Disease Prevalence and Health Determinants in Nevada

In this report, we use recent data to describe the health of Nevada and update the previous report (Monnat, 2012) on health outcomes and health determinants in the Silver State. Data for this report are mainly obtained from the County Health Rankings, America’s Health Rankings, and the 2016 Center for Disease Control and Prevention’s Division of Nutrition, Physical Activity, and Obesity report. In line with the previous report by Monnat (2012), we reference Nevada’s disease prevalence in relation to the U.S. average and other states, as well as disease distribution among counties in Nevada. We also compaire health indicators in the U.S. with those in other countries, discuss the health determinants and examine their impact on Nevadans’ health. The chapter concludes with the recommendations on strategies to improve health of Nevada residents. Additional resources include the national, state and community public health organizations (Appendix 1) and examples of public health related legislative actions in Nevada (Appendix 2). In the last several decades, there has been growing interest in how modifiable risk factors contribute to disease and mortality rates. Studies point to five key domains as the principal determinants of health: (a) genetic predisposition, (b) social circumstances, (c) environmental conditions, (d) health behaviors, and (e) medical care. It is estimated that as much as 60% of disease risk is attributable to modifiable factors, such as health behaviors, social circumstances, and environmental conditions (McGinnis, Williams-Ruso, & Knickman, 2002). In recent years, health behaviors (e.g. tobacco use, poor diet, and physical inactivity) and social determinants (e.g. poverty, access to health care) have been singled out as contributing to health inequalities (Lewis & Burb-Sharps, 2010; Marmot, 2005). The effect of behavioral and social determinants of health outcomes is evident throughout the U.S and Nevada

Large mechanism design with moment-based allocation externality

In many mechanism design problems in practice, often allocation externality exists (e.g., peer effects in student allocation, and post-license com- petition in oligopoly). Despite the practical importance, mechanism design with allocation externality has not been much explored in the literature, per- haps due to the tractability issue of the problem. In this paper, we propose a simple and tractable model of mechanism design with allocation externality. We characterize the optimal mechanism, which has a very simple form in the sense that it is identified by only a few parameters. This simplicity of the optimal mechanism is also useful to obtain comparative statics results

Conducting Virtual Qualitative Interviews with International Key Informants: Insights from a Research Project

There is an increasing need for cross-cultural qualitative studies in an era of globalization. A focus group of five researchers, who were involved in a large international research project, identified effective strategies and challenges associated with five key domains of qualitative research with key informants: identification, recruitment, preparation, conducting the interview, and follow-up. Content analysis revealed nuanced tactics related to effective strategies and challenges associated with each domain. Examples of effective strategies include interview preparation to understand the specific expertise of the interviewee and allowing the informant to offer additional information beyond the questions asked. Challenges included technical difficulties with virtual platforms and scheduling interviews in multiple time zones. These findings provide practical guidelines for researchers conducting virtual interviews with international key informants

Structures of SMG1-UPFs Complexes: SMG1 Contributes to Regulate UPF2-Dependent Activation of UPF1 in NMD

SummarySMG1, a PI3K-related kinase, plays a critical role in nonsense-mediated mRNA decay (NMD) in mammals. SMG1-mediated phosphorylation of the UPF1 helicase is an essential step during NMD initiation. Both SMG1 and UPF1 are presumably activated by UPF2, but this regulation is incompletely understood. Here we reveal that SMG1C (a complex containing SMG1, SMG8, and SMG9) contributes to regulate NMD by recruiting UPF1 and UPF2 to distinct sites in the vicinity of the kinase domain. UPF2 binds SMG1 in an UPF1-independent manner in vivo, and the SMG1C-UPF2 structure shows UPF2 recognizes the FRB domain, a region that regulates the related mTOR kinase. The molecular architectures of several SMG1C-UPFs complexes, obtained by combining electron microscopy with in vivo and in vitro interaction analyses, competition experiments, and mutations, suggest that UPF2 can be transferred to UPF1 within SMG1C, inducing UPF2-dependent conformational changes required to activate UPF1 within an SMG1C-UPF1-UPF2 complex

Fatal pulmonary thromboembolism in gastrectomy intraoperative procedures by gastric adenocarcinoma: case report

The case of a patient with gastric adenocarcinoma with indication for gastrectomy is reported. The surgery took place without complications. A palliative, subtotal gastrectomy was performed after para-aortic lymph nodes compromised by neoplasm were found, which was confirmed by pathological exam of frozen sections carried out during the intervention. At the end of the gastroenteroanastomosis procedure, the patient began to show intense bradycardia: 38 beats per minute (bpm), arterial hypotension, changes in the electrocardiogram's waveform (upper unlevelling of segment ST), and cardiac arrest. Resuscitation maneuvers were performed with temporary success. Subsequently, the patient had another circulatory breakdown and again was recovered. Finally, the third cardiac arrest proved to be irreversible, and the intra-operative death occurred. Necropsy showed massive pulmonary embolism. The medical literature has recommended heparinization of patients, in an attempt to avoid pulmonary thromboembolism following major surgical interventions. However, in the present case, heparinization would have been insufficient to prevent death. This case indicates that it is necessary to develop preoperative propedeutics for diagnosing the presence of venous thrombi with potential to migrate, causing pulmonary thromboembolism (PTE). If such thrombi could be detected, preventative measures, such as filter installation in the Cava vein could be undertaken.Relata-se um caso de paciente com adenocarcinoma gástrico com indicação de gastrectomia. O ato operatório transcorreu sem anormalidades. Foi realizada gastrectomia subtotal paliativa, pois encontrou-se linfonodos para-aórticos comprometidos pela neoplasia, confirmado por exame anátomo-patológico de congelação realizado no decorrer da intervenção. Ao fim da confecção da gastroêntero-anastomose o paciente passou a apresentar bradicardia intensa: 38 batimentos por minuto (bpm), hipotensão arterial, alterações do traçado do eletrocardiograma (Supra-desnivelamento do segmento ST) e parada cardíaca. Realizadas as manobras de ressucitação com sucesso temporário, já que a seguir o paciente apresentou novo colapso circulatório, sendo novamente recuperado, finalmente a 3a parada cardíaca foi irreversível e constatou-se o óbito intra-operatório

In vivo microbiological evaluation of the effect of biomechanical preparation of root canals using different irrigating solutions

The aim of this study was to evaluate the antimicrobial effect of biomechanical preparation using different irrigating solutions. Seventy-eight root canals from premolars of four dogs were used. After experimental induction of periapical lesions, the root canals were prepared using the following solutions for irrigation: Group 1) 2.5% sodium hypochlorite (NaOCl); Group 2) 2% chlorhexidine (CHX); Group 3) saline solution and Group 4) control group with no biomechanical preparation. The microbiological evaluation of the root canals was performed by counting the colony forming units (CFUs) using different culture mediums. Two absorbent paper cones were used in each root canal in order to collect the microbiological samples before, and thirty days after the biomechanical preparation. The culture plates were incubated in aerobic, anaerobic and microaerophilic environment. Statistical evaluation was carried out using analysis of variance, Tukey and Student tests. The results demonstrated that there was reduction in the number of microorganisms in the NaOCl and CHX groups (pO objetivo deste estudo foi avaliar o efeito antimicrobiano do preparo biomecânico com diferentes soluções irrigadoras. Foram utilizados 78 canais radiculares de pré-molares de 4 cães. Após indução experimental das lesões periapicais, os canais radiculares foram preparados utilizando as seguintes soluções irrigadoras: grupo 1) hipoclorito de sódio a 2,5% (NaOCl); grupo 2) clorexidina a 2% (CHX); grupo 3) soro fisiológico. No grupo 4 (controle) não foi realizado preparo biomecânico. A avaliação microbiológica do canal radicular foi realizada pela contagem de unidades formadoras de colônia, em ufc, nos diferentes meios de cultura. Foram utilizados 2 cones de papel absorvente em cada canal radicular para a realização da colheita microbiológica antes e 30 dias após o preparo biomecânico. As placas de cultura foram incubadas em ambiente de aerobiose, anaerobiose e microaerofilia. A avaliação estatística foi realizada pela análise de variância complementada pelo teste de Tukey e de Student. Os resultados demonstraram que houve redução dos microrganismos nos grupos NaOCl e CHX (

Frontal sinus adenocarcinoma

CONTEXT: Paranasal sinus cancer is considered rare, with an incidence of less than 1 per 100,000 per year, with the frontal sinus being the primary site in only 0.3%. We report a case of adenocarcinoma arising in the frontal sinus. DESIGN: Case report. CASE REPORT: A 59-year-old woman, secretary, came in February 1998 with a 4-month history of low intensity frontal headache. She denied contact with wood dust. On examination a non-tender swelling was noted over her right forehead next to the medial aspect of the right orbit. CT scan showed a soft-tissue mass involving frontal sinus with intracranial invasion through the posterior wall. The anterior ethmoid sinus and the medial aspect of the right orbit were also involved. MRI demonstrated dural thickening in communication with the frontal mass. She underwent an en-bloc tumor resection by craniotomy including orbital clearance. Histology revealed an adenocarcinoma. After surgery she had tumor recurrence, and chemotherapy and radiotherapy were started resulting in partial improvement.CONTEXTO: O câncer dos seios paranasais é considerado raro com uma incidência menor que 1 por 100.000 por ano. O seio frontal é o sítio primário em apenas 0,3% dos casos. A seguir relatamos um caso de adenocarcinoma do seio frontal. TIPO DE ESTUDO: Relato de caso. RELATO DO CASO: Paciente do sexo feminino, 59 anos, secretária, com queixa de quatro meses de cefaléia frontal de leve intensidade (fevereiro de 1998). Negava contato com serragem. Ao exame notava-se um abaulamento frontal à direita, adjacente a borda medial da órbita direita, de característica endurecida. A tomografia computadorizada mostrava um tumor com densidade de partes moles preenchendo o seio frontal com invasão intracraniana através da parede posterior. O seio etmoidal anterior e a borda medial da órbita direita também estava envolvida. A ressonância nuclear magnética demonstrava espessamento dural em comunicação com o tumor. A paciente foi submetida a exérese tumoral em bloco através de craniotomia bicoronal incluindo exenteração orbitária à direita. O exame histopatológico revelou adenocarcinoma. Após a cirurgia a paciente apresentou recidiva tumoral com resposta parcial a radioterapia e quimioterapia.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Department of OtorhinolaryngologyUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Department of NeurosurgeryUNIFESP, EPM, Department of OtorhinolaryngologyUNIFESP, EPM, Department of NeurosurgerySciEL

The RNA helicase DHX34 functions as a scaffold for SMG1-mediated UPF1 phosphorylation

Nonsense-mediated decay (NMD) is a messenger RNA quality-control pathway triggered by SMG1-mediated phosphorylation of the NMD factor UPF1. In recent times, the RNA helicase DHX34 was found to promote mRNP remodelling, leading to activation of NMD. Here we demonstrate the mechanism by which DHX34 functions in concert with SMG1. DHX34 comprises two distinct structural units, a core that binds UPF1 and a protruding carboxy-terminal domain (CTD) that binds the SMG1 kinase, as shown using truncated forms of DHX34 and electron microscopy of the SMG1–DHX34 complex. Truncation of the DHX34 CTD does not affect binding to UPF1; however, it compromises DHX34 binding to SMG1 to affect UPF1 phosphorylation and hence abrogate NMD. Altogether, these data suggest the existence of a complex comprising SMG1, UPF1 and DHX34, with DHX34 functioning as a scaffold for UPF1 and SMG1. This complex promotes UPF1 phosphorylation leading to functional NMD

Nc886 is epigenetically repressed in prostate cancer and acts as a tumor suppressor through the inhibition of cell growth

Background: Nc886 is a 102 bp non-coding RNA transcript initially classified as a microRNA precursor (Pre-miR-886), later as a divergent homologue of the vault RNAs (vtRNA 2-1) and more recently as a novel type of RNA (nc886). Although nc886/vtRNA2-1/Pre-miR-886 identity is still controversial, it was shown to be epigenetically controlled, presenting both tumor suppressor and oncogenic function in different cancers. Here, we study for the first time the role of nc886 in prostate cancer. Methods: Nc886 promoter methylation status and its correlation with patient clinical parameters or DNMTs levels were evaluated in TCGA and specific GEO prostate tissue datasets. Nc886 level was measured by RT-qPCR to compare normal/neoplastic prostate cells from radical prostatectomies and cell lines, and to assess nc886 response to demethylating agents. The effect of nc886 recovery in cell proliferation (in vitro and in vivo) and invasion (in vitro) was evaluated using lentiviral transduced DU145 and LNCaP cell lines. The association between the expression of nc886 and selected genes was analyzed in the TCGA-PRAD cohort. Results: Nc886 promoter methylation increases in tumor vs. normal prostate tissue, as well as in metastatic vs. normal prostate tissue. Additionally, nc886 promoter methylation correlates with prostate cancer clinical staging, including biochemical recurrence, Clinical T-value and Gleason score. Nc886 transcript is downregulated in tumor vs. normal tissue -in agreement with its promoter methylation status- and increases upon demethylating treatment. In functional studies, the overexpression of nc886 in the LNCaP and DU145 cell line leads to a decreased in vitro cell proliferation and invasion, as well as a reduced in vivo cell growth in NUDE-mice tumor xenografts. Finally, nc886 expression associates with the prostate cancer cell cycle progression gene signature in TCGA-PRAD. Conclusions: Our data suggest a tumor suppressor role for nc886 in the prostate, whose expression is epigenetically silenced in cancer leading to an increase in cell proliferation and invasion. Nc886 might hold clinical value in prostate cancer due to its association with clinical parameters and with a clinically validated gene signature