados por meio de 12 iniciadores ISSR. A partir dos perfis eletroforéticos das bandas foi gerada a matriz de dissimilaridade genética, utilizada na elaboração do dendrograma e no agrupamento dos indivíduos, que também foi realizado segundo o método de Tocher.  O Índice de Coincidência foi calculado para verificar a existência de relação entre o agrupamento dos acessos e seu local de coleta. Um total de 44 bandas foram amplificadas, sendo 26 polimórficas (49,08%). As distâncias genéticas entre os genótipos variaram de 0,034 a 0,314. Os métodos de agrupamento permitiram a formação de grupos distintos, com um total de três grupos formados pelo Método de Tocher e sete pelo método UPGMA. Os acessos estudados apresentaram base genética estreita, o que poderá trazer dificuldades ao processo de melhoramento da cultura e levar a uma maior vulnerabilidade genética das novas cultivares lançadas.Palavras-chave: Jatropha curcas; marcadores moleculares; diversidade genética. GENETIC DIVERSITY IN THE PHYSIC NUT BASED ON ISSR MARKERS ABSTRACT: The use of oleaginous species is an alternative in the growing search for biofuels, where the physic nut (Jatropha curcas) stands out due to its robustness and the quality of its oil. The result is a demand to develop cultivars of this species, and for this, a knowledge of its genetic variability is fundamental. The aim of this study was to evaluate the genetic diversity of 23 accessions of jatropha collected in different regions of Brazil. The DNA of the accessions was extracted and analysed by means of 12 ISSR primers. A genetic dissimilarity matrix was generated from the electrophoretic profiles of the bands and used in elaborating the dendrogram and in grouping the individuals, which was also carried out as per the Tocher method. A Coincidence Index was calculated to check the existence of a relationship between the groups of accessions and their places of collection. A total of 44 bands were amplified, of which 26 were polymorphic (49.08%). The genetic distance between the genotypes ranged from 0.034 to 0.314. The clustering methods resulted in the formation of distinct groups, where three groups were formed by the Tocher Method and seven by the UPGMA. The accessions under study had a narrow genetic base, which could cause difficulties for the process of crop breeding, and lead to greater genetic vulnerability in the new cultivars.Keywords: Jatropha curcas; molecular markers; genetic diversity

Intraoperative transfusion practices in Europe

BACKGROUND: Transfusion of allogeneic blood influences outcome after surgery. Despite widespread availability of transfusion guidelines, transfusion practices might vary among physicians, departments, hospitals and countries. Our aim was to determine the amount of packed red blood cells (pRBC) and blood products transfused intraoperatively, and to describe factors determining transfusion throughout Europe. METHODS: We did a prospective observational cohort study enrolling 5803 patients in 126 European centres that received at least one pRBC unit intraoperatively, during a continuous three month period in 2013. RESULTS: The overall intraoperative transfusion rate was 1.8%; 59% of transfusions were at least partially initiated as a result of a physiological transfusion trigger- mostly because of hypotension (55.4%) and/or tachycardia (30.7%). Haemoglobin (Hb)- based transfusion trigger alone initiated only 8.5% of transfusions. The Hb concentration [mean (sd)] just before transfusion was 8.1 (1.7) g dl(-1) and increased to 9.8 (1.8) g dl(-1) after transfusion. The mean number of intraoperatively transfused pRBC units was 2.5 (2.7) units (median 2). CONCLUSION: Although European Society of Anaesthesiology transfusion guidelines are moderately implemented in Europe with respect to Hb threshold for transfusion (7-9 g dl(-1)), there is still an urgent need for further educational efforts that focus on the number of pRBC units to be transfused at this threshold. CLINICAL TRIAL REGISTRATION: NCT 01604083

Factors influencing terrestriality in primates of the Americas and Madagascar

Among mammals, the order Primates is exceptional in having a high taxonomic richness in which the taxa are arboreal, semiterrestrial, or terrestrial. Although habitual terrestriality is pervasive among the apes and African and Asian monkeys (catarrhines), it is largely absent among monkeys of the Americas (platyrrhines), as well as galagos, lemurs, and lorises (strepsirrhines), which are mostly arboreal. Numerous ecological drivers and species-specific factors are suggested to set the conditions for an evolutionary shift from arboreality to terrestriality, and current environmental conditions may provide analogous scenarios to those transitional periods. Therefore, we investigated predominantly arboreal, diurnal primate genera from the Americas and Madagascar that lack fully terrestrial taxa, to determine whether ecological drivers (habitat canopy cover, predation risk, maximum temperature, precipitation, primate species richness, human population density, and distance to roads) or species-specific traits (body mass, group size, and degree of frugivory) associate with increased terrestriality. We collated 150,961 observation hours across 2,227 months from 47 species at 20 sites in Madagascar and 48 sites in the Americas. Multiple factors were associated with ground use in these otherwise arboreal species, including increased temperature, a decrease in canopy cover, a dietary shift away from frugivory, and larger group size. These factors mostly explain intraspecific differences in terrestriality. As humanity modifies habitats and causes climate change, our results suggest that species already inhabiting hot, sparsely canopied sites, and exhibiting more generalized diets, are more likely to shift toward greater ground use