Real and Perceived Discordance in Physicians and U.S. Adults’ Beliefs Regarding the Causes and Controllability of Type 2 Diabetes

Discordance between physicians and patients’ health beliefs can impede health communication efforts. However, little research considers physicians’ perceptions of patient beliefs, despite the importance of perceptions in shaping communication. In the current work, we examine instances of actual and perceived discordance between physicians and U.S. adults’ beliefs regarding the causes and controllability of type 2 diabetes. 229 family physicians completed an online survey measuring their health beliefs and perceptions of their patients’ beliefs. Physicians’ responses were contrasted against beliefs from a national survey sample of 1,168 U.S. adults. T-tests assessed whether (a) physicians’ beliefs diverged from the national sample’s beliefs (actual discordance), (b) physicians perceived that their health beliefs diverged from their patients’ beliefs (perceived discordance), and (c) physicians’ perceptions of patient beliefs diverged from the national sample’s beliefs (accuracy of perceived discordance). Findings revealed evidence of actual discordance; compared to the national sample, physicians were more likely to attribute type 2 diabetes to genes (versus lifestyle factors) and perceived greater control over developing diabetes. Moreover, although physicians perceived discordance between their own and their patients’ beliefs, data from the national sample suggested that these gaps were less substantial than physicians expected. In particular, findings showed that physicians generally overestimated discordance, expecting that people would be less likely to (1) attribute the development of diabetes to lifestyle factors (versus genes), and (2) perceive control over developing diabetes, than was actually reported. Implications of actual and perceived discordance for effective health communication and patient education are discussed

Observations of Infrared Radiative Cooling in the Thermosphere on Daily to Multiyear Timescales from the TIMED/SABER Instrument

We present observations of the infrared radiative cooling by carbon dioxide (CO2) and nitric oxide (NO) in Earth s thermosphere. These data have been taken over a period of 7 years by the SABER instrument on the NASA TIMED satellite and are the dominant radiative cooling mechanisms for the thermosphere. From the SABER observations we derive vertical profiles of radiative cooling rates (W/cu m), radiative fluxes (W/sq m), and radiated power (W). In the period from January 2002 through January 2009 we observe a large decrease in the cooling rates, fluxes, and power consistent with the declining phase of solar cycle. The power radiated by NO during 2008 when the Sun exhibited few sunspots was nearly one order of magnitude smaller than the peak power observed shortly after the mission began. Substantial short-term variability in the infrared emissions is also observed throughout the entire mission duration. Radiative cooling rates and radiative fluxes from NO exhibit fundamentally different latitude dependence than do those from CO2, with the NO fluxes and cooling rates being largest at high latitudes and polar regions. The cooling rates are shown to be derived relatively independent of the collisional and radiative processes that drive the departure from local thermodynamic equilibrium (LTE) in the CO2 15 m and the NO 5.3 m vibration-rotation bands. The observed NO and CO2 cooling rates have been compiled into a separate dataset and represent a climate data record that is available for use in assessments of radiative cooling in upper atmosphere general circulation models

Cancer risk in childhood-onset systemic lupus

INTRODUCTION: The aim of this study was to assess cancer incidence in childhood-onset systemic lupus erythematosus (SLE). METHODS: We ascertained cancers within SLE registries at 10 pediatric centers. Subjects were linked to cancer registries for the observational interval, spanning 1974 to 2009. The ratio of observed to expected cancers represents the standardized incidence ratio (SIR) or relative cancer risk in childhood-onset SLE, versus the general population. RESULTS: There were 1020 patients aged <18 at cohort entry. Most (82%) were female and Caucasian; mean age at cohort entry was 12.6 years (standard deviation (SD) = 3.6). Subjects were observed for a total of 7,986 (average 7.8) patient-years. Within this interval, only three invasive cancers were expected. However, 14 invasive cancers occurred with an SIR of 4.7, 95% confidence interval (CI) 2.6 to 7.8. Three hematologic cancers were found (two non-Hodgkin’s lymphoma, one leukemia), for an SIR of 5.2 (95% CI 1.1 to 15.2). The SIRs stratified by age group and sex, were similar across these strata. There was a trend for highest cancer occurrence 10 to 19 years after SLE diagnosis. CONCLUSIONS: These results suggest an increased cancer risk in pediatric onset SLE versus the general population. In absolute terms, this represents relatively few events. Of note, risk may be highest only after patients have transferred to adult care

WFPC2 Studies of the Crab Nebula. I. HST and ROSAT Imaging of the Synchrotron Nebula

We present images of the Crab synchrotron nebula obtained with the Wide Field and Planetary Camera 2 (WFPC2) on board the Hubble Space Telescope. These data are compared with ROSAT HRI images, and with 0':5 resolution Canada-France-Hawaii Telescope (CFHT) images previously published by van den Bergh & Pritchet (1989). These data strengthen the emerging picture of the Crab as a cylindrically symmetrical object with an axis running southeast to northwest, and inclined by ~20°-30° with respect to the plane of the sky. Identification of structure very near to the pulsar which shares this symmetry helps to better establish the link between the symmetry axis of the nebula and the spin axis of the pulsar. We report the discovery of a bright knot of visible emission located 0º.65 to the southeast of the pulsar, along the axis of the system. This knot and a second knot 3".8 from the pulsar appear to be present but not well resolved in the 1988 CFHT image, indicating that they are persistent structures. The inner knot is interpreted as a shock in the pulsar wind ~ 1500 AU above the pole of the pulsar. No corresponding knots are seen to the northwest of the pulsar, which may indicate that the characteristics of the wind from the two poles are not symmetrical. The closest of the "wisps" to the northwest of the pulsar appear to close into a ringlike "halo" encircling the axis of the nebula. The wisps are resolved, with widths of ~ 0".2. This allows· calculation of their volumes and volume emissivities, and in turn their equipartition fields and pressures. Equipartition pressures calculated for the knots and wisps are typically 10 to as much as 80 times the equipartition pressure calculated for the nebula as a whole. The wisps show significant substructure which changed considerably between 1988 and 1994. Previous reports of relativistic motions of the wisps were probably due to changes in the unresolved substructure of these features. Comparison of the CFHT and WFPC2 images show remarkable changes in the inner nebula, but inferences about physical conditions based on this comparison are limited by the resolution of the CFHT data and the long 5 year baseline between the images. The structure of the nebula in 1994 may be inconsistent with the recent model by Gallant & Arons (1994). Very fine fibrous texture visible in the WFPC2 image follows the structure of the X-ray torus. A puzzling anticorrelation is seen between the X-ray and visible surface brightness through part of the torus. Long contiguous low contrast features with widths of ~ 1"-2" are seen to run throughout the volume of the nebula. These features are seen to move outward through the nebula at velocities in excess of homologous expansion. These features trace the magnetic structure of the nebula; they are probably due to differences in emissivity accompanying varying degrees of departure from equipartition at roughly constant total pressure. Visible fibers "drape over" and appear to expand away from an X-ray counterjet to the northwest of the pulsar, supporting the interpretation of the counterjet as a directed flow of energy along the symmetry axis of the nebula. Other associations are also seen between X-ray and visible structures, including X-ray emission surrounding the east and west bays. An association is proposed between the observed structure of the nebula and different latitude zones found in models of winds from partially oblique rotators. We concur with previous suggestions that the X-ray torus and the sharp visible fibers associated with it mark a shock at r_s ~ 1.2 x 10^(18) cm in an equatorial striped magnetic wind. The halo and anvil arise at a distance of ~ 1.4 x 10^(17) cm from the pulsar in a helically polarized wind at latitudes greater than about 35°. Well collimated polar jets may be responsible for the knots to the southeast of the pulsar and for the jet and counterjet seen at X-ray and visible wavelengths

Efficacy of neoadjuvant bevacizumab added to docetaxel followed by fluorouracil, epirubicin, and cyclophosphamide, for women with HER2-negative early breast cancer (ARTemis): an open-label, randomised, phase 3 trial

Background: The ARTemis trial was developed to assess the efficacy and safety of adding bevacizumab to standard neoadjuvant chemotherapy in HER2-negative early breast cancer. Methods: In this randomised, open-label, phase 3 trial, we enrolled women (≥18 years) with newly diagnosed HER2-negative early invasive breast cancer (radiological tumour size >20 mm, with or without axillary involvement), at 66 centres in the UK. Patients were randomly assigned via a central computerised minimisation procedure to three cycles of docetaxel (100 mg/m2 once every 21 days) followed by three cycles of fluorouracil (500 mg/m2), epirubicin (100 mg/m2), and cyclophosphamide (500 mg/m2) once every 21 days (D-FEC), without or with four cycles of bevacizumab (15 mg/kg) (Bev+D-FEC). The primary endpoint was pathological complete response, defined as the absence of invasive disease in the breast and axillary lymph nodes, analysed by intention to treat. The trial has completed and follow-up is ongoing. This trial is registered with EudraCT (2008-002322-11), ISRCTN (68502941), and ClinicalTrials.gov (NCT01093235). Findings: Between May 7, 2009, and Jan 9, 2013, we randomly allocated 800 participants to D-FEC (n=401) and Bev+D-FEC (n=399). 781 patients were available for the primary endpoint analysis. Significantly more patients in the bevacizumab group achieved a pathological complete response compared with those treated with chemotherapy alone: 87 (22%, 95% CI 18–27) of 388 patients in the Bev+D-FEC group compared with 66 (17%, 13–21) of 393 patients in the D-FEC group (p=0·03). Grade 3 and 4 toxicities were reported at expected levels in both groups, although more patients had grade 4 neutropenia in the Bev+D-FEC group than in the D-FEC group (85 [22%] vs 68 [17%]). Interpretation: Addition of four cycles of bevacizumab to D-FEC in HER2-negative early breast cancer significantly improved pathological complete response. However, whether the improvement in pathological complete response will lead to improved disease-free and overall survival outcomes is unknown and will be reported after longer follow-up. Meta-analysis of available neoadjuvant trials is likely to be the only way to define subgroups of early breast cancer that would have clinically significant long-term benefit from bevacizumab treatment

IMI 2021 Yearly Digest

PURPOSE. The International Myopia Institute (IMI) Yearly Digest highlights new research considered to be of importance since the publication of the first series of IMI white papers. METHODS. A literature search was conducted for articles on myopia between 2019 and mid-2020 to inform definitions and classifications, experimental models, genetics, interventions, clinical trials, and clinical management. Conference abstracts from key meetings in the same period were also considered. RESULTS. One thousand articles on myopia have been published between 2019 and mid-2020. Key advances include the use of the definition of premyopia in studies currently under way to test interventions in myopia, new definitions in the field of pathologicmyopia, the role of new pharmacologic treatments in experimental models such as intraocular pressure-lowering latanoprost, a large meta-analysis of refractive error identifying 336 new genetic loci, new clinical interventions such as the defocus incorporated multisegment spectacles and combination therapy with low-dose atropine and orthokeratology (OK), normative standards in refractive error, the ethical dilemma of a placebo control group when myopia control treatments are established, reporting the physical metric of myopia reduction versus a percentage reduction, comparison of the risk of pediatric OK wear with risk of vision impairment in myopia, the justification of preventing myopic and axial length increase versus quality of life, and future vision loss. CONCLUSIONS. Large amounts of research in myopia have been published since the IMI 2019 white papers were released. The yearly digest serves to highlight the latest research and advances in myopia.Peer reviewe

Burmese pythons in Florida: A synthesis of biology, impacts, and management tools

Burmese pythons (Python molurus bivittatus) are native to southeastern Asia, however, there is an established invasive population inhabiting much of southern Florida throughout the Greater Everglades Ecosystem. Pythons have severely impacted native species and ecosystems in Florida and represent one of the most intractable invasive-species management issues across the globe. The difficulty stems from a unique combination of inaccessible habitat and the cryptic and resilient nature of pythons that thrive in the subtropical environment of southern Florida, rendering them extremely challenging to detect. Here we provide a comprehensive review and synthesis of the science relevant to managing invasive Burmese pythons. We describe existing control tools and review challenges to productive research, identifying key knowledge gaps that would improve future research and decision making for python control. (119 pp

Population genomics applications for conservation: the case of the tropical dry forest dweller Peromyscus melanophrys

Recent advances in genomic sequencing have opened new horizons in the study of population genetics and evolution in non-model organisms. However, very few population genomic studies have been performed on wild mammals to understand how the landscape affects the genetic structure of populations, useful information for the conservation of biodiversity. Here, we applied a genomic approach to evaluate the relationship between habitat features and genetic patterns at spatial and temporal scales in an endangered ecosystem, the Tropical Dry Forest (TDF). We studied populations of the Plateau deer mouse Peromyscus melanophrys to analyse its genomic diversity and structure in a TDF protected area in the Huautla Mountain Range (HMR), Mexico based on 8,209 SNPs obtained through Genotyping-by-Sequencing. At a spatial scale, we found a significant signature of isolation-by-distance, few significant differences in genetic diversity indices among study sites, and no significant differences between habitats with different levels of human perturbation. At a temporal scale, while genetic diversity levels fluctuated significantly over time, neither seasonality nor disturbance levels had a significant effect. Also, outlier analysis revealed loci potentially under selection. Our results suggest that the population genetics of P. melanophrys may be little impacted by anthropogenic disturbances, or by natural spatial and temporal habitat heterogeneity in our study area. The genome-wide approach adopted here provides data of value for conservation planning, and a baseline to be used as a reference for future studies on the effects of habitat fragmentation and seasonality in the HMR and in TDF