Perspectives on self-managed abortion among providers in hospitals along the Texas– Mexico border

Background Following self-managed abortion (SMA), or a pregnancy termination attempt outside of the formal health system, some patients may seek care in an emergency department. Information about provider experiences treating these patients in hospital settings on the Texas-Mexico border is lacking. Methods The study team conducted semi-structured interviews with physicians, advanced practice clinicians, and nurses who had experience with patients presenting with early pregnancy complications in emergency and/or labor and delivery departments in five hospitals near the Texas-Mexico border. Interview questions focused on respondents’ roles at the hospital, knowledge of abortion services and laws, perspectives on SMA trends, experiences treating patients presenting after SMA, and potential gaps in training related to abortion. Researchers conducted interviews in person between October 2017 and January 2018, and analyzed transcripts using a thematic analysis approach. Results Most of the 54 participants interviewed said that the care provided to SMA patients was, and should be, the same as for patients presenting after miscarriage. The majority had treated a patient they suspected or confirmed had attempted SMA; typically, these cases required only expectant management and confirmation of pregnancy termination, or treatment for incomplete abortion. In rare cases, further clinical intervention was required. Many providers lacked clinical and legal knowledge about abortion, including local resources available. Conclusions Treatment provided to SMA patients is similar to that provided to patients presenting after early pregnancy loss. Lack of provider knowledge about abortion and SMA, despite their involvement with SMA patients, highlights a need for improved training

Reproducing the CO-to-H₂ conversion factor in cosmological simulations of Milky-Way-mass galaxies

We present models of CO(1–0) emission from Milky-Way-mass galaxies at redshift zero in the FIRE-2 cosmological zoom-in simulations. We calculate the molecular abundances by post-processing the simulations with an equilibrium chemistry solver while accounting for the effects of local sources, and determine the emergent CO(1–0) emission using a line radiative transfer code. We find that the results depend strongly on the shielding length assumed, which, in our models, sets the attenuation of the incident UV radiation field. At the resolution of these simulations, commonly used choices for the shielding length, such as the Jeans length, result in CO abundances that are too high at a given H₂ abundance. We find that a model with a distribution of shielding lengths, which has a median shielding length of ∼3 pc in cold gas (T < 300 K) for both CO and H₂, is able to reproduce both the observed CO(1–0) luminosity and inferred CO-to-H₂ conversion factor at a given star formation rate compared with observations. We suggest that this short shielding length can be thought of as a subgrid model, which controls the amount of radiation that penetrates giant molecular clouds

Galaxy And Mass Assembly (GAMA) : The mechanisms for quiescent galaxy formation at z&lt;1

© 2016 The Authors. One key problem in astrophysics is understanding how and why galaxies switch off their star formation, building the quiescent population that we observe in the local Universe. From the Galaxy And Mass Assembly and VIsible MultiObject Spectrograph Public Extragalactic Redshift surveys, we use spectroscopic indices to select quiescent and candidate transition galaxies.We identify potentially rapidly transitioning post-starburst (PSB) galaxies and slower transitioning green-valley galaxies. Over the last 8Gyr, the quiescent population has grown more slowly in number density at high masses (M * > 10 11 M ⊙ ) than at intermediate masses (M * > 10 10.6 M ⊙ ). There is evolution in both the PSB and green-valley stellar mass functions, consistent with higher mass galaxies quenching at earlier cosmic times.At intermediatemasses (M * > 10 10.6 M ⊙ ), we find a green-valley transition time-scale of 2.6 Gyr. Alternatively, at z ~ 0.7, the entire growth rate could be explained by fast-quenching PSB galaxies, with a visibility time-scale of 0.5 Gyr. At lower redshift, the number density of PSBs is so low that an unphysically short visibility window would be required for them to contribute significantly to the quiescent population growth. The importance of the fast-quenching route may rapidly diminish at z 10 11 M ⊙ ), there is tension between the large number of candidate transition galaxies compared to the slow growth of the quiescent population. This could be resolved if not all high-mass PSB and green-valley galaxies are transitioning from star forming to quiescent, for example if they rejuvenate out of the quiescent population following the accretion of gas and triggering of star formation, or if they fail to completely quench their star formation

Adherence to Accelerometer Protocols Among Women From Economically Disadvantaged Neighborhoods

Background: Objective measurement of physical activity with accelerometers is a challenging task in community-based intervention research. Challenges include distribution of and orientation to monitors, nonwear, incorrect placement, and loss of equipment. Data collection among participants from disadvantaged populations may be further hindered by factors such as transportation challenges, competing responsibilities, and cultural considerations. Methods: Research staff distributed accelerometers and provided an orientation that was tailored to the population group. General adherence strategies such as follow-up calls, daily diaries, verbal and written instructions, and incentives were accompanied by population-specific strategies such as assisting with transportation, reducing obstacles to wearing the accelerometer, tailoring the message to the participant population, and creating a nonjudgmental environment. Results: Sixty women asked to wear the Actigraph GT1M returned the accelerometer, and 57 of them provided sufficient data for analysis (at least 10 hours a day for a minimum of 4 days) resulting in 95% adherence to the protocol. Participants wore the accelerometers for an average of 5.98 days and 13.15 hours per day. Conclusions: The high accelerometer monitoring adherence among this group of economically disadvantaged women demonstrates that collection of high-quality, objective physical data from disadvantaged populations in field-based research is possible

Synthetic Gaia surveys from the FIRE cosmological simulations of Milky Way-mass galaxies

With Gaia Data Release 2, the astronomical community is entering a new era of multidimensional surveys of the Milky Way. This new phase-space view of our Galaxy demands new tools for comparing observations to simulations of Milky-Way-mass galaxies in a cosmological context, to test the physics of both dark matter and galaxy formation. We present ananke, a framework for generating synthetic phase-space surveys from high-resolution baryonic simulations, and use it to generate a suite of synthetic surveys resembling Gaia DR2 in data structure, magnitude limits, and observational errors. We use three cosmological simulations of Milky-Way-mass galaxies from the Latte suite of the Feedback In Realistic Environments (FIRE) project, which feature self-consistent clustering of star formation in dense molecular clouds and thin stellar/gaseous disks in live cosmological halos with satellite dwarf galaxies and stellar halos. We select three solar viewpoints from each simulation to generate nine synthetic Gaia-like surveys. We sample synthetic stars by assuming each star particle (of mass 7070 $M_{\odot}$) represents a single stellar population. At each viewpoint, we compute dust extinction from the simulated gas metallicity distribution and apply a simple error model to produce a synthetic Gaia-like survey that includes both observational properties and a pointer to the generating star particle. We provide the complete simulation snapshot at $z = 0$ for each simulated galaxy. We describe data access points, the data model, and plans for future upgrades. These synthetic surveys provide a tool for the scientific community to test analysis methods and interpret Gaia data.Comment: Matches accepted version. Data accompanying this paper are available at https://ananke.hub.yt and https://binder.flatironinstitute.org/~rsanderson/ananke. More info and updates at http://fire.northwestern.edu/anank

Regulation of PTEN Inhibition by the Pleckstrin Homology Domain of P-REX2 During Insulin Signaling and Glucose Homeostasis

Insulin activation of phosphoinositide 3-kinase (PI3K) signaling regulates glucose homeostasis through the production of phosphatidylinositol 3,4,5-trisphosphate (PIP3). The dual-specificity phosphatase and tensin homolog deleted on chromosome 10 (PTEN) blocks PI3K signaling by dephosphorylating PIP3, and is inhibited through its interaction with phosphatidylinositol 3,4,5-trisphosphate-dependent Rac exchanger 2 (P-REX2). The mechanism of inhibition and its physiological significance are not known. Here, we report that P-REX2 interacts with PTEN via two interfaces. The pleckstrin homology (PH) domain of P-REX2 inhibits PTEN by interacting with the catalytic region of PTEN, and the inositol polyphosphate 4-phosphatase domain of P-REX2 provides high-affinity binding to the postsynaptic density-95/Discs large/zona occludens-1-binding domain of PTEN. P-REX2 inhibition of PTEN requires C-terminal phosphorylation of PTEN to release the P-REX2 PH domain from its neighboring diffuse B-cell lymphoma homology domain. Consistent with its function as a PTEN inhibitor, deletion of Prex2 in fibroblasts and mice results in increased Pten activity and decreased insulin signaling in liver and adipose tissue. Prex2 deletion also leads to reduced glucose uptake and insulin resistance. In human adipose tissue, P-REX2 protein expression is decreased and PTEN activity is increased in insulin-resistant human subjects. Taken together, these results indicate a functional role for P-REX2 PH-domain-mediated inhibition of PTEN in regulating insulin sensitivity and glucose homeostasis and suggest that loss of P-REX2 expression may cause insulin resistance

Background and Method of the Striving to be Strong Study a RCT Testing the Efficacy of a M-health Self-management Intervention

Background Osteoporosis is a prevalent and debilitating condition affecting \u3e50% of post-menopausal women. Yet, a low percentage of women regularly engage in health promoting behaviors associated with osteoporosis prevention. Complex, multidimensional, m-Health interventions hold promise to effect engagement in health behavior change related to calcium and vitamin D intake, balance, core and leg strength, and physical activity. Methods Striving to be Strong study (R01NR013913-01) tests the efficacy of a research and theory based, patient centered, dynamically tailored intervention delivered via smart phone apps. Ecological Momentary Assessments (EMAs) enhance immediate feedback and complement traditional measures. The desired outcomes are the maintenance of osteoporosis self-management behaviors and a decrease in the loss of bone density over time. The Individual and Family Self-management Theory provided the conceptual foundation for the study. The sample consists of 290 healthy women between the ages of 40 and 60 with an anticipated attrition of 33%. This three group repeated measures Randomized Clinical Trial spans a 12-month time period. Data collected occurs via web site, smart-phone app, self-report, observation, and measures. Proximal (engagement in osteoporosis health behaviors) and distal (serum vitamin D, DXA, and body composition) outcomes are collected for testing of the efficacy of the intervention and theory evaluation. Discussion Active and rigorous quality management processes continually evaluate enrollment and retention goals, functionality of the automated intervention delivery and data collection systems, EMAs, and dispersion of incentives

Activation of Toll-like receptors nucleates assembly of the MyDDosome signaling hub.

Infection and tissue damage induces assembly of supramolecular organizing centres (SMOCs)), such as the Toll-like receptor (TLR) MyDDosome, to co-ordinate inflammatory signaling. SMOC assembly is thought to drive digital all-or-none responses, yet TLR activation by diverse microbes induces anything from mild to severe inflammation. Using single-molecule imaging of TLR4-MyDDosome signaling in living macrophages, we find that MyDDosomes assemble within minutes of TLR4 stimulation. TLR4/MD2 activation leads only to formation of TLR4/MD2 heterotetramers, but not oligomers, suggesting a stoichiometric mismatch between activated receptors and MyDDosomes. The strength of TLR4 signalling depends not only on the number and size of MyDDosomes formed but also how quickly these structures assemble. Activated TLR4, therefore, acts transiently nucleating assembly of MyDDosomes, a process that is uncoupled from receptor activation. These data explain how the oncogenic mutation of MyD88 (L265P) assembles MyDDosomes in the absence of receptor activation to cause constitutive activation of pro-survival NF-κB signalling