More Social Needs Endorsed by Caregivers of Young Children Experiencing Everyday Discrimination

Background: Both discrimination and social needs are underlying risk factors for poor health outcomes; however, there are no studies looking at how feelings of discrimination impact reporting of social needs in the pediatric health care setting. Objective: To compare caregiver report of social needs and desire for help addressing social needs in the pediatric primary care setting based on respondents’ experiences with discrimination. Methods: We conducted a cross-sectional study of caregivers of children aged 2-5 in an urban primary care setting. Caregivers completed a tool to screen for 15 social needs and desire for help to address these needs, with in-person assistance available. The tool was adapted based on qualitative data with this same population and included items from the PHQ-2, 2-item food insecurity screener, and WE CARE survey. The short version of the “Everyday Discrimination Scale” was also completed, and caregivers were categorized as experiencing everyday discrimination if they responded “rarely”, “sometimes”, or “often” on any of 5 types of discrimination. If caregivers experienced everyday discrimination, they were also asked about perceived basis for discrimination. T-tests were conducted to compare the number of reported social needs and number of needs for which a caregiver desired help between groups based on experience of everyday discrimination and type of discrimination. Results: One hundred seventy-eight caregivers (94% mothers, mean age 32) of diverse racial and ethnic backgrounds (29% white, 61% black; 10% Hispanic) completed the screening tool. Sixty-seven percent had public insurance, and 35% were from households with an annual income below $20,000. Fifty-three percent of caregivers reported everyday discrimination, especially in regards to being treated with less respect and receiving poorer service in stores and restaurants (Figure 1) and most commonly on the basis of race (48%), gender (38%), and age (31%). Both caregivers who endorsed everyday discrimination in general, and those endorsing discrimination specifically by gender and age, reported a significantly higher number of social needs and number of social needs for which they wanted help (Table 1). Conclusions: In an urban population of mostly young Black mothers, the majority endorsed feeling some degree of everyday discrimination. Despite this, caregivers who endorsed feelings of discrimination, especially because of their gender and age, reported more social needs and a greater desire for help addressing these needs. This suggests that caregivers feel comfortable reporting sensitive social needs in the context of a child’s healthcare setting even though they may experience everyday discrimination. These findings may also suggest an association between experienced discrimination and social needs, with both potentially influenced by similar sociodemographic factors

Opioid Consumption after Orthopedic Surgery: Prospective Randomized Trial on the Effects of Preoperative Counseling

Introduction: Recently, there have been increases in morbidity and mortality associated with opioid medications. Physician overprescribing, particularly within orthopedics, contributes to large quantities of leftover opioids, leading to an increased risk of non-medical opioid use and abuse. Objective: To understand the role of preoperative patient counseling on postoperative opioid consumption, a prospective randomized study was done, with the idea that patients receiving counseling would take fewer opioids than their control counterparts. Methods: Patients undergoing elective outpatient orthopedic surgery at Jefferson affiliate hospitals were enrolled over a 3-month period. Patients were randomized to a control group or to receive preoperative counseling in the form of a multimedia presentation aimed at educating the patient on opioid medications, strategies for pain management and the opioid epidemic. Information on demographics, surgical procedure, amount and type of opioid prescribed, number of opioids consumed and non-opioid analgesic use was collected at the first postoperative visit. Results: 283 patients were enrolled (57% women, 43% men). On average, patients who were counseled consumed 2.30 fewer opioids than their control counterparts (P=0.0497), equating to 34% of their entire prescription, compared to 42% in the control. Among patients who were counseled, 84.16% thought the preoperative multimedia presentation was helpful and 92.86% thought that all patients should watch the video before surgery. Discussion: There is evidence to suggest that preoperative opioid counseling is effective in decreasing postoperative opioid consumption. Leftover opioids totaled nearly 4,000 among all patients, indicating that orthopedic surgeons are prescribing far more than are being consumed

From Climate Change to COVID-19: Using Entertainment-Education for Public Health

Entertainment-education (EE) is a theory and evidence-based health communication strategy that embeds didactic information into entertaining narratives for children and adults alike. U.S. examples include Sesame Street, episodes of Grey’s Anatomy, and the hit Hulu T.V. show East Los High. EE has been developed for audiences around the world to address a wide range of public health topics. In this webinar, we define entertainment-education, briefly describe its history and theoretical foundation, and present findings from two recent projects: one focused on climate change and the other on COVID-19. Presentation: 48:5

Status of Grauer’s Gorilla and Chimpanzees in Eastern Democratic Republic of Congo: Historical and Current Distribution and Abundance

This report summarises the current state of knowledge on the distribution, densities and trends in abundance of Grauer’s gorilla (Gorilla beringei graueri) and the eastern chimpanzee (Pan troglodytes schweinfurthii) in eastern Democratic Republic of Congo (DRC). It summarises the historical knowledge about the distribution of Grauer’s gorilla across its range and describes the development of a Conservation Action Plan (CAP) for these two ape species. A result of this CAP was funding to undertake an assessment of the current status of these apes across the range of Grauer’s gorilla. Wildlife Conservation Society (WCS) and Fauna & Flora International (FFI) worked with Institut Congolais pour la Conservation de la Nature (ICCN) and the Reserve managers of the Reserve des Gorilles de Punia (RGPU) and local communities to undertake surveys across the region using a variety of methods: line transects, recces along paths and patrol data from data collected by rangers while on patrol and entered into SMART software

Acetyl-CoA synthetase 2 promotes acetate utilization and maintains cancer cell growth under metabolic stress

A functional genomics study revealed that the activity of acetyl-CoA synthetase 2 (ACSS2) contributes to cancer cell growth under low-oxygen and lipid-depleted conditions. Comparative metabolomics and lipidomics demonstrated that acetate is used as a nutritional source by cancer cells in an ACSS2-dependent manner, and supplied a significant fraction of the carbon within the fatty acid and phospholipid pools. ACSS2 expression is upregulated under metabolically stressed conditions and ACSS2 silencing reduced the growth of tumor xenografts. ACSS2 exhibits copy-number gain in human breast tumors, and ACSS2 expression correlates with disease progression. These results signify a critical role for acetate consumption in the production of lipid biomass within the harsh tumor microenvironment

Catastrophic Decline of World's Largest Primate: 80% Loss of Grauer's Gorilla (Gorilla beringei graueri) Population Justifies Critically Endangered Status

Grauer's gorilla (Gorilla beringei graueri), the World's largest primate, is confined to eastern Democratic Republic of Congo (DRC) and is threatened by civil war and insecurity. During the war, armed groups in mining camps relied on hunting bushmeat, including gorillas. Insecurity and the presence of several militia groups across Grauer's gorilla's range made it very difficult to assess their population size. Here we use a novel method that enables rigorous assessment of local community and ranger-collected data on gorilla occupancy to evaluate the impacts of civil war on Grauer's gorilla, which prior to the war was estimated to number 16,900 individuals. We show that gorilla numbers in their stronghold of Kahuzi- Biega National Park have declined by 87%. Encounter rate data of gorilla nests at 10 sites across its range indicate declines of 82-100% at six of these sites. Spatial occupancy analysis identifies three key areas as the most critical sites for the remaining populations of this ape and that the range of this taxon is around 19,700 km2. We estimate that only 3,800 Grauer's gorillas remain in the wild, a 77% decline in one generation, justifying its elevation to Critically Endangered status on the IUCN Red List of Threatened Species

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Postpartum in a Pandemic: Using Photo-elicitation to Explore Experiences of New Mothers During COVID-19

Objective: To shed light on the post-partum experiences of women who gave birth during COVID-19 in order to identify short- and long-term opportunities for providers to address maternal-child health during this pandemic, its aftermath, and future disruptions to the postpartum experience. Methods: This qualitative photo-elicitation study asked women between 3-10 weeks postpartum to take photographs that encompassed their experience as a new mother during the pandemic, and two trained interviewers elicited elements of this experience using the photos as an anchor during virtual, hour-long interviews. Interview transcripts were analyzed using directed content analysis, including a process of open coding to identify key ideas, codebook development, and refinement. Fifty percent of transcripts were team coded to ensure coding accuracy. Following coding, the study team organized codes to inform the development of an explanatory model. Results: Interviews illuminated important stressors new mothers experienced that were worsened during the pandemic, namely fear, childcare, older children, loss, isolation, and employment. Interviews also highlighted key support structures (self-care, interpersonal, and structural supports) that were at times helpful in alleviating stressors and at others were inadequate to counter stress and even enhanced stress. The stressors caused by the pandemic exposed fault lines in support systems postpartum women need and highlight key action items that providers can utilize for supporting postpartum patients during disasters like this pandemic and in the years of its aftermath. Conclusion: For postpartum individuals overall, the pandemic posed a major strain to an already stressful time. These findings highlight key takeaways in considering care for this population both now and in the future, and suggest action items to improve quality of care in the postpartum period more broadly

The molecular basis of quinolone drug action on DNA gyrase.

Quinolones are a clinically-useful class of antibacterial agents known to target DNA gyrase, a bacterial type II topoisomerase. Gyrase is unique among topoisomerases in its ability to introduce negative supercoils into DNA using the energy derived from ATP hydrolysis. The active enzyme is composed of two GyrA and two GyrB subunits, forming an A2B2 tetramer of molecular weight 374 kDa. The mechanism of supercoiling by gyrase involves the ATP-driven passage of one segment of DNA through a gyrase-stabilised double-stranded break in another. Tyrosine 122 of E. coli GyrA becomes covalently attached to DNA when gyrase breaks the phosphodiester bonds of DNA during supercoiling. When this residue is mutated to serine or phenylalanine, gyrase can no longer cleave or supercoil DNA, but can bind DNA normally. Rapid-gel filtration experiments have shown that quinolones can still bind to proteins bearing these mutations, suggesting that DNA cleavage by gyrase is not required for quinolone binding. Transcription by T7 and E. coli RNA polymerases is blocked by the presence of a gyrase-quinolone-DNA complex. Mapping of the transcription termination sites in the presence of gyrase and quinolones shows that blocking occurs about 10 to 20 base-pairs upstream of the gyrase cleavage site. Blocking of transcription by T7 RNA polymerase by a gyrase-quinolone complex on DNA does not occur when the active-site tyrosine of gyrase is mutated to serine, which indicates that the polymerase blocking requires DNA cleavage. Analysis of transcription in the absence of drug suggest that RNA polymerase does not displace gyrase from the template. DNA gyrase is also the target of the CcdB protein which is encoded by the F plasmid. When its action is not prevented by CcdA protein, CcdB is a potent cytotoxin. Using in vitro transcription by T7 RNA polymerase, it has been shown that CcdB complexed with gyrase can block transcription in a similar manner to the gyrase-quinolone complex. Furthermore, in the presence of CcdA, CcdB can no longer induce gyrase to block transcription