DISPARITIES IN STAGE-APPROPRIATE THERAPY FOR RESECTABLE NON-SMALL CELL LUNG CANCER IN KENTUCKY

Lung cancer (NSCLC) is the leading cause of cancer related mortality. Lung cancer screening aims to detect treatable cancers, however survival advantage will only be seen with early and appropriate stage-directed therapy. This study aims to understand recent rates of therapy for early-stage lung cancer in Kentucky, and to explore potential sources of disparities in treatment and outcomes. A Kentucky Cancer Registry query was performed of all NSCLC cases treated in the state from 2005-2014. Of 39,763 lung cancer patients, 10,622 were clinically operable. Of these, overall 40% did not receive surgery, while 16% did not receive any stage-appropriate local therapy. Wide variation was noted in rates of surgery and local therapy at the county level. Increased age, non-private insurance status, non-white race, male gender, and non-married status were less likely to receive surgery. Median survival in patients who underwent surgery was 59.1 months vs 16 months (p\u3c 0.001). Appropriate stage-directed local therapy is a very important factor in survival of patients with early stage NSCLC. County-level variation in rates of therapy need further study. Demographic factors continue to drive disparities in therapy and outcomes in Kentucky and should inform health policy and ongoing research and education efforts

Esophageal granular cell tumor colliding with intramucosal adenocarcinoma: a case report

We report a case of a granular cell tumor colliding with intramucosal adenocarcinoma of the esophagus. A 58-year-old white was found to have a 5 mm nodule in the distal esophagus detected by upper gastrointestinal endoscopy performed as part of the workup of long standing reflux. Endoscopic biopsies revealed intramucosal adenocarcinoma arising in the setting of Barrett’s esophagus. The adenocarcinoma infiltrated a granular cell tumor also present at the nodular site. Endoscopic mucosal resection using Duette band ligation and hot snare electrocautery was performed. Margins were negative for both tumors, and endoscopic surveillance for recurrence is planned

Central Blood Pressure and Peripheral Reactive Vasodilation in Plant-Based and Typical Dieting African Americans

African American individuals (AA) face higher mortality rates from cardiovascular disease than Americans from other racial/ethnic backgrounds. The cause of this health disparity is multifactorial and is in part related to impaired vascular function as well as other variables including diet and numerous socioeconomic factors. Diets rich in whole plant foods and low in animal products may protect blood vessels through their high antioxidant capacity and low inflammatory load. PURPOSE: The purpose of this study was to test the hypothesis that AA adhering to a 100% plant-based (vegan) diet (PBD) would have a more favorable dietary intake of several key nutrients and more optimal blood cholesterol, which would contribute to better blood pressure and peripheral reactive vasodilation relative to AA following a typical American diet (TAD). METHODS: Seventeen AA participated in the study. Of them, 8 (5 female; age: 25±2 years; BMI: 23.4±1.4 kg/m2) were following a PBD for 2.5±0.3 years and 9 (5 female; age: 21±1 years; BMI: 25.3±2.1 kg/m2) were following a TAD. A fasting venous blood draw was performed to assess blood lipids. Participants completed a comprehensive diet questionnaire (DHQIII, NIH). Peripheral and central blood pressures were measured via the SphygmoCor system (AtCor Medical). Brachial artery flow-mediated dilation (FMD) and reactive hyperemia (RH) were assessed via well-established procedures. Briefly, 2 min baseline measurements of brachial artery diameter and blood velocity were taken via Doppler ultrasound before a forearm cuff was inflated to 220 mmHg for 5 min. Post-occlusion data were recorded for 3 min. Measurement of baseline to peak post-occlusion brachial artery diameter and blood velocity were performed by pairing a video capture system (Elgato) with edge-detection and blood velocity-tracking software (Quipu). RESULTS: PBD AA consumed more dark green vegetables and whole grains and less cholesterol than TAD AA (p\u3c.05 for all). Consumption of sodium, potassium, and vitamins C & E was not different between groups (p\u3e.05 for all). Total (TC) and low-density lipoprotein (LDL-C) blood cholesterol concentrations were lower in PBD AA relative to TAD AA (TC: 136±9 vs. 174±12 mg/dl; LDL-C: 77±6 vs. 106±11 mg/dl; respectively; p\u3c.05 for both). Resting brachial (b) and central (c) mean arterial blood pressures (MAP) were lower in PBD AA relative to TAD AA (bMAP: 85±2 vs. 91±2 mmHg; cMAP: 80±2 vs. 87±2 mmHg; respectively; p\u3c.05 for both). There were no differences between groups in FMD nor RH (p\u3e.05 for all). FMD and FMD/shear rate were 7.7±0.8% and 0.33±0.05 au in PBD AA and 6.2±0.9% and 0.27±0.03 au in TAD AA, respectively. For RH, the percentage change in blood velocity and flow were 1441±479% and 1425±466% in PBD AA and 707±495% and 671±76% in TAD AA, respectively. CONCLUSION: These preliminary data suggest that a diet rich in whole plant foods but devoid of animal products may be associated with healthier blood cholesterol and peripheral and central blood pressures in AA but that these differences may not yet be translating to differences in peripheral reactive vasodilation

Sympathetically-Mediated Cutaneous Vasoconstriction Is Similar Between Non-Hispanic Black and White Individuals

Cardiovascular disease (CVD) prevalence is highest in non-Hispanic Black (BL) individuals compared to any other race. The mechanisms responsible remain incompletely understood and can be impacted by several environmental, psychosocial, and socioeconomic factors. A major contributing factor to elevated CVD risk/prevalence in the BL population is altered vascular function, which could be attributed to an exaggerated vasoconstrictor response to efferent sympathetic activity (i.e., sympathetic vascular transduction). Previous data from our group demonstrates heightened sympathetic vascular transduction in the peripheral vasculature of BL males. However, whether sympathetically-mediated vasoconstriction is exaggerated in the cutaneous circulation of BL individuals remains unknown. PURPOSE: This study tested the hypothesis that BL individuals exhibit exaggerated vasoconstriction to intra-dermal infusions of the α-adrenoreceptor agonist norepinephrine (NE) relative to White (WH) individuals. METHODS: In this study, young, healthy college-aged BL (n=13; 6 females) and WH (n=10; 4 females) individuals participated. Participants were instrumented with an intradermal microdialysis membrane in the dorsal forearm. Red blood cell flux was continuously assessed via laser Doppler flowmetry before (baseline) and during incrementally stronger infusions of NE (10-8 M – 10-2 M; 6 min/dose). Data were analyzed as a relative (i.e., percent) reduction in cutaneous vascular conductance (CVC: flux/MAP) compared to the pre-infusion baseline. RESULTS: NE caused a dose-dependent reduction in CVC in both groups (P\u3c0.001). There was no difference between the BL and WH individuals (P=0.37) nor was there a race x dose interaction (P=0.84). Similarly, when the data were separated by sex there was no difference between BL and WH males (P=0.56) or females (P=0.26). CONCLUSION: Vasoconstrictor responsiveness to α-adrenoreceptor activation was similar between BL and WH individuals. These data suggest that the cutaneous circulation may exhibit divergent sympathically-mediated vasoconstrictor responsiveness relative to other peripheral vascular beds in BL individuals

Machupo Virus Glycoprotein Determinants for Human Transferrin Receptor 1 Binding and Cell Entry

Machupo virus (MACV) is a highly pathogenic New World arenavirus that causes hemorrhagic fever in humans. MACV, as well as other pathogenic New World arenaviruses, enter cells after their GP1 attachment glycoprotein binds to their cellular receptor, transferrin receptor 1 (TfR1). TfR1 residues essential for this interaction have been described, and a co-crystal of MACV GP1 bound to TfR1 suggests GP1 residues important for this association. We created MACV GP1 variants and tested their effect on TfR1 binding and virus entry to evaluate the functional significance of some of these and additional residues in human and simian cells. We found residues R111, D123, Y122, and F226 to be essential, D155, and P160 important, and D114, S116, D140, and K169 expendable for the GP1-TfR1 interaction and MACV entry. Several MACV GP1 residues that are critical for the interaction with TfR1 are conserved among other New World arenaviruses, indicating a common basis of receptor interaction. Our findings also open avenues for the rational development of viral entry inhibitors

The Seventh Data Release of the Sloan Digital Sky Survey

This paper describes the Seventh Data Release of the Sloan Digital Sky Survey (SDSS), marking the completion of the original goals of the SDSS and the end of the phase known as SDSS-II. It includes 11663 deg^2 of imaging data, with most of the roughly 2000 deg^2 increment over the previous data release lying in regions of low Galactic latitude. The catalog contains five-band photometry for 357 million distinct objects. The survey also includes repeat photometry over 250 deg^2 along the Celestial Equator in the Southern Galactic Cap. A coaddition of these data goes roughly two magnitudes fainter than the main survey. The spectroscopy is now complete over a contiguous area of 7500 deg^2 in the Northern Galactic Cap, closing the gap that was present in previous data releases. There are over 1.6 million spectra in total, including 930,000 galaxies, 120,000 quasars, and 460,000 stars. The data release includes improved stellar photometry at low Galactic latitude. The astrometry has all been recalibrated with the second version of the USNO CCD Astrograph Catalog (UCAC-2), reducing the rms statistical errors at the bright end to 45 milli-arcseconds per coordinate. A systematic error in bright galaxy photometr is less severe than previously reported for the majority of galaxies. Finally, we describe a series of improvements to the spectroscopic reductions, including better flat-fielding and improved wavelength calibration at the blue end, better processing of objects with extremely strong narrow emission lines, and an improved determination of stellar metallicities. (Abridged)Comment: 20 pages, 10 embedded figures. Accepted to ApJS after minor correction

Temporal rarity is a better predictor of local extinction risk than spatial rarity

Spatial rarity is often used to predict extinction risk, but rarity can also occur temporally. Perhaps more relevant in the context of global change is whether a species is core to a community (persistent) or transient (intermittently present), with transient species often susceptible to human activities that reduce niche space. Using 5–12 yr of data on 1,447 plant species from 49 grasslands on five continents, we show that local abundance and species persistence under ambient conditions are both effective predictors of local extinction risk following experimental exclusion of grazers or addition of nutrients; persistence was a more powerful predictor than local abundance. While perturbations increased the risk of exclusion for low persistence and abundance species, transient but abundant species were also highly likely to be excluded from a perturbed plot relative to ambient conditions. Moreover, low persistence and low abundance species that were not excluded from perturbed plots tended to have a modest increase in abundance following perturbance. Last, even core species with high abundances had large decreases in persistence and increased losses in perturbed plots, threatening the long-term stability of these grasslands. Our results demonstrate that expanding the concept of rarity to include temporal dynamics, in addition to local abundance, more effectively predicts extinction risk in response to environmental change than either rarity axis predicts alone.Fil: Wilfahrt, Peter A.. University of Minnesota; Estados UnidosFil: Asmus, Ashley L.. University of Minnesota; Estados UnidosFil: Seabloom, Eric. University of Minnesota; Estados UnidosFil: Henning, Jeremiah A.. University of Minnesota; Estados UnidosFil: Adler, Peter. State University of Utah; Estados UnidosFil: Arnillas, Carlos A.. University of Toronto Scarborough; CanadáFil: Bakker, Jonathan. University of Washington; Estados UnidosFil: Biederman, Lori. University of Iowa; Estados UnidosFil: Brudvig, Lars A.. Michigan State University; Estados UnidosFil: Cadotte, Marc W.. University of Toronto Scarborough; CanadáFil: Daleo, Pedro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones Marinas y Costeras. Universidad Nacional de Mar del Plata. Facultad de Ciencias Exactas y Naturales. Instituto de Investigaciones Marinas y Costeras; ArgentinaFil: Eskelinen, Anu. German Centre for Integrative Biodiversity Research; AlemaniaFil: Firn, Jennifer. University of Queensland; AustraliaFil: Harpole, W. Stanley. German Centre for Integrative Biodiversity Research; Alemania. Helmholtz Centre for Environmental Research; Alemania. Martin Luther University Halle-Wittenberg; AlemaniaFil: Hautier, Yann. Utrecht University; Países BajosFil: Kirkman, Kevin P.. University of KwaZulu-Natal; SudáfricaFil: Komatsu, Kimberly J.. Smithsonian Environmental Research Center; Estados UnidosFil: Laungani, Ramesh. Doane University; Estados UnidosFil: MacDougall, Andrew. University of Guelph; CanadáFil: McCulley, Rebecca L.. University of Kentucky; Estados UnidosFil: Moore, Joslin L.. Monash University; AustraliaFil: Morgan, John W.. La Trobe University; AustraliaFil: Mortensen, Brent. Benedictine College; Estados UnidosFil: Ochoa Hueso, Raul. Universidad de Cádiz; EspañaFil: Ohlert, Timothy. University of New Mexico; Estados UnidosFil: Power, Sally A.. University of Western Sydney; AustraliaFil: Price, Jodi. Charles Sturt University; AustraliaFil: Risch, Anita C.. Swiss Federal Institute for Forest, Snow and Landscape Research; SuizaFil: Schuetz, Martin. Swiss Federal Institute for Forest, Snow and Landscape Research; SuizaFil: Shoemaker, Lauren. University of Wyoming; Estados UnidosFil: Stevens, Carly. Lancaster University; Reino UnidoFil: Strauss, Alexander T.. University of Minnesota; Estados Unidos. University of Georgia; Estados UnidosFil: Tognetti, Pedro Maximiliano. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones Fisiológicas y Ecológicas Vinculadas a la Agricultura. Universidad de Buenos Aires. Facultad de Agronomía. Instituto de Investigaciones Fisiológicas y Ecológicas Vinculadas a la Agricultura; ArgentinaFil: Virtanen, Risto. University of Oulu; FinlandiaFil: Borer, Elizabeth. University of Minnesota; Estados Unido

When Can Antibiotic Treatments for Trachoma Be Discontinued? Graduating Communities in Three African Countries

Trachoma, the major cause of infectious blindness in the world, occurs when repeated infections of the ocular strains of Chlamydia trachomatis lead to a cascade of conjunctival scarring, in-turned eyelids and eyelashes, and eventually blindness due to corneal opacity. To reduce the prevalence of infection, the World Health Organization (WHO) advocates at least three annual community-wide distributions of oral antibiotics in affected areas. This approach has proven effective, but there is room to explore other treatment strategies which reduce the use of antibiotics. Here, we used mathematical models and data from three trachoma-endemic countries (Tanzania, The Gambia, and Ethiopia) to analyze different treatment strategies. In the simulations, we show that a graduation strategy can reduce antibiotic distributions more than 2-fold in moderately affected areas. Both treatment strategies provide favorable results in reducing the prevalence of ocular chlamydia, but high costs and the potential for resistance are important issues to consider when administering mass doses of antibiotics

Active Trachoma and Ocular Chlamydia trachomatis Infection in Two Gambian Regions: On Course for Elimination by 2020?

Trachoma is the leading infectious cause of blindness worldwide, and is mainly found in tropical and poor countries. It is caused by infection of the eyes with the bacterium Chlamydia trachomatis. However, sometimes the clinical signs of disease can be present without infection being detected. Control efforts involve surgery, antibiotic treatment, face washing, and environmental improvement for better hygiene. Surveys of trachoma help countries to know whether and where they should implement control interventions. The Gambia is found in West Africa and has suffered from trachoma for decades. We conducted a survey of two Gambian regions to look at how much trachoma disease and C. trachomatis infection there is in the eyes. We found that although there was enough disease (≥10%) to warrant antibiotic treatment for everyone in the regions, there was nearly no infection (0.3%). This means that using clinical signs alone to make treatment decisions in low prevalence settings like The Gambia can lead to the waste of scarce resources. Our results also suggest that since less than 1% of children are infected with C. trachomatis, The Gambia is on course to achieve the World Health Organization's aim of eliminating blinding trachoma by the year 2020