Traversing barriers to health care among LGBTQ+ Latinx emerging adults: Utilizing patient experiences to model access

Enduring multiple sources of marginalization, lesbian, gay, bisexual, transgender, and/or queer (LGBTQ+) youth of color living at the United States-Mexico border navigate stigma and health challenges surrounding their LGBTQ+ and ethnic identities. This study sought to delineate barriers to health care experienced by marginalized young adult patients. We qualitatively examined the patient experiences of 41 LGBTQ+ Latinx young adults (ages 18-24) in the Rio Grande Valley between 2016 and 2017. Often tied to their experiences of emerging adulthood, most respondents emphasized how financial barriers, including cost of services and disruptions to insurance status, prevented them from seeking care (barriers to care). However, youth also underscored how prior patient experiences tied to their ethnic and LGBTQ+ identities, including apprehension discussing their sexuality with care providers (barriers within care), shaped their health care seeking strategies. This study utilized patient experiences to delineate potential sources of barriers to care experienced by LGBTQ+ Latinx young adults. Practitioners should seek to actively create inclusive and identity-affirming care environments and be sensitive to how prior negative experiences may be deterring young adult patients from seeking care or revealing personal details during the care encounter. If we are to better model access, we need to consider the patient experiences of diverse populations. Experience Framework This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework). Access other PXJ articles related to this lens. Access other resources related to this lens

RidA proteins prevent metabolic damage inflicted by PLP-dependent dehydratases in all domains of life

ABSTRACT Pyridoxal 5′-phosphate (PLP) is a coenzyme synthesized by all forms of life. Relevant to the work reported here is the mechanism of the PLP-dependent threonine/serine dehydratases, which generate reactive enamine/imine intermediates that are converted to keto acids by members of the RidA family of enzymes. The RidA protein of Salmonella enterica serovar Typhimurium LT2 is the founding member of this broadly conserved family of proteins (formerly known as YjgF/YER057c/UK114). RidA proteins were recently shown to be enamine deaminases. Here we demonstrate the damaging potential of enamines in the absence of RidA proteins. Notably, S. enterica strains lacking RidA have decreased activity of the PLP-dependent transaminase B enzyme IlvE, an enzyme involved in branched-chain amino acid biosynthesis. We reconstituted the threonine/serine dehydratase (IlvA)-dependent inhibition of IlvE in vitro, show that the in vitro system reflects the mechanism of RidA function in vivo, and show that IlvE inhibition is prevented by RidA proteins from all domains of life. We conclude that 2-aminoacrylate (2AA) inhibition represents a new type of metabolic damage, and this finding provides an important physiological context for the role of the ubiquitous RidA family of enamine deaminases in preventing damage by 2AA. IMPORTANCE External stresses that disrupt metabolic components can perturb cellular functions and affect growth. A similar consequence is expected if endogenously generated metabolites are reactive and persist in the cellular environment. Here we show that the metabolic intermediate 2-aminoacrylate (2AA) causes significant cellular damage if allowed to accumulate aberrantly. Furthermore, we show that the widely conserved protein RidA prevents this accumulation by facilitating conversion of 2AA to a stable metabolite. This work demonstrates that the reactive metabolite 2AA, previously considered innocuous in the cell due to a short half-life in aqueous solution, can survive in the cellular environment long enough to cause damage. This work provides insights into the roles and persistence of reactive metabolites in vivo and shows that the RidA family of proteins is able to prevent damage caused by a reactive intermediate that is created as a consequence of PLP-dependent chemistry

Perceived weight gain and eating disorder symptoms among LGBTQ+ adults during the COVID-19 pandemic: a convergent mixed-method study

Background: In this study, we further explore the role of COVID-19 pandemic-related stress, social support, and resilience on self-reported eating disorder symptoms (using the EDE-QS) and perceived weight gain among lesbian, gay, bisexual, transgender, and/or queer (LGBTQ+ adults) in the US context during the COVID-19 pandemic. Methods: Employing a convergent mixed method design, we surveyed 411 individuals, and conducted qualitative semi-structured follow-up interviews with 43 LGBTQ+ -identifying survey respondents. Using OLS regression and multinomial logistic regression, we modeled eating disorder symptoms and perceived weight gain among LGBTQ+ individuals (n = 120) and cisgender and heterosexual-identifying women (n = 230), to cisgender and heterosexual-identifying men (n = 61). We also explored complementary interview narratives among LGBTQ+ people by employing selective coding strategies. Results: Study results suggest that LGBTQ+ individuals are likely experiencing uniquely high levels of pandemic-related stress, and secondly, that pandemic-related stress is associated with elevated eating disorder symptoms and higher risk of perceived weight gain. Nearly 1 in 3 participants reported eating disorder symptoms of potentially clinical significance. Social support, but not resilient coping, was found to be protective against increased eating disorder symptoms. Qualitative analyses revealed that LGBTQ+ individuals situated physical exercise constraints, challenging eating patterns, and weight concerns within their pandemic experiences. Conclusions: Clinicians of diverse specialties should screen for eating disorder symptoms and actively engage patients in conversations about their COVID-19-related weight gain and eating behaviors, particularly with LGBTQ+ -identifying adults

Chiral magnetohydrodynamics with zero total chirality

We study the evolution of magnetic fields coupled with chiral fermion asymmetry in the framework of chiral magnetohydrodynamics with zero initial total chirality. The initial magnetic field has a turbulent spectrum peaking at a certain characteristic scale and is fully helical with positive helicity. The initial chiral chemical potential is spatially uniform and negative. We consider two opposite cases where the ratio of the length scale of the chiral plasma instability (CPI) to the characteristic scale of the turbulence is smaller and larger than unity. These initial conditions might be realized in cosmological models such as certain types of axion inflation. The magnetic field and chiral chemical potential evolve with inverse cascading in such a way that the magnetic helicity and chirality cancel each other at all times. The CPI time scale is found to determine mainly the time when the magnetic helicity spectrum attains negative values at high wave numbers. The turnover time of the energy-carrying eddies, on the other hand, determines the time when the peak of the spectrum starts to shift to smaller wave numbers via an inverse cascade. The onset of helicity decay is determined by the time when the chiral magnetic effect becomes efficient at the peak of the initial magnetic energy spectrum. When spin flipping is important, the chiral chemical potential vanishes and the magnetic helicity becomes constant, which leads to a faster increase of the correlation length, as expected from magnetic helicity conservation. This also happens when the initial total chirality is imbalanced. Our findings have important implications for baryogenesis after axion inflation.Comment: 21 pages, 20 figures, 4 table

Focal subarachnoid haemorrhage mimicking transient ischaemic attack - do we really need MRI in the acute stage?

Background: Acute non-traumatic focal subarachnoid haemorrhage (fSAH) is a rare transient ischaemic attack (TIA)-mimic. MRI is considered to be indispensable by some authors in order to avoid misdiagnosis, and subsequent improper therapy. We therefore evaluated the role of CT and MRI in the diagnosis of fSAH patients by comparing our cases to those from the literature. Methods: From 01/2010 to 12/2012 we retrospectively identified seven patients with transient neurological episodes due to fSAH, who had received unenhanced thin-sliced multiplanar CT and subsequent MRI within 3 days on a 1.5 T scanner. MRI protocol included at least fast-field-echo (FFE), diffusion-weighted imaging (DWI), T2-weighted fluid-attenuated inversion recovery (FLAIR) and time-of-flight (TOF) MRA sequences. By using MRI as gold-standard, we re-evaluated images and data from recent publications regarding the sensitivity to detect fSAH in unenhanced CT. Results: fSAH was detected by CT and by FFE and FLAIR on MRI in all of our own cases. However, DWI and T2w-spinecho sequences revealed fSAH in 3 of 7 and 4 of 6 cases respectively. Vascular imaging was negative in all cases. FFE-MRI revealed additional multiple microbleeds and superficial siderosis in 4 of 7 patients and 5 of 7 patients respectively. Including data from recently published literature CT scans delivered positive results for fSAH in 95 of 100 cases (95%), whereas MRI was positive for fSAH in 69 of 69 cases (100%). Conclusions: Thin-sliced unenhanced CT is a valuable emergency diagnostic tool to rule out intracranial haemorrhage including fSAH in patients with acute transient neurological episodes if immediate MRI is not available. However, MRI work-up is crucial and mandatorily has to be completed within the next 24-72 hours

The Crystal Structure of the Signal Recognition Particle in Complex with Its Receptor

Cotranslational targeting of membrane and secretory proteins is mediated by the universally conserved signal recognition particle (SRP). Together with its receptor (SR), SRP mediates the guanine triphosphate (GTP)–dependent delivery of translating ribosomes bearing signal sequences to translocons on the target membrane. Here, we present the crystal structure of the SRP:SR complex at 3.9 angstrom resolution and biochemical data revealing that the activated SRP:SR guanine triphosphatase (GTPase) complex binds the distal end of the SRP hairpin RNA where GTP hydrolysis is stimulated. Combined with previous findings, these results suggest that the SRP:SR GTPase complex initially assembles at the tetraloop end of the SRP RNA and then relocalizes to the opposite end of the RNA. This rearrangement provides a mechanism for coupling GTP hydrolysis to the handover of cargo to the translocon

Can particulate extraction from the ascending aorta reduce neurologic injury in cardiac surgery?

AbstractObjectiveThis study examined whether extraction of particulate emboli using intra-aortic filtration could decrease neurologic outcomes.MethodsPatients (N = 582) were enrolled in a prospective, controlled study and alternately assigned to the therapy arm (n = 304; intra-aortic filtration) or control arm (n = 278). Preoperative, procedural, and postoperative data were collected. Neurologic examinations included the National Institutes of Health Stroke Scale, Glasgow Coma Scale, and memory tests. Investigators administering neurologic tests were blinded to the study arm. By the use of logistic regression and propensity matching, composite neurologic outcomes (transient ischemic attack, stroke, delirium, coma, and memory deficit) were evaluated.ResultsPatients in the filter group experienced a lower incidence of adverse neurologic outcomes than patients in the control group (4.3% vs 11.9%) (P < .001). There were significantly less transient ischemic attacks (0% vs 1.4%), delirium (3.0% vs 6.5%), and memory deficit (1.3% vs 6.2%). There were fewer strokes in the filter group compared with the control group (0.7% vs 2.2%), although the sample size was too small for a significant finding. Both groups experienced 1 coma outcome. The use of a filter was associated with an adjusted odds ratio of 0.375, implying that a patient who does not receive a filter is 2.7 times more likely to experience an adverse neurologic event. Logistic modeling also demonstrated that there are increasing chances of poor neurologic outcome with increasing age. The model indicates that there may be an increasing protective benefit from the filter with increasing age, although the interaction was not significant.ConclusionsThe extraction of particulate emboli using intra-aortic filtration resulted in decreased neurologic outcomes

Fear on the move: predator hunting mode predicts variation in prey mortality and plasticity in prey spatial response

Summary 1. Ecologists have long searched for a framework of a priori species traits to help predict predator-prey interactions in food webs. Empirical evidence has shown that predator hunting mode and predator and prey habitat domain are useful traits for explaining predator-prey interactions. Yet, individual experiments have yet to replicate predator hunting mode, calling into question whether predator impacts can be attributed to hunting mode or merely species identity. 2. We tested the effects of spider predators with sit-and-wait, sit-and-pursue and active hunting modes on grasshopper habitat domain, activity and mortality in a grassland system. We replicated hunting mode by testing two spider predator species of each hunting mode on the same grasshopper prey species. We observed grasshoppers with and without each spider species in behavioural cages and measured their mortality rates, movements and habitat domains. We likewise measured the movements and habitat domains of spiders to characterize hunting modes. 3. We found that predator hunting mode explained grasshopper mortality and spider and grasshopper movement activity and habitat domain size. Sit-and-wait spider predators covered small distances over a narrow domain space and killed fewer grasshoppers than sit-and-pursue and active predators, which ranged farther distances across broader domains and killed more grasshoppers, respectively. Prey adjusted their activity levels and horizontal habitat domains in response to predator presence and hunting mode: sedentary sit-and-wait predators with narrow domains caused grasshoppers to reduce activity in the same-sized domain space; more mobile sit-and-pursue predators with broader domains caused prey to reduce their activity within a contracted horizontal (but not vertical) domain space; and highly mobile active spiders led grasshoppers to increase their activity across the same domain area. All predators impacted prey activity, and sit-and-pursue predators generated strong effects on domain size. 4. This study demonstrates the validity of utilizing hunting mode and habitat domain for predicting predator-prey interactions. Results also highlight the importance of accounting for flexibility in prey movement ranges as an anti-predator response rather than treating the domain as a static attribute

Химические элементы в воде объектов водопользования бывшего Семипалатинского испытательного полигона как фактор экологического воздействия

Изучен элементный состав вод объектов водопользования расположенных на территории бывшего Семипалатинского испытательного полигона. Содержание U, Mo и Sr в изученных водах имеют превышения над средним составом подземных вод зон гипергенеза и континентального засоления. Выделены химические показатели и элементы превышающие ПДК это минерализация, общая жесткость, сульфаты, натрий и уран.The elemental composition of the water of odjects of water use in the territory of the former Semey test site was studied. The content of U, Mo and Sr in the studied waters has an excess over the average composition of groundwater in the areas of hypergenesis and continental salinization. Chemical indices and elements above MPC are identified as mineralization, total hardness, sulfates, sodium and uranium