Health care experiences of Black cancer survivors: A qualitative study exploring drivers of low and high Consumer Assessment of Healthcare Providers and Systems global ratings of care

Background: The purpose of this study was to understand the experiences of Black patients with cancer in health care by comparing drivers of high and low ratings. / Methods: Semistructured in-depth interviews were conducted with 18 Black patients with cancer recruited from cancer survivorship support groups and Facebook between May 2019 and March 2020. Interviews were coded across all transcripts by using a thematic analysis approach before comparing low- and high-rating groups. / Results: There were three major themes that influenced whether patients rated their care as low or high, which included the patient–provider relationship, health care staff interactions, and cancer care coordination. For example, the high-rating group described good communication with the health care team as physicians listening to their needs, being responsive to their concerns, and providing recommendations on how to address side effects. In contrast, the low-rating group described poor communication with their health care team as their needs being dismissed and being excluded from decision-making processes. Additionally, there were two distinct themes that influenced patients’ low ratings: insurance and financial toxicity issues and experiences of health care discrimination. / Conclusions: In an effort to promote equitable cancer care experiences for Black patients, it is important that health systems work to prioritize patient interactions with health care providers and staff, comprehensive care management for patients with cancer, and reductions in the financial burden of caring for cancer

Connection of Isolated Stereoclusters by Combining C-13-RCSA, RDC, and J-Based Configurational Analyses and Structural Revision of a Tetraprenyltoluquinol Chromane Meroterpenoid from Sargassum muticum

The seaweed Sargassum muticum, collected on the southern coast of Galicia, yielded a tetraprenyltoluquinol chromane meroditerpene compound known as 1b, whose structure is revised. The relative configuration of 1b was determined by J-based configurational methodology combined with an iJ/DP4 statistical analysis and further confirmed by measuring two anisotropic properties: carbon residual chemical shift anisotropies (13C-RCSAs) and one-bond 1H-13C residual dipolar couplings (1DCH-RDCs). The absolute configuration of 1b was deduced by ECD/OR/TD-DFT methods and established as 3R,7S,11R

Modelling the Inorganic Bromine Partitioning in the Tropical Tropopause over the Pacific Ocean

The stratospheric inorganic bromine burden (Bry) arising from the degradation of brominated very short-lived organic substances (VSL org ), and its partitioning between reactive and reservoir species, is needed for a comprehensive assessment of the ozone depletion potential of brominated trace gases. Here we present modelled inorganic bromine abundances over the Pacific tropical tropopause based on aircraft observations of VSL org of two campaigns of the Airborne Tropical TRopopause EXperiment (ATTREX 2013 carried out over eastern Pacific and ATTREX 2014 carried out over the western Pacific) and chemistry-climate simulations (along ATTREX flight tracks) using the specific meteorology prevailing. Using the Community Atmosphere Model with Chemistry (CAM-Chem), we model that BrO and Br are the daytime dominant species. Integrated across all ATTREX flights BrO represents ~ 43 % and 48 % of daytime Bry abundance at 17 km over the Western and Eastern Pacific, respectively. The results also show zones where Br/BrO >1 depending on the solar zenith angle (SZA), ozone concentration and temperature. On the other hand, BrCl and BrONO 2 were found to be the dominant night-time species with ~ 61% and 56 % of abundance at 17 km over the Western and Eastern Pacific, respectively. The western-to-eastern differences in the partitioning of inorganic bromine are explained by different abundances of ozone (O3), nitrogen dioxide (NO2) , and total inorganic chlorine (Cly).Fil: Navarro, María A.. University of Miami; Estados UnidosFil: Saiz-lopez, Alfonso. Consejo Superior de Investigaciones Científicas. Instituto de Química Física; EspañaFil: Cuevas, Carlos Alberto. Consejo Superior de Investigaciones Científicas. Instituto de Química Física; EspañaFil: Fernandez, Rafael Pedro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza; Argentina. Universidad Nacional de Cuyo. Facultad de Ciencias Exactas y Naturales; Argentina. Universidad Tecnologica Nacional. Facultad Regional Mendoza. Secretaría de Ciencia, Tecnología y Postgrado; ArgentinaFil: Atlas, Elliot. University of Miami; Estados UnidosFil: Rodriguez Lloeveras, Xavier. Consejo Superior de Investigaciones Científicas. Instituto de Química Física; EspañaFil: Kinnison, Douglas E.. National Center For Atmospheric Research. Amospheric Chemistry División; Estados UnidosFil: Lamarque, Jean Francois. National Center For Atmospheric Research. Amospheric Chemistry División; Estados UnidosFil: Tilmes, Simone. National Center For Atmospheric Research. Amospheric Chemistry División; Estados UnidosFil: Thornberry, Troy. State University of Colorado at Boulder; Estados Unidos. Earth System Research Laboratory; Estados UnidosFil: Rollins, Andrew. State University of Colorado at Boulder; Estados Unidos. Earth System Research Laboratory; Estados UnidosFil: Elkins, James W.. Earth System Research Laboratory; Estados UnidosFil: Hintsa, Eric J.. State University of Colorado at Boulder; Estados Unidos. Earth System Research Laboratory; Estados UnidosFil: Moore, Fred L.. State University of Colorado at Boulder; Estados Unidos. Earth System Research Laboratory; Estados Unido

Evaluación del comportamiento a macro-fisuración por fatiga de mezclas bituminosas modificadas con polvo de neumático

The use of crumb rubber modified bitumen (CRMB) in asphalt mixes is a road engineering technology that has become increasingly important in recent years. Given the many economic and environmental benefits of this type of binder, the goal is to give CRMB the same level of performance as conventional polymermodified bitumen. The appearance and propagation of cracks due to fatigue phenomena is one of the most common distresses affecting road pavements. Since crumb rubber enhances the mechanical properties of asphalt mixes, it can provide a viable solution for fatigue cracking. This paper presents the results of a comparative analysis of the fatigue-cracking behavior of asphalt mixtures manufactured with crumb rubber modified bitumen and polymer-modified bitumen.El empleo de betunes modificados con polvo de neumático usado en la fabricación de mezclas bituminosas es una de las técnicas que mayor auge está teniendo en los últimos años en la ingeniería de carreteras. Dadas sus grandes ventajas económicas y ambientales, este tipo de ligantes pretende conseguir prestaciones similares a la de los betunes modificados con polímeros utilizados habitualmente. La aparición de fisuras debido a fenómenos de fatiga es una de las patologías más comunes en firmes de carretera. Debido a las mejoras de las propiedades mecánicas del betún aportadas tras la incorporación de polvo de neumático, las mezclas fabricadas con estos ligantes se postulan como una posible solución a dicho problema. En este artículo se lleva a cabo un análisis comparativo del comportamiento a fisuración por fatiga realizado sobre mezclas bituminosas fabricadas con betún modificado con polvo de neumático y con polímeros.This research was carried out within the framework of the R + D + i project entitled Proyecto Integrado de Investigación, Desarrollo y Demostración de Tecnologías para la aplicación de neumáticos fuera de uso en firmes de carretera resistentes a la propagación de grietas (ref. IDI-20091076), funded by the Center for Industrial Technological Development (CDTI) of the Ministry of Science and Innovation in Spain

Effect of Co-Inoculation with Mycorrhiza and Rhizobia on the Nodule Trehalose Content of Different Bean Genotypes

Studies on Rhizobium-legume symbiosis show that trehalose content in nodules under drought stress correlates positively with an increase in plant tolerance to this stress. Fewer reports describe trehalose accumulation in mycorrhiza where, in contrast with rhizobia, there is no flux of carbohydrates from the microsymbiont to the plant. However, the trehalose dynamics in the Mycorrhiza-Rhizobium-Legume tripartite symbiosis is unknown. The present study explores the role of this tripartite symbiosis in the trehalose content of nodules grown under contrasting moisture conditions. Three wild genotypes (P. filiformis, P. acutifolis and P. vulgaris) and two commercial genotypes of Phaseolus vulgaris (Pinto villa and Flor de Mayo) were used. Co-inoculation treatments were conducted with Glomus intraradices and a mixture of seven native rhizobial strains, and trehalose content was determined by GC/MS. The results showed a negative effect of mycorrhizal inoculation on nodule development, as mycorrhized plants showed fewer nodules and lower nodule dry weight compared to plants inoculated only with Rhizobium. Mycorrhizal colonization was also higher in plants inoculated only with Glomus as compared to plants co-inoculated with both microsymbionts. In regard to trehalose, co-inoculation negatively affects its accumulation in the nodules of each genotype tested. However, the correlation analysis showed a significantly positive correlation between mycorrhizal colonization and nodule trehalose content

Disability and perceived stress in primary care patients with major depression

Background: Major depressive disorder (MDD) is highly prevalent in the Spanish primary care (PC) setting and the leading cause of disability in Spain. The aim of this study was to evaluate several key psychometric properties of the Sheehan Disability Scale (SDS) in patients with or without MDD and varying degrees of symptom severity using the Patient Health Questionnaire-9 (PHQ-9). Method: A total of 1, 704 PC patients participating in the PsicAP clinical trial completed the SDS and PHQ-9. We evaluated the factor structure, measurement invariance across gender, internal consistency, and the discriminative and predictive validity. Results: Confirmatory factor analyses revealed a unifactorial model of the SDS containing 4 items (SDS-4) with the best model fit (CFI: .99; GFI: .99; TLI: 96; RMSEA: .10). This model contained the three life domain items (work, family, and social life) plus perceived stress (PS) with significant loadings. The internal consistency of the SDS-4 was acceptable in patients with or without MDD, regardless of symptom severity. The SDS-4 also showed good discriminative capacity and acceptable predictive validity in all subsamples. Conclusions: These findings support the use of the SDS-4 to assess depression-related disability in patients at Spanish primary care centres

Can we identify individuals with an ALPL variant in adults with persistent hypophosphatasaemia?

Hypophosphatasia (HPP) is an inborn error of metabolism characterized by low levels of serum alkaline phosphatase (ALP). Scarce evidence exists about features that should signal the potential association between hypophosphatasaemia and HPP in adults. The aim of this study is to estimate the prevalence of ALPL variants in subjects with persistent hypophosphatasaemia and determine the associated clinical and laboratory features. For this cross-sectional study, laboratory records of 386,353 subjects were screened by measurement of ALP activity. A total of 85 (0.18%) subjects with persistent hypophosphatasaemia (≥2 serum alkaline phosphatase-ALP-measurements ≤35 IU/L and none > 45 IU/L) were included (secondary causes previously discarded). ALPL genetic testing and a systematized questionnaire to retrieve demographic, clinical and laboratory data were performed. Descriptive analysis and logistic regression models were employed to identify the clinical and laboratory characteristics associated with ALPL variants. Results: Forty subjects (47%) had a variant(s) in ALPL. With regard to clinical characteristics, the presence of an ALPL variant was significantly associated only with musculoskeletal pain (OR: 7.6; 95% IC: 1.9-30.9). Nevertheless, a trend to present more dental abnormalities (OR: 3.6; 95% IC: 0.9-13.4) was observed. Metatarsal stress fractures were also more frequent (4 vs 0; p < 0.05) in this group. Regarding laboratory features, median ALP levels were lower in subjects with ALPL variants (26 vs 29 IU/L; p < 0.005). Interestingly, the threshold of ALP levels < 25 IU/L showed a specificity, positive predictive value and positive likelihood ratio of 97.8, 94.4% and 19.8 to detect a positive ALPL test, respectively. Conclusions: In subjects with persistent hypophosphatasaemia -secondary causes excluded- one out of two presented ALPL variants. Musculoskeletal pain and ALP levels < 25 IU/L are associated with this variant(s). In this scenario, ALP levels < 25 IU/L seem to be very useful to identify individuals with the presence of an ALPL variantGenetic testing was supported by a grant from Alexion Pharmaceuticals Inc., which had no role in the study design or data analysi