Long term cognitive outcomes of early term (37-38 weeks) and late preterm (34-36 weeks) births: a systematic review

Background: There is a paucity of evidence regarding long-term outcomes of late preterm (34-36 weeks) and early term (37-38 weeks) delivery.  The objective of this systematic review was to assess long-term cognitive outcomes of children born at these gestations. Methods: Four electronic databases (Medline, Embase, clinicaltrials.gov and PsycINFO) were searched.  Last search was 5 th August 2016.  Studies were included if they reported gestational age, IQ measure and the ages assessed.  The protocol was registered with the International prospective register of systematic reviews (PROSPERO Record CRD42015015472).  Two independent reviewers assessed the studies.  Data were abstracted and critical appraisal performed of eligible papers. Results: Of 11,905 potential articles, seven studies reporting on 41,344 children were included.  For early term births, four studies (n = 35,711) consistently showed an increase in cognitive scores for infants born at full term (39-41 weeks) compared to those born at early term (37-38 weeks) with increases for each week of term (difference between 37 and 40 weeks of around 3 IQ points), despite differences in age of testing and method of IQ/cognitive testing.  Four studies (n = 5644) reporting childhood cognitive outcomes of late preterm births (34 - 36 weeks) also differed in study design (cohort and case control); age of testing; and method of IQ testing, and found no differences in outcomes between late preterm and term births, although risk of bias was high in included studies. Conclusion:  Children born at 39-41 weeks have higher cognitive outcome scores compared to those born at early term (37-38 weeks).  This should be considered when discussing timing of delivery.  For children born late preterm, the data is scarce and when compared to full term (37-42 weeks) did not show any difference in IQ scores

Syndemics and the PrEP Cascade: Results from a Sample of Young Latino Men Who Have Sex with Men.

Young Latino men who have sex with men (MSM) are a highly vulnerable population for HIV infection. Pre-exposure prophylaxis (PrEP) is a novel biomedical HIV prevention tool that may aid in reducing the disparity in HIV incidence among Latino MSM. However, PrEP use is disproportionally low among Latino MSM and, therefore, identifying barriers along the PrEP continuum of care (the "PrEP cascade") would provide insight into how to best deploy PrEP interventions. Syndemics theory is a prominent framework employed in HIV prevention; however, to date, no known studies have applied this theory to PrEP. Thus, the aim of the current study was to explore the association between syndemics and the PrEP cascade, including the degree to which psychosocial and structural syndemic constructs are related to the PrEP cascade. Participants were 151 young Latino MSM (M age = 24 years; SD = 3) residing in San Diego, California, who completed a battery of online self-report measures. Results indicated high levels of syndemic indicators and varying levels of engagement across the PrEP cascade. As syndemic indicators increased, the odds of engagement across the PrEP cascade were significantly lowered. Psychosocial and structural syndemic factors accounted for unique variance in the PrEP cascade. Results highlight the need for combination interventions that address both psychosocial and structural barriers to PrEP use and persistence among young Latino MSM

Digital Spatial Profiling identifies distinct patterns of immuno-oncology-related gene expression within oropharyngeal tumours in relation to HPV and p16 status

BACKGROUND: The incidence of oropharyngeal cancer (OPC) is increasing, due mainly to a rise in Human Papilloma Virus (HPV)-mediated disease. HPV-mediated OPC has significantly better prognosis compared with HPV-negative OPC, stimulating interest in treatment de-intensification approaches to reduce long-term sequelae. Routine clinical testing frequently utilises immunohistochemistry to detect upregulation of p16 as a surrogate marker of HPV-mediation. However, this does not detect discordant p16-/HPV+ cases and incorrectly assigns p16+/HPV- cases, which, given their inferior prognosis compared to p16+/HPV+, may have important clinical implications. The biology underlying poorer prognosis of p16/HPV discordant OPC requires exploration.METHODS: GeoMx digital spatial profiling was used to compare the expression patterns of selected immuno-oncology-related genes/gene families (n=73) within the tumour and stromal compartments of formalin-fixed, paraffin-embedded OPC tumour tissues (n=12) representing the three subgroups, p16+/HPV+, p16+/HPV- and p16-/HPV-.RESULTS: Keratin (multi KRT) and HIF1A, a key regulator of hypoxia adaptation, were upregulated in both p16+/HPV- and p16-/HPV- tumours relative to p16+/HPV+. Several genes associated with tumour cell proliferation and survival (CCND1, AKT1 and CD44) were more highly expressed in p16-/HPV- tumours relative to p16+/HPV+. Conversely, multiple genes with potential roles in anti-tumour immune responses (immune cell recruitment/trafficking, antigen processing and presentation), such as CXCL9, CXCL10, ITGB2, PSMB10, CD74, HLA-DRB and B2M, were more highly expressed in the tumour and stromal compartments of p16+/HPV+ OPC versus p16-/HPV- and p16+/HPV-. CXCL9 was the only gene showing significant differential expression between p16+/HPV- and p16-/HPV- tumours being upregulated within the stromal compartment of the former. CONCLUSIONS: In terms of immune-oncology-related gene expression, discordant p16+/HPV- OPCs are much more closely aligned with p16-/HPV-OPCs and quite distinct from p16+/HPV+ tumours. This is consistent with previously described prognostic patterns (p16+/HPV+ &gt;&gt; p16+/HPV- &gt; p16-/HPV-) and underlines the need for dual p16 and HPV testing to guide clinical decision making.</p

Seasonal Occurrence, Horizontal Movements, and Habitat Use Patterns of Whale Sharks (\u3ci\u3eRhincodon typus\u3c/i\u3e) in the Gulf of Mexico

In the northern Gulf of Mexico (GOM), whale sharks (Rhincodon typus) form large aggregations at continental shelf-edge banks during summer; however, knowledge of movements once they leave aggregation sites is limited. Here we report on the seasonal occurrence of whale sharks in the northern GOM based on over 800 whale shark sightings from 1989 to 2016, as well as the movements of 42 whale sharks tagged with satellite-linked and popup satellite archival transmitting tags from 2008 to 2015. Sightings data were most numerous during summer and fall often with aggregations of individuals reported along the continental shelf break. Most sharks (66%) were tagged during this time at Ewing Bank, a known aggregation site off the coast of Louisiana. Whale shark track duration ranged from three to 366 days and all tagged individuals, which ranged from 4.5 to 12.0 m in total length, remained within the GOM. Sightings data revealed that whale sharks occurred primarily in continental shelf and shelf-edge waters (81%) whereas tag data revealed the sharks primarily inhabited continental slope and open ocean waters (91%) of the GOM. Much of their time spent in open ocean waters was associated with the edge of the Loop Current and associated mesoscale eddies. During cooler months, there was a net movement southward, corresponding with the time of reduced sighting reports. Several sharks migrated to the southwest GOM during fall and winter, suggesting this region could be important overwintering habitat and possibly represents another seasonal aggregation site. The three long-term tracked whale sharks exhibited interannual site fidelity, returning one year later to the vicinity where they were originally tagged. The increased habitat use of north central GOM waters by whale sharks as summer foraging grounds and potential interannual site fidelity to Ewing Bank demonstrate the importance of this region for this species

The Phoenix Mars Landing: An Initial Look

This presentation was part of the session : Ongoing and Proposed EDL Technology DevelopmentSixth International Planetary Probe WorkshopNASA's Phoenix Mars Lander will make a landing on Mars on May 25th, 2008. Following on from the overview of the Phoenix entry, descent and landing (EDL) system given at IPPW5, an initial look at the Phoenix landing will be presented, highlighting the salient, high level events that occurred during EDL. Initial EDL flight reconstruction results will be presented, along with a retelling of the flight operations events that occurred on approach to Mars, and during the landing event itself. Note: Given the short time duration between the Phoenix landing and IPPW6, only a presentation will be prepared for the workshop.NAS

Best practices for virtual participation in meetings : experiences from synthesis centers

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Impact of the COVID-19 Pandemic on Resilience to Climate Change in Underserved Communities

Coastal communities in South Louisiana and worldwide are increasingly impacted by climate-related events such as hurricanes, floods, and rising sea levels. In addition, they have recently faced the burden of a global pandemic that may also be a consequence of climate change. In many under-resourced communities, nongovernmental community-based organizations (CBOs) represent the backbone of the response to the COVID-19 pandemic. However, little is known about the pandemic's impact on the efforts of these organizations to support and sustain individual and community resilience to this event and to the disruptive impacts of climate change-related weather events. Procedures embedded in the Rapid Assessment Procedure - Informed Community Ethnography methodology were used to analyze data collected from semi-structured interviews with 26 representatives of 24 different community-based programs in South Louisiana. The pandemic created numerous challenges to under-resourced community resilience by revealing the fragmented nature of community solidarity in adhering to public health guidelines; the lack of available social, political, and economic resources; and the influence of systemic racism and social determinants of health. To address these challenges, communities relied on social connections and support; prior experiences with climate-related disasters and adversity; and the resilience building, supporting, and sustaining efforts of CBOs. These organizations have responded to these challenges through provision of new services, expansion of existing services, providing access to training webinars, partnerships with other CBOs, and initiatives to address broader social issues, while balancing the disparity between increased demand and reduced supply of services and increased reliance on technology that is not uniformly accessible to all communities and residents. In responding to the pandemic, CBOs have played a major role in addressing the threats to individual and community resilience needed to prepare for and respond to natural disasters and other consequences of global environmental change in underserved communities

The Lantern Vol. 46, No. 2, April 1980

• The Voyage to Man\u27s Destiny • If I Could Keep the Times • Barstool Blues • I Didn\u27t Know • Felonious, Friend • Cool Ride • Georgia • Let Us Eat and Drink • In a Field • New Born Foal • Union to Freedom • In the Woods • Anthropomorphism • Runner • C.C. • Lake Attempt • A Fuzzy Blue Line • Trust Me • Haven\u27t We Met Before? • Rationality • Expecting Me • Short Storyhttps://digitalcommons.ursinus.edu/lantern/1116/thumbnail.jp

Practice Readiness? Trends in Chief Resident Year Training Experience Across 13 Residency Programs

IntroductionUrology residency prepares trainees for independent practice. The optimal operative chief resident year experience to prepare for practice is undefined. We analyzed the temporal arc of cases residents complete during their residency compared to their chief year in a multi-institutional cohort.MethodsAccreditation Council for Graduate Medical Education case logs of graduating residents from 2010 to 2022 from participating urology residency programs were aggregated. Resident data for 5 categorized index procedures were recorded: (1) general urology, (2) endourology, (3) reconstructive urology, (4) urologic oncology, and (5) pediatric urology. Interactions were tested between the trends for total case exposure in residency training relative to the chief resident year.ResultsFrom a sample of 479 resident graduates, a total of 1,287,433 total cases were logged, including 375,703 during the chief year (29%). Urologic oncology cases had the highest median percentage completed during chief year (56%) followed by reconstructive urology (27%), general urology (24%), endourology (17%), and pediatric urology (2%). Across the study period, all categories of cases had a downward trend in median percentage completed during chief year except for urologic oncology. However, only trends in general urology (slope of -0.68, P = .013) and endourology (slope of -1.71, P ≤ .001) were significant.ConclusionsOver 50% of cases completed by chief residents are urologic oncology procedures. Current declining trends indicate that residents are being exposed to proportionally fewer general urology and endourology cases during their chief year prior to entering independent practice