Untold Perspectives: The Impact of the Closure of a Health Institution in a Black Community in North St. Louis County

Based on the literature of social determinants of health, health equity, and anchor institutions, it is evident that hospitals have a role to play in ensuring the health of their community. However, our understanding of the impact of hospital closures is limited, especially when it comes to Black communities. The purpose of this study is to examine the relationship of the closure of the Normandy Osteopathic Hospital to the social determinants of health—specifically access to care and economic stability as it relates to income and wealth generation—for a Black community in one near-North suburb of St. Louis. Ten individuals with a connection to the Normandy Osteopathic Hospital were interviewed using qualitative methods and an oral history protocol. Data was coded and analyzed using thematic analysis. Findings showed layers of disinvestment over time through national and local health care management decisions. Findings also showed that the hospital closure not only had an impact on access to health care, but also on community self-worth and economic wellbeing. As a result of these findings, policy implications and recommendations are explored

Discovery and characterisation of detached M-dwarf eclipsing binaries in the WFCAM Transit Survey

We report the discovery of 16 detached M-dwarf eclipsing binaries with J<16 mag and provide a detailed characterisation of three of them, using high-precision infrared light curves from the WFCAM Transit Survey (WTS). Such systems provide the most accurate and model-independent method for measuring the fundamental parameters of these poorly understood yet numerous stars, which currently lack sufficient observations to precisely calibrate stellar evolution models. We fully solve for the masses and radii of three of the systems, finding orbital periods in the range 1.5<P<4.9 days, with masses spanning 0.35-0.50 Msun and radii between 0.38-0.50 Rsun, with uncertainties of ~3.5-6.4% in mass and ~2.7-5.5% in radius. Close-companions in short-period binaries are expected to be tidally-locked into fast rotational velocities, resulting in high levels of magnetic activity. This is predicted to inflate their radii by inhibiting convective flow and increasing star spot coverage. The radii of the WTS systems are inflated above model predictions by ~3-12%, in agreement with the observed trend, despite an expected lower systematic contribution from star spots signals at infrared wavelengths. We searched for correlation between the orbital period and radius inflation by combining our results with all existing M-dwarf radius measurements of comparable precision, but we found no statistically significant evidence for a decrease in radius inflation for longer period, less active systems. Radius inflation continues to exists in non-synchronised systems indicating that the problem remains even for very low activity M-dwarfs. Resolving this issue is vital not only for understanding the most populous stars in the Universe, but also for characterising their planetary companions, which hold the best prospects for finding Earth-like planets in the traditional habitable zone.Comment: 30 pages, 14 figures, 16 tables, Accepted for publication in MNRA

System-level policies on appropriate opioid use, a multi-stakeholder consensus

Background:  This consensus statement was developed because there are concerns about the appropriate use of opioids for acute pain management, with opposing views in the literature. Consensus statement on policies for system-level interventions may help inform organisations such as management structures, government agencies and funding bodies. Methods:  We conducted a multi-stakeholder survey using a modified Delphi methodology focusing on policies, at the system level, rather than at the prescriber or patient level. We aimed to provide consensus statements for current developments and priorities for future developments. Results:  Twenty-five experts from a variety of fields with experience in acute pain management were invited to join a review panel, of whom 23 completed a modified Delphi survey of policies designed to improve the safety and quality of opioids prescribing for acute pain in the secondary care setting. Strong agreement, defined as consistent among> 75% of panellists, was observed for ten statements. Conclusions:  Using a modified Delphi study, we found agreement among a multidisciplinary panel, including patient representation, on prioritisation of policies for system-level interventions, to improve governance, pain management, patient/consumers care, safety and engagement.Publisher PDFPeer reviewe

The SIB Swiss Institute of Bioinformatics' resources: focus on curated databases

The SIB Swiss Institute of Bioinformatics (www.isb-sib.ch) provides world-class bioinformatics databases, software tools, services and training to the international life science community in academia and industry. These solutions allow life scientists to turn the exponentially growing amount of data into knowledge. Here, we provide an overview of SIB's resources and competence areas, with a strong focus on curated databases and SIB's most popular and widely used resources. In particular, SIB's Bioinformatics resource portal ExPASy features over 150 resources, including UniProtKB/Swiss-Prot, ENZYME, PROSITE, neXtProt, STRING, UniCarbKB, SugarBindDB, SwissRegulon, EPD, arrayMap, Bgee, SWISS-MODEL Repository, OMA, OrthoDB and other databases, which are briefly described in this article

High-resolution planktic stable isotope and trace element record of ODP Hole 161-976

Multi-decadal to centennial planktic d18O and Mg/Ca records were generated at ODP976 in the Alboran Sea. The site is in the flow path of Atlantic inflow waters entering the Mediterranean and captured North Atlantic signals through the surface inflow and the atmosphere. The records reveal similar climatic oscillations during the last two glacial-to-interglacial transitions, albeit with a different temporal pacing. Glacial termination 1 (T1) was marked by Heinrich event 1 (H1), post-H1 Bolling/Allerod (B/A) warming and Younger Dryas (YD) cooling. During T2 the H11 d18O anomaly was twice as high and lasted 30% longer than during H1. The post-H11 warming marked the start of MIS5e while the subsequent YD-style cooling occurred during early MIS5e. The post-H11 temperature increase at ODP976 matched the sudden Asian Monsoon Termination II at 129 ka BP. Extending the 230Th-dated speleothem timescale to ODP976 suggests glacial conditions in the Northeast Atlantic region were terminated abruptly and interglacial warmth was reached in less than a millennium. The early-MIS5e cooling and freshening at ODP976 coincided with similar changes at North Atlantic sites suggesting this was a basin-wide event. By analogy with T1 we argue that this was a YD-type event that was shifted into the early stages of the last interglacial period. This scenario is consistent with evidence from northern North Atlantic and Nordic Sea sites that the continuing disintegration of the large Saalian Stage (MIS6) ice sheet in Eurasia delayed the advection of warm North Atlantic waters and full-strength convective overturn until later stages of MIS5e

High-resolution planktic stable isotope and trace element record of ODP Site 161-976, MIS6-T2-MIS5e

Multi-decadal to centennial planktic d18O and Mg/Ca records were generated at ODP976 in the Alboran Sea. The site is in the flow path of Atlantic inflow waters entering the Mediterranean and captured North Atlantic signals through the surface inflow and the atmosphere. The records reveal similar climatic oscillations during the last two glacial-to-interglacial transitions, albeit with a different temporal pacing. Glacial termination 1 (T1) was marked by Heinrich event 1 (H1), post-H1 Bolling/Allerod (B/A) warming and Younger Dryas (YD) cooling. During T2 the H11 d18O anomaly was twice as high and lasted 30% longer than during H1. The post-H11 warming marked the start of MIS5e while the subsequent YD-style cooling occurred during early MIS5e. The post-H11 temperature increase at ODP976 matched the sudden Asian Monsoon Termination II at 129 ka BP. Extending the 230Th-dated speleothem timescale to ODP976 suggests glacial conditions in the Northeast Atlantic region were terminated abruptly and interglacial warmth was reached in less than a millennium. The early-MIS5e cooling and freshening at ODP976 coincided with similar changes at North Atlantic sites suggesting this was a basin-wide event. By analogy with T1 we argue that this was a YD-type event that was shifted into the early stages of the last interglacial period. This scenario is consistent with evidence from northern North Atlantic and Nordic Sea sites that the continuing disintegration of the large Saalian Stage (MIS6) ice sheet in Eurasia delayed the advection of warm North Atlantic waters and full-strength convective overturn until later stages of MIS5e

Similarities and dissimilarities between the last two deglaciations and interglaciations in the North Atlantic region

Sea surface temperatures (SSTs) recorded by alkenones and oxygen isotopes in the Alboran basin are used here to describe, at an unprecedented fine temporal resolution, the present interglaciation (PIG, initiated at 11.7kaBP), the last interglaciation (LIG, onset approximately at 129ka) and respective deglaciations. Similarities and dissimilarities in the progression of these periods are reviewed in comparison with ice cores and stalagmites. Cold spells coeval with the Heinrich events (H) described in the North Atlantic include multi-decadal scale oscillations not previously obvious (up to 4°C in less than eight centuries within the stadials associated with H1 and H11, ca133ka and 17ka respectively). These abrupt oscillations precede the accumulation of organic rich layers deposited when perihelion moves from alignment with NH spring equinox to the summer solstice, a reference for deglaciations. Events observed during the last deglaciation at 17ka, 14.8ka and 11.7ka are reminiscent of events occurred during the penultimate deglaciation at ca136ka, 132ka and 129ka, respectively. The SST trend during the PIG is no more than 2°C (from 20°C to 18°C; up to-0.2°C/ka). The trend is steeper during the LIG, i.e. up to a 5°C change from the early interglaciation to immediately before the glacial inception (from 23°C to 18°C; up to-0.4°C/ka). Events are superimposed upon a long term trend towards colder SSTs, beginning with SST maxima followed by temperate periods until perihelion aligned with the NH autumn equinox (before ca5.3ka for the PIG and 121ka for the LIG). A cold spell of around eight centuries at 2.8ka during the PIG was possibly mimicked during the LIG at ca118ka by a SST fall of around 1°C in a millennium. These events led interglacial SST to stabilise at around 18°C. The glacial inception, barely evident at the beginning ca115ka (North Atlantic event C25, after perihelion passage in the NH winter solstice), culminated with a SST drop of at least 2°C in two millennia (event C24, ca111ka). The Little Ice Age (0.7ka) also occurred after the latest perihelion passage in the NH winter solstice and could be an example of how a glacial pre-inception event following an interglaciation might be.a Department of Environmental Chemistry, Institute of Environmental Assessment and Water Research (IDÆA), Spanish Council for Scientific Research (CSIC), 08034 Barcelona, Spain b University of Cambridge, Department of Earth Sciences, Downing Street, Cambridge CB2 3EQ, United Kingdom c Institute of Environmental Science and Technology and Department of Geography, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain d Institució Catalana de Recerca i Estudis Avançats (ICREA), Inst. of Environmental Science and Technology and Dept. of Geography, Universitat Autònoma de Barcelona, 08193 Bellaterra, SpainPeer reviewe