Geographic disparities in the distribution of the U.S. gynecologic oncology workforce: A Society of Gynecologic Oncology study

A recent ASCO workforce study projects a significant shortage of oncologists in the U.S. by 2020, especially in rural/underserved (R/US) areas. The current study aim was to determine the patterns of distribution of U.S. gynecologic oncologists (GO) and to identify provider-based attitudes and barriers that may prevent GOs from practicing in R/US regions. U.S. GOs (n = 743) were electronically solicited to participate in an on-line survey regarding geographic distribution and participation in outreach care. A total of 320 GOs (43%) responded; median age range was 35–45 years and 57% were male. Most practiced in an urban setting (72%) at a university hospital (43%). Only 13% of GOs practiced in an area with a population \u3c 50,000. A desire to remain in academics and exposure to senior-level mentorship were the factors most influencing initial practice location. Approximately 50% believed geographic disparities exist in GO workforce distribution that pose access barriers to care; however, 39% “strongly agreed” that cancer patients who live in R/US regions should travel to urban cancer centers to receive care within a center of excellence model. GOs who practice within 50 miles of only 0–5 other GOs were more likely to provide R/US care compared to those practicing within 50 miles of ≥ 10 GOs (p \u3c 0.0001). Most (39%) believed the major barriers to providing cancer care in R/US areas were volume and systems-based. Most also believed the best solution was a hybrid approach, with coordination of local and centralized cancer care services. Among GOs, a self-reported rural-urban disparity exists in the density of gynecologic oncologists. These study findings may help address barriers to providing cancer care in R/US practice environments

A imagem feminina na arte cubana. Uma análise da perspectiva de gênero

The treatment of the feminine image in Cuban art responds to the historical evolution of the representation of women in the international arena. During its development it has been tied to the canons established by a patriarchal culture, particularly in naive art, which reflects the subjectivity of the authors without mediating the academic filters. In the Cuban scenario there is not an abundance of scientific literature on the representation of the feminine image in art and its intrinsic relationship with the social contexts of women, which in Cuba and Latin America are connected to a historically phallocentric culture. The objective of the study is to identify the characteristics of the feminine image in Cuban art, with emphasis on naive art. To obtain results, methods at the theoretical and empirical levels are used. In the theoretical level the historical-logical method were used. At the empirical level, documentary analysis is used, mainly the authors María Teresa Alario (2000), Adelaida de Juan (2002, 2006) and Yolanda Wood (2017). This article deals with the treatment of the feminine image in Cuban art from a gender perspective. It is concluded that the representation of the feminine image in Cuban naive art responds to the patriarchal domination schemes normalized in the current Cuban society.El tratamiento de la imagen femenina en el arte cubano responde a la evolución histórica de la representación de la mujer en el ámbito internacional. Durante su desarrollo ha estado atada a los cánones establecidos por una cultura patriarcal, de manera particular en el arte naif, que refleja la subjetividad de los autores sin mediar los filtros académicos. En el escenario cubano no existe una abundancia de literatura científica sobre la representación de la imagen femenina en el arte y su relación intrínseca con los contextos sociales de las mujeres, que en Cuba y Latinoamérica están conectados a una cultura históricamente falocéntrica. Se plantea como objetivo del estudio: identificar las características de la imagen femenina en el arte cubano, con énfasis en el arte naif. Para la obtención de resultados se emplean métodos en los niveles teórico y empírico. En el nivel teórico se emplea el método histórico-lógico. En el nivel empírico se utiliza el análisis documental, fundamentalmente los autores María Teresa Alario (2000), Adelaida de Juan (2002, 2006) y Yolanda Wood (2017). El presente artículo aborda el tratamiento de la imagen femenina en el arte cubano desde una perspectiva de género. Se concluye que la representación de la imagen femenina en el arte naif cubano responde a los esquemas de dominación patriarcal normalizados en la sociedad cubana actual.O tratamento da imagem feminina na arte cubana responde à evolução histórica da representação das mulheres na esfera internacional. Durante o seu desenvolvimento, tem estado vinculado aos cânones estabelecidos por uma cultura patriarcal, particularmente na arte naif, que reflete a subjetividade dos autores sem mediar filtros acadêmicos. No cenário cubano não há abundância de literatura científica sobre a representação da imagem feminina na arte e sua relação intrínseca com os contextos sociais das mulheres, que em Cuba e na América Latina estão ligados a uma phalocêntrico. Pretende-se como o objetivo do estudo: identificar as características da imagem feminina na arte cubana, com ênfase na arte naif. Para a obtenção dos resultados foram usados métodos de teóricos e empíricos. No que concerne ao nível teórico, utilizou-se o método histórico-lógico. No nível empírico utilizou-se a análise documental, principalmente os autores María Teresa Alario (2000), Adelaide de Juan (2002, 2006) e Yolanda Wood (2017). Este artigo aborda o tratamento da imagem feminina na arte cubana a partir de uma perspectiva de gênero. Conclui-se que a representação da imagem feminina na arte naif cubana responde aos esquemas de dominação patriarcal normalizados na sociedade cubana actual

La utilización de las Aulas Virtuales en la enseñanza de la Educación Artística

El presente trabajo se centra en la necesidad de la utilización del espacio virtual en la universidad cubana como prerrogativa para la apreciación de las artes. Constituyen núcleos esenciales de la investigación algunos criterios indispensables para la didáctica en la habilidad apreciación artística; así como las experiencias en la preparación del profesorado para el empleo de la creatividad en el montaje y desarrollo de las aulas virtuales en el departamento de Educación Artística de la Universidad Central “Marta Abreu” de Las Villas. La metodología empleada es la investigación acción participativa, de donde emerge el constructo que se expone en el trabajo. Los resultados que se ofrecen representan una alternativa didáctica para el tratamiento de la habilidad apreciación del arte desde contextos virtuales con una repercusión favorable en la carrera de Educación Artística para el perfeccionamiento de la formación del egresado

Bi-directional gene set enrichment and canonical correlation analysis identify key diet-sensitive pathways and biomarkers of metabolic syndrome

peer-reviewedBackground Currently, a number of bioinformatics methods are available to generate appropriate lists of genes from a microarray experiment. While these lists represent an accurate primary analysis of the data, fewer options exist to contextualise those lists. The development and validation of such methods is crucial to the wider application of microarray technology in the clinical setting. Two key challenges in clinical bioinformatics involve appropriate statistical modelling of dynamic transcriptomic changes, and extraction of clinically relevant meaning from very large datasets. Results Here, we apply an approach to gene set enrichment analysis that allows for detection of bi-directional enrichment within a gene set. Furthermore, we apply canonical correlation analysis and Fisher's exact test, using plasma marker data with known clinical relevance to aid identification of the most important gene and pathway changes in our transcriptomic dataset. After a 28-day dietary intervention with high-CLA beef, a range of plasma markers indicated a marked improvement in the metabolic health of genetically obese mice. Tissue transcriptomic profiles indicated that the effects were most dramatic in liver (1270 genes significantly changed; p < 0.05), followed by muscle (601 genes) and adipose (16 genes). Results from modified GSEA showed that the high-CLA beef diet affected diverse biological processes across the three tissues, and that the majority of pathway changes reached significance only with the bi-directional test. Combining the liver tissue microarray results with plasma marker data revealed 110 CLA-sensitive genes showing strong canonical correlation with one or more plasma markers of metabolic health, and 9 significantly overrepresented pathways among this set; each of these pathways was also significantly changed by the high-CLA diet. Closer inspection of two of these pathways - selenoamino acid metabolism and steroid biosynthesis - illustrated clear diet-sensitive changes in constituent genes, as well as strong correlations between gene expression and plasma markers of metabolic syndrome independent of the dietary effect. Conclusion Bi-directional gene set enrichment analysis more accurately reflects dynamic regulatory behaviour in biochemical pathways, and as such highlighted biologically relevant changes that were not detected using a traditional approach. In such cases where transcriptomic response to treatment is exceptionally large, canonical correlation analysis in conjunction with Fisher's exact test highlights the subset of pathways showing strongest correlation with the clinical markers of interest. In this case, we have identified selenoamino acid metabolism and steroid biosynthesis as key pathways mediating the observed relationship between metabolic health and high-CLA beef. These results indicate that this type of analysis has the potential to generate novel transcriptome-based biomarkers of disease.Department of Agriculture and Food, Ireland - Food Institutional Research Measure (project no. 5254); IRCSET postgraduate scholarship scheme (MJM); Science Foundation Ireland Principal Investigator Programme (HMR) Programme

HIV-1 predisposed to acquiring resistance to maraviroc (MVC) and other CCR5 antagonists in vitro has an inherent, low-level ability to utilize MVC-bound CCR5 for entry

<p>Abstract</p> <p>Background</p> <p>Maraviroc (MVC) and other CCR5 antagonists are HIV-1 entry inhibitors that bind to- and alter the conformation of CCR5, such that CCR5 is no longer recognized by the viral gp120 envelope (Env) glycoproteins. Resistance to CCR5 antagonists results from HIV-1 Env acquiring the ability to utilize the drug-bound conformation of CCR5. Selecting for HIV-1 resistance to CCR5-antagonists <it>in vitro </it>is relatively difficult. However, the CCR5-using CC1/85 strain appears to be uniquely predisposed to acquiring resistance to several CCR5 antagonists <it>in vitro </it>including MVC, vicriviroc and AD101.</p> <p>Findings</p> <p>Here, we show that Env derived from the parental CC1/85 strain is inherently capable of a low affinity interaction with MVC-bound CCR5. However, this phenotype was only revealed in 293-Affinofile cells and NP2-CD4/CCR5 cells that express very high levels of CCR5, and was masked in TZM-bl, JC53 and U87-CD4/CCR5 cells as well as PBMC, which express comparatively lower levels of CCR5 and which are more commonly used to detect resistance to CCR5 antagonists.</p> <p>Conclusions</p> <p>Env derived from the CC1/85 strain of HIV-1 is inherently capable of a low-affinity interaction with MVC-bound CCR5, which helps explain the relative ease in which CC1/85 can acquire resistance to CCR5 antagonists <it>in vitro</it>. The detection of similar phenotypes in patients may identify those who could be at higher risk of virological failure on MVC.</p

Standing up for Myself (STORM): Adapting and piloting a web-delivered psychosocial group intervention for people with intellectual disabilities

BACKGROUND: Our STORM intervention was developed for people (16 +) with intellectual disabilities to enhance their capacity to manage and resist stigma. The current study describes the adaptation of STORM for (synchronous) on-line delivery in the context of the Covid-19 pandemic. AIMS: To adapt the manualised face-to-face STORM group intervention for delivery via web-based meeting platforms and to conduct an initial pilot study to consider its acceptability and feasibility. METHODS AND PROCEDURES: The 5-session STORM intervention was carefully adapted for online delivery. In a pilot study with four community groups (N = 22), outcome, health economics and attendance data were collected, and fidelity of delivery assessed. Focus groups with participants, and interviews with facilitators provided data on acceptability and feasibility. OUTCOMES AND RESULTS: The intervention was adapted with minimal changes to the content required. In the pilot study, 95% of participants were retained at follow-up, 91% attended at least three of the five sessions. Outcome measure completion and fidelity were excellent, and facilitators reported implementation to be feasible. The intervention was reported to be acceptable by participants. CONCLUSIONS AND IMPLICATIONS: When provided with the necessary resources and support, people with intellectual disabilities participate actively in web-delivered group interventions

Standing up for Myself (STORM): Adapting and piloting a web-delivered psychosocial group intervention for people with intellectual disabilities

Background: Our STORM intervention was developed for people (16 +) with intellectual disabilities to enhance their capacity to manage and resist stigma. The current study describes the adaptation of STORM for (synchronous) on-line delivery in the context of the Covid-19 pandemic. Aims: To adapt the manualised face-to-face STORM group intervention for delivery via web-based meeting platforms and to conduct an initial pilot study to consider its acceptability and feasibility. Methods and procedures: The 5-session STORM intervention was carefully adapted for online delivery. In a pilot study with four community groups (N = 22), outcome, health economics and attendance data were collected, and fidelity of delivery assessed. Focus groups with participants, and interviews with facilitators provided data on acceptability and feasibility. Outcomes and results: The intervention was adapted with minimal changes to the content required. In the pilot study, 95% of participants were retained at follow-up, 91% attended at least three of the five sessions. Outcome measure completion and fidelity were excellent, and facilitators reported implementation to be feasible. The intervention was reported to be acceptable by participants. Conclusions and implications: When provided with the necessary resources and support, people with intellectual disabilities participate actively in web-delivered group interventions

Asn 362 in gp120 contributes to enhanced fusogenicity by CCR5-restricted HIV-1 envelope glycoprotein variants from patients with AIDS

<p>Abstract</p> <p>Background</p> <p>CCR5-restricted (R5) human immunodeficiency virus type 1 (HIV-1) variants cause CD4+ T-cell loss in the majority of individuals who progress to AIDS, but mechanisms underlying the pathogenicity of R5 strains are poorly understood. To better understand envelope glycoprotein (Env) determinants contributing to pathogenicity of R5 viruses, we characterized 37 full-length R5 Envs from cross-sectional and longitudinal R5 viruses isolated from blood of patients with asymptomatic infection or AIDS, referred to as pre-AIDS (PA) and AIDS (A) R5 Envs, respectively.</p> <p>Results</p> <p>Compared to PA-R5 Envs, A-R5 Envs had enhanced fusogenicity in quantitative cell-cell fusion assays, and reduced sensitivity to inhibition by the fusion inhibitor T-20. Sequence analysis identified the presence of Asn 362 (N362), a potential N-linked glycosylation site immediately N-terminal to CD4-binding site (CD4bs) residues in the C3 region of gp120, more frequently in A-R5 Envs than PA-R5 Envs. N362 was associated with enhanced fusogenicity, faster entry kinetics, and increased sensitivity of Env-pseudotyped reporter viruses to neutralization by the CD4bs-directed Env mAb IgG1b12. Mutagenesis studies showed N362 contributes to enhanced fusogenicity of most A-R5 Envs. Molecular models indicate N362 is located adjacent to the CD4 binding loop of gp120, and suggest N362 may enhance fusogenicity by promoting greater exposure of the CD4bs and/or stabilizing the CD4-bound Env structure.</p> <p>Conclusion</p> <p>Enhanced fusogenicity is a phenotype of the A-R5 Envs studied, which was associated with the presence of N362, enhanced HIV-1 entry kinetics and increased CD4bs exposure in gp120. N362 contributes to fusogenicity of R5 Envs in a strain dependent manner. Our studies suggest enhanced fusogenicity of A-R5 Envs may contribute to CD4+ T-cell loss in subjects who progress to AIDS whilst harbouring R5 HIV-1 variants. N362 may contribute to this effect in some individuals.</p

Pathogenicity and immunogenicity of attenuated, nef-deleted HIV-1 strains in vivo

In efforts to develop an effective vaccine, sterilizing immunity to primate lentiviruses has only been achieved by the use of live attenuated viruses carrying major deletions in nef and other accessory genes. Although live attenuated HIV vaccines are unlikely to be developed due to a myriad of safety concerns, opportunities exist to better understand the correlates of immune protection against HIV infection by studying rare cohorts of long-term survivors infected with attenuated, nef-deleted HIV strains such as the Sydney blood bank cohort (SBBC). Here, we review studies of viral evolution, pathogenicity, and immune responses to HIV infection in SBBC members. The studies show that potent, broadly neutralizing anti-HIV antibodies and robust CD8+ T-cell responses to HIV infection were not necessary for long-term control of HIV infection in a subset of SBBC members, and were not sufficient to prevent HIV sequence evolution, augmentation of pathogenicity and eventual progression of HIV infection in another subset. However, a persistent T-helper proliferative response to HIV p24 antigen was associated with long-term control of infection. Together, these results underscore the importance of the host in the eventual outcome of infection. Thus, whilst generating an effective antibody and CD8+ T-cell response are an essential component of vaccines aimed at preventing primary HIV infection, T-helper responses may be important in the generation of an effective therapeutic vaccine aimed at blunting chronic HIV infection

Citizen Science Terminology Matters: Exploring Key Terms

Much can be at stake depending on the choice of words used to describe citizen science, because terminology impacts how knowledge is developed. Citizen science is a quickly evolving field that is mobilizing people’s involvement in information development, social action and justice, and large-scale information gathering. Currently, a wide variety of terms and expressions are being used to refer to the concept of ‘citizen science’ and its practitioners. Here, we explore these terms to help provide guidance for the future growth of this field. We do this by reviewing the theoretical, historical, geopolitical, and disciplinary context of citizen science terminology; discussing what citizen science is and reviewing related terms; and providing a collection of potential terms and definitions for ‘citizen science’ and people participating in citizen science projects. This collection of terms was generated primarily from the broad knowledge base and on-the-ground experience of the authors, by recognizing the potential issues associated with various terms. While our examples may not be systematic or exhaustive, they are intended to be suggestive and invitational of future consideration. In our collective experience with citizen science projects, no single term is appropriate for all contexts. In a given citizen science project, we suggest that terms should be chosen carefully and their usage explained; direct communication with participants about how terminology affects them and what they would prefer to be called also should occur. We further recommend that a more systematic study of terminology trends in citizen science be conducted