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Spatial epidemiological patterns suggest mechanisms of land-sea transmission for Sarcocystis neurona in a coastal marine mammal.
Sarcocystis neurona was recognised as an important cause of mortality in southern sea otters (Enhydra lutris nereis) after an outbreak in April 2004 and has since been detected in many marine mammal species in the Northeast Pacific Ocean. Risk of S. neurona exposure in sea otters is associated with consumption of clams and soft-sediment prey and is temporally associated with runoff events. We examined the spatial distribution of S. neurona exposure risk based on serum antibody testing and assessed risk factors for exposure in animals from California, Washington, British Columbia and Alaska. Significant spatial clustering of seropositive animals was observed in California and Washington, compared with British Columbia and Alaska. Adult males were at greatest risk for exposure to S. neurona, and there were strong associations with terrestrial features (wetlands, cropland, high human housing-unit density). In California, habitats containing soft sediment exhibited greater risk than hard substrate or kelp beds. Consuming a diet rich in clams was also associated with increased exposure risk. These findings suggest a transmission pathway analogous to that described for Toxoplasma gondii, with infectious stages traveling in freshwater runoff and being concentrated in particular locations by marine habitat features, ocean physical processes, and invertebrate bioconcentration
Association between pain outcomes and race and opioid treatment: Retrospective cohort study of Veterans
We examined whether pain outcomes (pain interference, perceived pain treatment effectiveness) vary by race and then whether opioid use moderates these associations.
These analyses are part of a retrospective cohort study among 3,505 black and 46,203 non-Hispanic, white Department of Veterans Affairs (VA) patients with diagnoses of chronic musculoskeletal pain who responded to the 2007 VA Survey of Healthcare Experiences of Patients (SHEP). We used electronic medical record data to identify prescriptions for pharmacologic pain treatments in the year after diagnosis (Pain Diagnosis index visit) and before the SHEP index visit (the visit that made one eligible to complete the SHEP); pain outcomes came from the SHEP. We found no significant associations between race and pain interference or perceived effectiveness of pain treatment. VA patients with opioid prescriptions between the Pain Diagnosis index visit and the SHEP index visit reported greater pain interference on the SHEP than those without opioid prescriptions during that period. Opioid prescriptions were not associated with perceived treatment effectiveness for most patients. Findings raise questions about benefits of opioids for musculoskeletal pain and point to the need for alternative treatments for addressing chronic noncancer pain
Soothing the Threatened Brain: Leveraging Contact Comfort with Emotionally Focused Therapy
Social relationships are tightly linked to health and well-being. Recent work suggests that social relationships can even serve vital emotion regulation functions by minimizing threat-related neural activity. But relationship distress remains a significant public health problem in North America and elsewhere. A promising approach to helping couples both resolve relationship distress and nurture effective interpersonal functioning is Emotionally Focused Therapy for couples (EFT), a manualized, empirically supported therapy that is strongly focused on repairing adult attachment bonds. We sought to examine a neural index of social emotion regulation as a potential mediator of the effects of EFT. Specifically, we examined the effectiveness of EFT for modifying the social regulation of neural threat responding using an fMRI-based handholding procedure. Results suggest that EFT altered the brain\u27s representation of threat cues in the presence of a romantic partner. EFT-related changes during stranger handholding were also observed, but stranger effects were dependent upon self-reported relationship quality. EFT also appeared to increase threat-related brain activity in regions associated with self-regulation during the no-handholding condition. These findings provide a critical window into the regulatory mechanisms of close relationships in general and EFT in particular
Clinical outcomes of patients with advanced synovial sarcoma or myxoid/round cell liposarcoma treated at major cancer centers in the United States
BACKGROUND: Outcomes data regarding advanced synovial sarcoma (SS) and myxoid/round cell liposarcoma (MRCL) are limited, consisting primarily of retrospective series and post hoc analyses of clinical trials.
METHODS: In this multi-center retrospective study, data were abstracted from the medical records of 350 patients from nine sarcoma centers throughout the United States and combined into a registry. Patients with advanced/unresectable or metastatic SS (n = 249) or MRCL (n = 101) who received first-line systemic anticancer therapy and had records of tumor imaging were included. Overall survival (OS), time to next treatment, time to distant metastasis, and progression-free survival (PFS) were evaluated using the Kaplan-Meier method and Cox regression.
RESULTS: At start of first-line systemic anticancer therapy, 92.4% of patients with SS and 91.1% of patients with MRCL had metastatic lesions. However, 74.7% of patients with SS and 72.3% of patients with MRCL had â„2 lines of systemic therapy. Median OS and median PFS from first-line therapy for SS was 24.7 months (95% CI, 20.9-29.4) and 7.5 months, respectively (95% CI, 6.4-8.4). Median OS and median PFS from start of first-line therapy for MRCL was 29.9 months (95% CI, 27-44.6) and 8.9 months (95% CI 4.5-12.0).
CONCLUSIONS: To the best of our knowledge, this is the largest retrospective study of patients with SS and MRCL. It provides an analysis of real-world clinical outcomes among patients treated at major sarcoma cancer centers and could inform treatment decisions and design of clinical trials. In general, the survival outcomes for this selected population appear more favorable than in published literature
The 3rd Fermi GBM Gamma-Ray Burst Catalog: The First Six Years
Since its launch in 2008, the Fermi Gamma-ray Burst Monitor (GBM) has
triggered and located on average approximately two gamma-ray bursts (GRB) every
three days. Here we present the third of a series of catalogs of GRBs detected
by GBM, extending the second catalog by two more years, through the middle of
July 2014. The resulting list includes 1405 triggers identified as GRBs. The
intention of the GBM GRB catalog is to provide information to the community on
the most important observables of the GBM detected GRBs. For each GRB the
location and main characteristics of the prompt emission, the duration, peak
flux and fluence are derived. The latter two quantities are calculated for the
50-300~keV energy band, where the maximum energy release of GRBs in the
instrument reference system is observed, and also for a broader energy band
from 10-1000 keV, exploiting the full energy range of GBM's low-energy NaI(Tl)
detectors. Using statistical methods to assess clustering, we find that the
hardness and duration of GRBs are better fitted by a two-component model with
short-hard and long-soft bursts, than by a model with three components.
Furthermore, information is provided on the settings and modifications of the
triggering criteria and exceptional operational conditions during years five
and six in the mission. This third catalog is an official product of the Fermi
GBM science team, and the data files containing the complete results are
available from the High-Energy Astrophysics Science Archive Research Center
(HEASARC).Comment: 225 pages, 13 figures and 8 tables. Accepted for publication in
Astrophysical Journal Supplement 201
Communicating with providers about racial healthcare disparities: The role of providersâ prior beliefs on their receptivity to different narrative frames
Objective
Evaluate narratives aimed at motivating providers with different pre-existing beliefs to address racial healthcare disparities.
Methods
Survey experiment with 280 providers. Providers were classified as high or low in attributing disparities to providers (HPA versus LPA) and were randomly assigned to a non-narrative control or 1 of 2 narratives: âProvider Successâ (provider successfully resolved problem involving Black patient) and âProvider Biasâ (Black patient experienced racial bias, which remained unresolved). Participants' reactions to narratives (including identification with narrative) and likelihood of participating in disparities-reduction activities were immediately assessed. Four weeks later, participation in those activities was assessed, including self-reported participation in a disparities-reduction training course (primary outcome).
Results
Participation in training was higher among providers randomized to the Provider Success narrative compared to Provider Bias or Control. LPA participants had higher identification with Provider Success than Provider Bias narratives, whereas among HPA participants, differences in identification between the narratives were not significant.
Conclusions
Provider Success narratives led to greater participation in training than Provider Bias narratives, although providersâ pre-existing beliefs influenced the narrative they identified with.
Practice implications
Provider Success narratives may be more effective at motivating providers to address disparities than Provider Bias narratives, though more research is needed
Detection of a Thermal Spectral Component in the Prompt Emission of GRB 100724B
Observations of GRB 100724B with the Fermi Gamma-Ray Burst Monitor (GBM) find
that the spectrum is dominated by the typical Band functional form, which is
usually taken to represent a non-thermal emission component, but also includes
a statistically highly significant thermal spectral contribution. The
simultaneous observation of the thermal and non-thermal components allows us to
confidently identify the two emission components. The fact that these seem to
vary independently favors the idea that the thermal component is of
photospheric origin while the dominant non-thermal emission occurs at larger
radii. Our results imply either a very high efficiency for the non-thermal
process, or a very small size of the region at the base of the flow, both quite
challenging for the standard fireball model. These problems are resolved if the
jet is initially highly magnetized and has a substantial Poynting flux.Comment: 6 pages, 3 figures, 1 table, Accepted for publication in the
Astrophysical Journal Letters November, 23 2010 (Submitted October, 20 2010
Temporal Deconvolution study of Long and Short Gamma-Ray Burst Light curves
The light curves of Gamma-Ray Bursts (GRBs) are believed to result from
internal shocks reflecting the activity of the GRB central engine. Their
temporal deconvolution can reveal potential differences in the properties of
the central engines in the two populations of GRBs which are believed to
originate from the deaths of massive stars (long) and from mergers of compact
objects (short). We present here the results of the temporal analysis of 42
GRBs detected with the Gamma-ray Burst Monitor onboard the Fermi Gamma-ray
Space Telescope. We deconvolved the profiles into pulses, which we fit with
lognormal functions. The distributions of the pulse shape parameters and
intervals between neighboring pulses are distinct for both burst types and also
fit with lognormal functions. We have studied the evolution of these parameters
in different energy bands and found that they differ between long and short
bursts. We discuss the implications of the differences in the temporal
properties of long and short bursts within the framework of the internal shock
model for GRB prompt emission.Comment: 38 pages, 11 figure
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