Women’s responses to changes in U.S. preventive task force’s mammography screening guidelines: results of focus groups with ethnically diverse women

Background: The 2009 U.S. Preventive Services Task Force (USPSTF) changed mammography guidelines to recommend routine biennial screening starting at age 50. This study describes women’s awareness of, attitudes toward, and intention to comply with these new guidelines. Methods: Women ages 40–50 years old were recruited from the Boston area to participate in focus groups (k = 8; n = 77). Groups were segmented by race/ethnicity (Caucasian = 39%; African American = 35%; Latina = 26%), audio-taped, and transcribed. Thematic content analysis was used. Results: Participants were largely unaware of the revised guidelines and suspicious that it was a cost-savings measure by insurers and/or providers. Most did not intend to comply with the change, viewing screening as obligatory. Few felt prepared to participate in shared decision-making or advocate for their preferences with respect to screening. Conclusions: Communication about the rationale for mammography guideline changes has left many women unconvinced about potential disadvantages or limitations of screening. Since further guideline changes are likely to occur with advances in technology and science, it is important to help women become informed consumers of health information and active participants in shared decision-making with providers. Additional research is needed to determine the impact of the USPSTF change on women’s screening behaviors and on breast cancer outcomes

The barycentric motion of exoplanet host stars: tests of solar spin-orbit coupling

Empirical evidence suggests a tantalising but unproven link between various indicators of solar activity and the barycentric motion of the Sun. The latter is exemplified by transitions between regular and more disordered motion modulated by the motions of the giant planets, and rare periods of retrograde motion with negative orbital angular momentum. An examination of the barycentric motion of exoplanet host stars, and their stellar activity cycles, has the potential of proving or disproving the Sun's motion as an underlying factor in the complex patterns of short- and long-term solar variability indices, by establishing whether such correlations exist in other planetary systems. A variety of complex patterns of barycentric motions of exoplanet host stars is demonstrated, depending on the number, masses and orbits of the planets. Each of the behavioural types proposed to correlate with solar activity are also evident in exoplanet host stars: repetitive patterns influenced by massive multiple planets, epochs of rapid change in orbital angular momentum, and intervals of negative orbital angular momentum. The study provides the basis for independent investigations of the widely-studied but unproven suggestion that the Sun's motion is somehow linked to various indicators of solar activity. We show that, because of the nature of their barycentric motions, the host stars HD168443 and HD74156 offer particularly powerful tests of this hypothesis.Comment: 7 pages, 3 figures. Accepted for publication in A&

The Natural History of Trachoma Infection and Disease in a Gambian Cohort with Frequent Follow-Up

Trachoma is an infectious disease of the eye that causes blindness in many of the poorest parts of the world. In this paper, we use a novel statistical approach to estimate the characteristics of this disease among people living in The Gambia who were examined every 2 weeks over a 6-month period. We found that the typical duration of infection with Chlamydia trachomatis and of clinically active disease were significantly longer than previously estimated. We tested different hypotheses about the natural history of trachoma that explain the relationship between infection and disease observed in the field. We also confirmed that disease lasts significantly longer among young children under 5 years old compared with older children and adults, even after accounting for high rates of re-infection in this age group, consistent with the development of immunity with age. The long duration of infection, especially among younger children, contributes to the persistence and gradual return of trachoma after community-wide treatment with azithromycin. This implies the need for high treatment coverage if infection is to be eliminated from a community, even where the return of infection after treatment is seen to be slow

Sixteen diverse laboratory mouse reference genomes define strain-specific haplotypes and novel functional loci.

We report full-length draft de novo genome assemblies for 16 widely used inbred mouse strains and find extensive strain-specific haplotype variation. We identify and characterize 2,567 regions on the current mouse reference genome exhibiting the greatest sequence diversity. These regions are enriched for genes involved in pathogen defence and immunity and exhibit enrichment of transposable elements and signatures of recent retrotransposition events. Combinations of alleles and genes unique to an individual strain are commonly observed at these loci, reflecting distinct strain phenotypes. We used these genomes to improve the mouse reference genome, resulting in the completion of 10 new gene structures. Also, 62 new coding loci were added to the reference genome annotation. These genomes identified a large, previously unannotated, gene (Efcab3-like) encoding 5,874 amino acids. Mutant Efcab3-like mice display anomalies in multiple brain regions, suggesting a possible role for this gene in the regulation of brain development

Genomic epidemiology of SARS-CoV-2 in a UK university identifies dynamics of transmission

AbstractUnderstanding SARS-CoV-2 transmission in higher education settings is important to limit spread between students, and into at-risk populations. In this study, we sequenced 482 SARS-CoV-2 isolates from the University of Cambridge from 5 October to 6 December 2020. We perform a detailed phylogenetic comparison with 972 isolates from the surrounding community, complemented with epidemiological and contact tracing data, to determine transmission dynamics. We observe limited viral introductions into the university; the majority of student cases were linked to a single genetic cluster, likely following social gatherings at a venue outside the university. We identify considerable onward transmission associated with student accommodation and courses; this was effectively contained using local infection control measures and following a national lockdown. Transmission clusters were largely segregated within the university or the community. Our study highlights key determinants of SARS-CoV-2 transmission and effective interventions in a higher education setting that will inform public health policy during pandemics.</jats:p

Antibody responses to the major outer membrane protein of Chlamydia trachomatis

The major outer membrane protein (MOMP) of C.trachomatis is the main candidate for the production of a sub-unit vaccine against trachoma. MOMP contains four variable segments (VS1-VS4) evenly interspersed by five constant regions. Monoclonal and polyclonal antibodies to serovar-, sub species-, and species-specific epitopes from the variable segments neutralise Chlamydia in vitro and in vivo. This thesis describes the immunogenicity of synthetic MOMP-specific peptides, recombinant fragments of MOMP (rMOMP) and chemically conjugated tMOMP-peptide constructs in rabbits and mice. Rabbit antisera to synthetic peptides corresponding to the serovar-, sub species- and species-specific epitopes of serovar B MOMP recognised cognate epitopes on native Chlamydia. Immunisation of rabbits with a serovar L1, 3/4 length, recombinant fragment of MOMP (rMOMP) elicited antisera that bound to intact C.trachomatis in a species-specific manner. Serovar-specific peptides from trachoma serovars A, B and C were chemically conjugated to a backbone of L1 3/4 tMOMP, generating antisera reactive with the rMOMP backbone, the haptenic peptides and serovar A, B and C and L1 C.trachomatis Experiments were undertaken to investigate the ability of rMOMP-peptide conjugates to prime mice to produce a heterotypic anamnestic antibody response after secondary immunisation with a single serovar of C.trachomatis. Mice were primed in the absence of adjuvant with rMOMP conjugated to serovar-species B cell determinants from serovars A, B and C and a known human T cell epitope. Mice boosted with C.trachomatis serovar L1 produced secondary antibody responses specific to the serovar A, B and C-specific B-cell peptides. The presence of the human T cell epitope augmented anamnestic anti-B-cell peptide responses homologous to the challenge organism.</p

Vascularized thoracodorsal to suprascapular nerve transfer, a novel technique to restore shoulder function in partial brachial plexopathy

We describe the clinical outcome of a novel nerve transfer to restore active shoulder motion in upper brachial plexus injury. The thoracodorsal nerve was successfully used as a vascularized donor nerve to neurotize to the suprascapular nerve in a patient with limited donor nerve availability. At four years follow-up, he had regained useful external rotation of the injured limb, with no significant donor site morbidity. Shoulder abduction return was less impressive however, and reasons for this are discussed. We provide a comprehensive review of the literature on this topic and a subsequent discussion on the details of this novel technique. This is the first reported case of thoracodorsal nerve to suprascapular nerve transfer, and also the first reported case of a vascularized thoracodorsal nerve transfer in the English language literature. We advocate direct thoracodorsal to suprascapular nerve transfer as a valid surgical option for the restoration of shoulder function in patients with partial brachial plexus avulsion, when conventional nerve donors are unavailable