Self-interest often drives US states’ adoption of evidence based policy measures

In the US, lawmaking at the state level is often heavily linked to the ideology of the party which controls the legislature. Evidenced Based Policy, on the other hand, provides a means for lawmakers to develop measures based on research and data. In new research, Luke Yingling and Daniel J. Mallinson look at what drives the adoption of Evidence Based Policy across the states, finding that it is often motivated by reasons of practicality and electoral self-interest rather than a desire to improve policy outcomes

Developing and applying a gene functional association network for anti-angiogenic kinase inhibitor activity assessment in an angiogenesis co-culture model

<p>Abstract</p> <p>Background</p> <p>Tumor angiogenesis is a highly regulated process involving intercellular communication as well as the interactions of multiple downstream signal transduction pathways. Disrupting one or even a few angiogenesis pathways is often insufficient to achieve sustained therapeutic benefits due to the complexity of angiogenesis. Targeting multiple angiogenic pathways has been increasingly recognized as a viable strategy. However, translation of the polypharmacology of a given compound to its antiangiogenic efficacy remains a major technical challenge. Developing a global functional association network among angiogenesis-related genes is much needed to facilitate holistic understanding of angiogenesis and to aid the development of more effective anti-angiogenesis therapeutics.</p> <p>Results</p> <p>We constructed a comprehensive gene functional association network or interactome by transcript profiling an in vitro angiogenesis model, in which human umbilical vein endothelial cells (HUVECs) formed capillary structures when co-cultured with normal human dermal fibroblasts (NHDFs). HUVEC competence and NHDF supportiveness of cord formation were found to be highly cell-passage dependent. An enrichment test of Biological Processes (BP) of differentially expressed genes (DEG) revealed that angiogenesis related BP categories significantly changed with cell passages. Built upon 2012 DEGs identified from two microarray studies, the resulting interactome captured 17226 functional gene associations and displayed characteristics of a scale-free network. The interactome includes the involvement of oncogenes and tumor suppressor genes in angiogenesis. We developed a network walking algorithm to extract connectivity information from the interactome and applied it to simulate the level of network perturbation by three multi-targeted anti-angiogenic kinase inhibitors. Simulated network perturbation correlated with observed anti-angiogenesis activity in a cord formation bioassay.</p> <p>Conclusion</p> <p>We established a comprehensive gene functional association network to model in vitro angiogenesis regulation. The present study provided a proof-of-concept pilot of applying network perturbation analysis to drug phenotypic activity assessment.</p

EEG spectra in dyslexic and normal readers during oral and silent reading

EEGs of extensively screened dyslexics and normal readers were recorded while they read easy and difficult texts silently and orally, and during two other verbal tasks which also differed in overt speaking but had no reading component: narrative speaking and listening to a story. Mid-temporal, central and parietal leads were referenced to linked ears and to Cz. Large differences between tasks and between groups were found.With the linked ears reference, power was higher in all bands in oral reading than in silent reading, with the largest change occuring in the temporal leads. In the theta and low beta bands the difference between oral and silent reading was greater for controls than for dyslexics. These effects were not accounted for by differences in reading speed or in difficulty. Similar results were found in two cohorts of subjects.The difference between groups in theta was found only in the reading tasks. In contrast, the group difference in low beta was also found in the change from listening to speaking. This implies that the oral-silent group difference in theta is related to some aspect of the reading tasks other than the presence or absence of overt speaking, and that the low beta group difference is related to some aspect of overt speaking rather than to reading per se. With the Cz reference no group differences were found/It is suggested that the groups differ in the reading strategies they use, and the degree to which they shift strategy between the silent and oral tasks. We hypothesize that these cognitive differences are reflected in the theta activity from the temporal lobe.While there were many differences between the tasks in alpha power and assymmetry, no group differences involving alpha were found.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30219/1/0000611.pd

Deconstructing the lesbian, gay, bisexual, transgender victim of sex trafficking: Harm, exceptionality and religion–sexuality tensions

Contrary to widespread belief, sex trafficking also targets lesbian, gay, bisexual, transgender (LGBT) communities. Contemporary social and political constructions of victimhood lie at the heart of regulatory policies on sex trafficking. Led by the US Department of State, knowledge about LGBT victims of trafficking constitutes the newest frontier in the expansion of criminalization measures. These measures represent a crucial shift. From a burgeoning range of preemptive measures enacted to protect an amorphous class of ‘all potential victims’, now policies are heavily premised on the risk posed by traffickers to ‘victims of special interest’. These constructed identities, however, are at odds with established structures. Drawing on a range of literatures, the core task of this article is to confront some of the complexities and tensions surrounding constructions of LGBT trafficking victims. Specifically, the article argues that discourses of ‘exceptional vulnerability’ and the polarized notions of ‘innocence’ and ‘guilt’ inform hierarchies of victimhood. Based on these insights, the article argues for the need to move beyond monolithic understandings of victims, by reframing the politics of harm accordingly

2020-05-16/17 DAILY UNM GLOBAL HEALTH COVID-19 BRIEFING

Executive Summary: Only 1 case in NM state prisons. NM case count. NM travel warning. NM web-based recovery reporting system. NM Mask Madness Tournament. Face covering in ABQ. NM graduate medical program funding. ABQ Memorial Day cancellation. NM affordable housing funding. Taos farmers market drive through opening. US correctional facility cases. Social distancing works. Dogs sniffing out COVID-19. Germany\u27s soccer league to restart. Mask effectiveness. Mask comfort w/cardboard cutout. Ammonium cleaning ineffective. CDC contact tracing guidance. Spanish immunity. CDC epidemic intelligence fellowship. Speaking transmits virus. Decontaminating workers. CDC advisory for children. Addressing ER fears. Indoor presymptomatic virus transfer. Virus transmission of currency. Safety advice for reopening. Lessons learned from universities. Dutch safe sex guidelines for singles. Recommendations are given on invasive management of acute coronary syndrome, onco-gynecologic surgery, endoscopy, hemodialysis, on resuming orthopedic surgery, clozapine monitoring, starting ADHD medications, orthodontics, and scaling up virtual services. At-home sample collection kit. Hydroxychloroquine no benefit. Tocilizumab reduces mortality rate. Calcium channel blockers beneficial. COVID-19 opinion/review vs. primary research. Disease severity and biomarkers. Concomitant liver injury. Gastrointestinal and liver involvement. Diabetes mortality. High incidence venous thrombosis. Monitoring global emotions with twitter

2020-05-29/30/31 DAILY UNM GLOBAL HEALTH COVID-19 BRIEFING

Executive Summary: NM Highlights: NM case count. Navajo Nation case update. Largest COVID-19 surge in Taos. ABQ BioPark to reopen. NM public schools reopening plan. NM unemployment claims. Rise in domestic and sexual abuse. US Highlights: Protests inspire fear of surge. Trump withdraws from WHO. Last aid bill. No new NY patients. ICE detainees sick. International Highlights: South Korea schools close. Undercounting in Russia. South African overburdened health care system. Economics, Workforce, Supply Chain, PPE: Reusable protection system. Protective household products. Longterm economic challenges. Epidemiology Highlights: Estimate virus reproduction numbers. Hypertension & cardiovascular disease impact on mortality. Gastrointestinal manifestations. Healthcare Policy Recommendations: Immunity passports are bad idea. Evaluation of hand WHO-recommended products. Opioid use-related challenges of COVID-19 management. Practice Guidelines: NICE guidelines on COVID-19 and acute kidney injury. Example of rapid conversion of an outpatient psychiatric hospital to a virtual telepsychiatry clinic. JAMA recommendations on conducting and reporting COVID-19 clinical research. Testing: Comparison of 4 antigen tests. Validation of antibody assays. Drugs, Vaccines, Therapies, Clinical Trials: Encouraging results of Ruxolitinib phase II RCT. Benefits of adjunctive herbal medicine. Potential inhibitors of viral protease screened. Anticoagulation alone is unlikely to protect from COVID-19 related morbidity and mortality. Open access database Covid19db for COVID-19 drugs. 49 new trials registered. Other Science: COVID-19 collateral damage. Telomere length and COVID-19 outcomes. Wastewater RNA early warning. Neurologic manifestation review. MRI reveals predominant anosmia cases. Self-quarantine weight gain. Immunosuppression vs. cytokine storm. Combatting misinformation

Effect of enhanced medical rehabilitation on functional recovery in older adults receiving skilled nursing care after acute rehabilitation: A randomized clinical trial

Importance: Enhanced medical rehabilitation (EMR) is a systematic and standardized approach for physical and occupational therapists to engage patients. Higher patient engagement in therapy might lead to improved functional recovery in rehabilitation settings, such as skilled nursing facilities (SNFs). Objective: To determine whether EMR improves older adults\u27 functional recovery. Design, Setting, and Participants: A double-blind, parallel-group, randomized clinical trial was conducted from July 29, 2014, to July 13, 2018, in 229 adults aged 65 years or older admitted to 2 US SNFs. Participants were randomized to receive EMR (n = 114) vs standard-of-care rehabilitation (n = 115). Intention-to-treat analysis was used. Interventions: The intervention group received their physical and occupational therapy from therapists trained in EMR. Based on models of motivation and behavior change, EMR is a toolkit of techniques to increase patient engagement and therapy intensity. The control group received standard-of-care rehabilitation from physical and occupational therapists not trained in EMR. Main Outcomes and Measures: The primary outcome was change in function in activities of daily living and mobility, as assessed with the Barthel Index, which measures 10 basic activities of daily living or mobility items (scale range, 0-100), from SNF admission to discharge; secondary outcomes were gait speed for 10 m, 6-minute walk test, discharge disposition, rehospitalizations, and self-reported functional status at days 30, 60, and 90. To examine the rehabilitation process, therapists\u27 engagement with patients and patient active time during therapy were measured for a sample of the sessions. Results: Of the 229 participants, 149 (65.1%) were women; 177 (77.3%) were white, and 51 (22.3%) were black; mean (SD) age was 79.3 (8.0) years. Participants assigned to EMR showed greater recovery of function than those assigned to standard of care (mean increase in Barthel Index score, 35 points; 95% CI, 31.6-38.3 vs 28 points; 95% CI, 25.2-31.7 points; P = .007). There was no evidence of a difference in the length of stay (mean [SD], 23.5 [13.1] days). However, there were no group by time differences in secondary outcome measures, including self-reported function after SNF discharge out to 90 days as measured on the Barthel Index (mean [SE] score: EMR, 83.65 [2.20]; standard of care, 84.67 [2.16]; P = .96). The EMR therapists used a median (interquartile range) of 24.4 (21.0-37.3) motivational messages per therapy session vs 2.3 (1.1-2.9) for nontrained therapists (P \u3c .001), and EMR patients were active during a mean (SD) of 52.5 (6.6%) of the therapy session time vs 41.2 (6.8%) for nontrained therapists (P = .001). Conclusions and Relevance: Enhanced medical rehabilitation modestly improved short-term functional recovery for selected older adults rehabilitating in SNFs. However, there was no evidence that the benefits persisted over the longer term. This study demonstrates the value of engaging and motivating older adults in rehabilitation therapy, but more work is needed to extend these benefits to longer-term outcomes after discharge home. Trial Registration: ClinicalTrials.gov identifier: NCT02114879

The STOP COVID 2 study: Fluvoxamine vs placebo for outpatients with symptomatic COVID-19, a fully remote randomized controlled trial

BACKGROUND: Prior randomized clinical trials have reported benefit of fluvoxamine ≥200 mg/d vs placebo for patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: This randomized, double-blind, placebo-controlled, fully remote multisite clinical trial evaluated whether fluvoxamine prevents clinical deterioration in higher-risk outpatients with acute coronavirus disease 2019 (COVID-19). Between December 2020 and May 2021, nonhospitalized US and Canadian participants with confirmed symptomatic infection received fluvoxamine (50 mg on day 1, 100 mg twice daily thereafter) or placebo for 15 days. The primary modified intent-to-treat (mITT) population included participants who started the intervention within 7 days of symptom onset with a baseline oxygen saturation ≥92%. The primary outcome was clinical deterioration within 15 days of randomization, defined as having both (1) shortness of breath (severity ≥4 on a 0-10 scale or requiring hospitalization) RESULTS: A total of 547 participants were randomized and met mITT criteria (n = 272 fluvoxamine, n = 275 placebo). The Data Safety Monitoring Board recommended stopping early for futility related to lower-than-predicted event rates and declining accrual concurrent with vaccine availability in the United States and Canada. Clinical deterioration occurred in 13 (4.8%) participants in the fluvoxamine group and 15 (5.5%) participants in the placebo group (absolute difference at day 15, 0.68%; 95% CI, -3.0% to 4.4%; log-rank CONCLUSIONS: This trial did not find fluvoxamine efficacious in preventing clinical deterioration in unvaccinated outpatients with symptomatic COVID-19. It was stopped early and underpowered due to low primary outcome rates. CLINICAL TRIALS REGISTRATION: ClinicalTrials.gov Identifier: NCT04668950