Incidence of Stomach, Liver, and Colorectal Cancers by Geography and Social Vulnerability Among American Indian and Alaska Native Populations, 2010-2019

Social determinants of health and associated systems, policies, and practices are important drivers of health disparities. American Indian and Alaska Native (AI/AN) populations in the United States have elevated incidence rates of stomach, liver, and colorectal cancers compared with other racial/ethnic groups. In this study, we examined incidence rates of 3 types of gastrointestinal cancer among non-Hispanic AI/AN (NH-AI/AN) and non-Hispanic White (NHW) populations by geographic region and Social Vulnerability Index (SVI) score. Incident cases diagnosed during 2010-2019 were identified from population-based cancer registries linked with the Indian Health Service patient registration databases. Age-adjusted incidence rates (per 100,000 population) for stomach, liver, and colorectal cancers were compared within NH-AI/AN populations and between the NH-AI/AN and NHW populations by SVI score. Rates were higher among NH-AI/AN populations in moderate- and high-SVI-score counties in Alaska, the Southern Plains, and the East than in low-SVI counties. Incidence rates among NH-AI/AN populations were elevated when compared with NHW populations by SVI category. Results indicated that higher social vulnerability may drive elevated cancer incidence among NH-AI/AN populations. Additionally, disparities between NH-AI/AN and NHW populations persist even when accounting for SVI. Exploring social vulnerability can aid in designing more effective interventions to address root causes of cancer disparities among AI/AN populations.

Frequency-Dependent Squeezed Vacuum Source for the Advanced Virgo Gravitational-Wave Detector

In this Letter, we present the design and performance of the frequency-dependent squeezed vacuum source that will be used for the broadband quantum noise reduction of the Advanced Virgo Plus gravitational-wave detector in the upcoming observation run. The frequency-dependent squeezed field is generated by a phase rotation of a frequency-independent squeezed state through a 285 m long, high-finesse, near-detuned optical resonator. With about 8.5 dB of generated squeezing, up to 5.6 dB of quantum noise suppression has been measured at high frequency while close to the filter cavity resonance frequency, the intracavity losses limit this value to about 2 dB. Frequency-dependent squeezing is produced with a rotation frequency stability of about 6 Hz rms, which is maintained over the long term. The achieved results fulfill the frequency dependent squeezed vacuum source requirements for Advanced Virgo Plus. With the current squeezing source, considering also the estimated squeezing degradation induced by the interferometer, we expect a reduction of the quantum shot noise and radiation pressure noise of up to 4.5 dB and 2 dB, respectively.

P–099 MYD88 dependent pathway through TLR 1,2 and 6 activation play a role in interaction of high DNA fragmented human sperm with fallopian tube epithelial cells

Study question

How does sperm with high DFI disrupt the female reproductive system?

Summary answer

Sperm with damaged DNA could disrupt the female reproductive system by production of high inflammatory factors through activation of TLRs and MyD88-dependent pathway .

What is known already

Previous studies have also shown that the interaction between sperm and fallopian tube is a complex process and activates a number of immune mechanisms. Many TLRs, including TLR1, TLR2, and TLR6 are expressed in fallopian tube epithelial cells. TLRs have an important role in the immune interaction between fallopian tube and sperm. They are also involved in sperm capacitation, fertilization and pregnancy. Examining this interaction may lead us to valuable data.

Study design, size, duration

In this study, 10 Recurrent Implantation failure couples with high DFI ( >30% by SCSA evaluation) and 10 healthy donors men with low DFI (<30%) were considered as high DFI group and low DFI group respectively. After fresh semen preparation, sperm were co-cultured with human fallopian tube epithelial cell line( OE-E6/E7) for 24 hours.

Participants/materials, setting, methods

RNA were extracted from the cell line and PCR array for human innate and adaptive immune responses was performed by RT2 profiler PCR array.

Main results and the role of chance

Analysis of PCR array data showed that the expression of TLR–1, TLR–2, TLR–6, MYD88, TIRAP, IRAKS,TRAF6, MAPKS, NF-KB, G-CSF, GM-CSF, CXCL8, CXCL10, CCL2, IL–6, IL–1, TNFa in high DFI group was significantly higher than control group. All these factors are involved in the MyD88-dependent pathway. Our research suggests that the MyD88-dependent pathway through TLR1,2 and 6 activation may be the main inflammatory pathway activated by sperm with high DFI. The released DAMPs through damaged sperms were recognized by TLRs on the epithelial cells. Following the TLR1,2 and 6 signaling, and MYD88 activation, epithelial cells were producing the inflammatory cytokines which result in the neutrophils infiltration. In the lumen of the fallopian tube, the neutrophils were activated via TLR1/TLR2, complexes that lead to the neutrophils activation, phagocytosis, NET formation, and apoptosis.

Limitations, reasons for caution

Studying with a larger sample size and examining the final factors at the protein level will be better to detect the effect of sperm DNA fragmentation on fallopian tube.

Wider implications of the findings: MyD88-dependent pathway could be one of the mechanisms that involved in interaction of high DNA fragmented sperm with female reproductive tract.

Trial registration number

Not applicable

Study of the effect of external noise pickups on the performance of a cryogenic bolometer

This paper reports the detailed noise characterization, investigation of various noise sources, and its mitigation to improve the performance of a cryogenic bolometer detector for the TIN.TIN experiment. The noise spectrum has been measured for a sapphire bolometer test setup with an indigenously developed neutron transmutation doped Ge sensor in the cryogen free dilution refrigerator system at Mumbai. The effect of external noise, arising either from ground loops in the system or from the diagnostic and control electronics of the cryostat, on the performance of the bolometer is assessed. A systematic comparison of the influence of different noise pickups on the bolometer resolution is also presented. The best-achieved resolution (σ_E) at 15 mK is ∼15 keV for heater pulses and appears to be mainly limited by the noise due to the pulse tube cryocooler.

The experience of violence against children in domestic servitude in Haiti: Results from the Violence Against Children Survey, Haiti 2012

BACKGROUND

There have been estimates that over 150,000 Haitian children are living in servitude. Child domestic servants who perform unpaid labor are referred to as "restavèks." Restavèks are often stigmatized, prohibited from attending school, and isolated from family placing them at higher risk for experiencing violence. In the absence of national data on the experiences of restavèks in Haiti, the study objective was to describe the sociodemographic characteristics of restavèks in Haiti and to assess their experiences of violence in childhood.

METHODS

The Violence Against Children Survey was a nationally representative, cross-sectional household survey of 13-24year olds (n=2916) conducted May-June 2012 in Haiti. A stratified three-stage cluster design was used to sample households and camps containing persons displaced by the 2010 earthquake. Respondents were interviewed to assess lifetime prevalence of physical, emotional, and sexual violence occurring before age 18. Chi-squared tests were used to assess the association between having been a restavèk and experiencing violence in childhood.

FINDINGS

In this study 17.4% of females and 12.2% of males reported having been restavèks before age 18. Restavèks were more likely to have worked in childhood, have never attended school, and to have come from a household that did not have enough money for food in childhood. Females who had been restavèks in childhood had higher odds of reporting childhood physical (OR 2.04 [1.40-2.97]); emotional (OR 2.41 [1.80-3.23]); and sexual violence (OR 1.86 [95% CI 1.34-2.58]) compared to females who had never been restavèks. Similarly, males who had ever been restavèks in childhood had significantly increased odds of emotional violence (OR 3.06 [1.99-4.70]) and sexual violence (OR 1.85 [1.12-3.07]) compared to males who had never been restavèks, but there was no difference in childhood physical violence.

INTERPRETATION

This study demonstrates that child domestic servants in Haiti experience higher rates of childhood violence and have less access to education and financial resources than other Haitian children. These findings highlight the importance of addressing both the lack of human rights law enforcement and the poor economic circumstances that allow the practice of restavèk to continue in Haiti.

A national survey of childhood physical abuse among females in Swaziland

Objective: This study describes the scope and characteristics of childhood physical abuse in a nationally representative sample of 13–24 year-old females in Swaziland. The current study also examined health consequences and risk factors of childhood physical abuse.

Methods: The study utilized a two-stage cluster sampling design in order to conduct the household survey. Retrospective reports of childhood physical abuse and relevant risk factors were collected from 1292 females. Bivariate and multivariate logistic regression models examined associations between childhood physical abuse and both health consequences and risk factors.

Results: Nearly 1 in 5 females in Swaziland has experienced childhood physical abuse in their lifetime, with nearly 1 in 20 having experienced abuse that was so severe that it required medical attention. A number of risk factors for lifetime childhood physical abuse were identified including: maternal death prior to age 13; having lived with three or more families during their childhood; and having experienced emotional abuse prior to age 13.

Conclusions: Preventing childhood physical abuse in Swaziland may be addressed through: promoting safe, stable, and nurturing relationships between children and their caretakers; addressing social norms that contribute to harsh physical punishment; and addressing underlying stressors associated with severe social and economic disadvantage.

Risk factors associated with sexual violence towards girls in Swaziland

OBJECTIVE

To explore risk factors for sexual violence in childhood in a nationally representative sample of females aged 13 to 24 years in Swaziland.

METHODS

During a household survey respondents were asked to report any experiences of sexual violence before the age of 18 years. The association between childhood sexual violence and several potential demographic and social risk factors was explored through bivariate and multivariate logistic regression.

FINDINGS

Participants totalled 1244. Compared with respondents who had been close to their biological mothers as children, those who had not been close to her had higher odds of having experienced sexual violence (crude odds ratio, COR: 1.89; 95% CI: 1.14-3.14), as did those who had had no relationship with her at all (COR: 1.93; 95% CI: 1.34-2.80). In addition, greater odds of childhood sexual violence were noted among respondents who were not attending school at the time of the survey (COR: 2.26; 95% CI: 1.70-3.01); who were emotionally abused as children (COR: 2.04; 95% CI: 1.50-2.79); and who knew of another child who had been sexually assaulted (COR: 1.77; 95% CI: 1.31-2.40) or was having sex with a teacher (COR: 2.07; 95% CI: 1.59-2.69). Childhood sexual violence was positively associated with the number of people the respondent had lived with at any one time (COR: 1.03; 95% CI: 1.01-1.06).

CONCLUSION

Inadequate supervision or guidance and an unstable environment put girls at risk of sexual violence. Greater educational opportunities and an improved mother-daughter relationship could help prevent it.

Sexual violence and its health consequences for female children in Swaziland: a cluster survey study

BACKGROUND

Despite concern, few studies have been done about sexual violence against girls younger than 18 years of age in sub-Saharan Africa. We report the prevalence and circumstances of sexual violence in girls in Swaziland, and assess the negative health consequences.

METHODS

We obtained data from a nationally representative sample of girls and women aged 13-24 years from selected households in Swaziland between May 15, 2007, and June 16, 2007, with a two-stage cluster design. The questionnaire examined demographics, type of sexual violence that took place before the respondent was 18 years of age, circumstances of the incident, and health-related conditions. Information was gathered from 1244 women and girls (response rate 96.3%), of whom 1242 provided retrospective responses to questions about sexual violence. We used regression models adjusted for relevant demographics to estimate the odds ratios for the associations between sexual violence and health-related conditions.

FINDINGS

33.2% (95% CI 29.9-36.7) of respondents reported an incident of sexual violence before they reached 18 years of age. The most common perpetrators of the first incident were men or boys from the respondent's neighbourhood (32.3% [28.8-36.1]) and boyfriends or husbands (26.2% [22.2-30.7]). The first incident most often took place in the respondent's own home (26.1% [21.6-31.2]). Sexual violence was associated with reported lifetime experience of sexually transmitted diseases (adjusted OR 3.69 [95% CI 1.78-7.66]), pregnancy complications or miscarriages (3.54 [1.47-8.55]), unwanted pregnancy (2.92 [1.87-4.55]), and self-report of feeling depressed (2.30 [1.70-3.11]).

INTERPRETATION

Knowledge of the high prevalence of sexual violence against girls in Swaziland and its associated serious health-related conditions and behaviours should be used to develop effective prevention strategies.

FUNDING

UNICEF.

Retrospective determination of whether famine existed in Niger, 2005: two stage cluster survey

OBJECTIVE

To apply the famine scale by Howe and Devereux to the situation in Niger, west Africa, in 2005 to retrospectively determine whether famine existed.

DESIGN

Two stage cluster survey.

SETTING

Survey of households in each of Niger's eight regions.

PARTICIPANTS

4003 households.

MAIN OUTCOME MEASURES

Crude mortality, mortality in children under 5, and the proportion of caregivers both nationally and regionally adopting coping strategies to deal with insufficient food needs.

RESULTS

The estimated national crude mortality rate was 0.4 (0.4 to 0.5) deaths per 10,000 per day and under 5 mortality rate was 1.7 (1.4 to 1.9) deaths per 10,000 per day. Nationally, 22.3% (95% confidence interval 19.9% to 24.8%) of caregivers of under 5s did not resort to any coping strategies to deal with insufficient food needs. Reversible coping strategies were, however, used by 5.8% (4.7% to 7.0%) of caregivers, whereas 49.4% (46.9% to 51.8%) relied on irreversible coping strategies and 22.6% (20.0% to 25.4%) on survival strategies.

CONCLUSION

On the basis of the famine scale proposed by Howe and Devereux, most regions in Niger experienced food crisis conditions and some areas approached famine proportions.

Unintended shootings in a large metropolitan area: an incident-based analysis

STUDY OBJECTIVE

We determine the proportion of unintended shootings that might be prevented by promoting safe storage, safe handling, and/or safer firearm designs.

METHODS

A regional firearm injury surveillance system was used to identify fatal and nonfatal unintentional shootings in a 5-county metropolitan area. Case reports were reviewed, and the causes of each shooting were independently classified by 4 members of the research team. A consensus conference was held to resolve disagreements.

RESULTS

Between May 1, 1996, and June 30, 2000, 216 cases of unintentional firearm injury were identified, 3.8% of the shootings documented during the study period. Six (2.8%) were fatal. The majority of victims were between 15 and 34 years of age. One fourth (54) of the shootings involved victims younger than 18 years. Handguns were involved in 87% of the incidents. Enough information was available to characterize the incident in 122 (57%) cases. All but 6 fell into 1 or more of 3 broad categories of causation: Child access (14%), mishandling (74%), and/or deficiencies in firearm design (32%).

CONCLUSION

Many unintentional shootings could be prevented by promoting safe storage of guns in the home, promoting safe handling of firearms, and requiring that all new handguns incorporate basic safety features.

Epidemiology of violent deaths in the world

OBJECTIVE

This study describes epidemiologic patterns of mortality due to suicide, homicide, and war for the world in order to serve as a benchmark against which to measure future progress and to raise awareness about violence as a global public health problem.

SETTING

The world and its eight major regions.

METHOD

Data were derived from The Global Burden of Disease series and the US National Center for Health Statistics to estimate crude rates, age adjusted rates, sex rate ratios, and the health burden for suicide, homicide, and war related deaths for the world and its eight major regions in 1990.

RESULTS

In 1990, an estimated 1,851,000 people died from violence (35.3 per 100,000) in the world. There were an estimated 786,000 suicides. Overall suicide rates ranged from 3.4 per 100,000 in Sub-Saharan Africa to 30.4 per 100,000 in China. There were an estimated 563,000 homicides. Overall homicide rates ranged from 1.0 per 100,000 in established market economies to 44.8 per 100,000 in Sub-Saharan Africa with peaks among males aged 15-24 years old, and among females aged 0-4 years old. There were an estimated 502,000 war related deaths with peaks in rates for both sexes among people aged 0-4, 15-29, and 60-69 years old.

CONCLUSION

The number of violence related deaths in the world is unacceptably high. Coordinated prevention and control efforts are urgently needed.

Effects of pool-fencing ordinances and other factors on childhood drowning in Los Angeles County, 1990-1995

OBJECTIVES

This study estimated the effects of local pool-fencing ordinances and other factors on the rate of childhood drowning in Los Angeles County, California.

METHODS

Stage 1 was a retrospective dynamic cohort study of all drownings among children younger than 10 years that occurred in residential swimming pools in Los Angeles County between 1990 and 1995. Stage 2 was a matched case-control study that compared pools in which childhood drownings occurred (cases) with randomly selected pools in which drownings did not occur (controls).

RESULTS

The drowning rate was relatively high among toddlers (aged 1-4 years), boys, and African Americans and in areas with a high density of residential swimming pools. Pool-fencing ordinances were not associated with a reduced overall rate of childhood drowning.

CONCLUSIONS

Local ordinances enacted in Los Angeles County before 1996 do not appear to have been effective in reducing the rate of childhood drowning in residential pools. Possible reasons for this ineffectiveness are insufficient building codes for isolating pools from homes, inadequate enforcement of the ordinances, and inadequate operation or maintenance of fencing equipment by pool owners.

The first 50 cases of primary hyperparathyroidism treated by an endocrine surgery team

BACKGROUND

Primary hyperparathyroidism (HPT) is a common endocrine disease treated very effectively by surgery. There have been changes in the management of parathyroid surgery in our hospital: since 1991, all patients have been treated by a service of endocrine surgery.

OBJECTIVE

To analyze the outcome of the first 50 patients treated in the endocrine surgery service.

METHODS

A prospective analysis of clinical characteristics, laboratory studies, intraoperative findings, surgical complications and outcome of 50 patients with primary HPT seen between July 1991 and March 1994 was performed.

RESULTS

Ten patients were male and 40 female with a mean age of 53 years. A parathyroid adenoma was found in 43 patients, a parathyroid hyperplasia in five, a double adenoma in one and an adenoma in a supernumerary gland in one patient. Surgical cure of the disease was achieved in 96% of the patients after one surgical procedure and in 100% during the same hospital stay after repeat cervical exploration.

CONCLUSIONS

Our results support the use of surgical cervical exploration in the treatment of primary HPT.

Glucocorticoid-induced functional polarity of growth factor responsiveness regulates tight junction dynamics in transformed mammary epithelial tumor cells

The synthetic glucocorticoid, dexamethasone, induces the "normal-like" differentiated property of tight junction formation and suppresses growth of the Con8 mammary epithelial tumor cell line, derived from a 7,12-dimethylbenz(alpha)anthracene-induced rat mammary adenocarcinoma. Characterization of the transepithelial electrical resistance of Con8 mammary tumor cells cultured on permeable supports revealed that a novel response to dexamethasone is the generation of a polarized cell monolayer with respect to epidermal growth factor receptor responsiveness. Administration of transforming growth factor-alpha (TGF-alpha) to the basolateral, but not the apical, plasma membrane compartment disrupted the glucocorticoid-stimulated tight junction barrier. Confocal immunofluorescence microscopy revealed that dexamethasone caused the ZO-1 tight junction-associated protein to localize exclusively to the apical border of laterally adjacent membranes of the cell periphery, whereas basolateral administration of TGF-alpha caused the redistribution of ZO-1 back to disorganized aggregates along the cell periphery. In contrast, TGF-alpha was able to exert its mitogenic effects equally on both sides of the cell monolayer independent of its polarized disruption of tight junction formation. Our results represent the first evidence for a functional polarization of the epidermal growth factor receptor and strongly implicate the glucocorticoid-regulated formation of tight junctions in policing the polarized responsiveness of mammary cells to growth factors.

Transforming growth factor-alpha abrogates glucocorticoid-stimulated tight junction formation and growth suppression in rat mammary epithelial tumor cells

The glucocorticoid and transforming growth factor-alpha (TGF-alpha) regulation of growth and cell-cell contact was investigated in the Con8 mammary epithelial tumor cell line derived from a 7,12-dimethylbenz(alpha)anthracene-induced rat mammary adenocarcinoma. In Con8 cell monolayers cultured on permeable filter supports, the synthetic glucocorticoid, dexamethasone, coordinately suppressed [3H]thymidine incorporation, stimulated monolayer transepithelial electrical resistance (TER), and decreased the paracellular leakage of [3H]inulin or [14C]mannitol across the monolayer. These processes dose dependently correlated with glucocorticoid receptor occupancy and function. Constitutive production of TGF-alpha in transfected cells or exogenous treatment with TGF-alpha prevented the glucocorticoid growth suppression response and disrupted tight junction formation without affecting glucocorticoid responsiveness. Treatment with hydroxyurea or araC demonstrated that de novo DNA synthesis is not a requirement for the growth factor disruption of tight junctions. Immunofluorescence analysis revealed that the ZO-1 tight junction protein is localized exclusively at the cell periphery in dexamethasone-treated cells and that TGF-alpha caused-ZO-1 to relocalize from the cell periphery back to a cytoplasmic compartment. Taken together, our results demonstrate that glucocorticoids can coordinately regulate growth inhibition and cell-cell contact of mammary tumor cells and that TGF-alpha, can override both effects of glucocorticoids. These results have uncovered a novel functional "cross-talk" between glucocorticoids and TGF-alpha which potentially regulates the proliferation and differentiation of mammary epithelial cells.

Ectopic parathyroid adenoma in the posterior triangle of the neck

Ectopic parathyroid adenomas are a major cause of persistent hyperparathyroidism. They can be located anywhere from the base of the tongue to the mediastinum. We describe a patient with hyperparathyroidism from an adenoma in a supernumerary gland located in the left posterior triangle of the neck, outside of the carotid sheath.

[Thyroglossal duct with papillary carcinoma. Report of a case]

We report the case of a 32-year old woman with an anterior cervical cystic mass originating in the thyroglossal duct. At surgical exploration, the mass was reacted, including the thyroglossal duct and the mid-portion of the hyoid bone (Sistrunk's procedure). The histopathologic study demonstrated a papillary carcinoma. Fine needle aspiration biopsies of both thyroid lobes were performed postoperatively without any histopathologic abnormalities. The patient was discharged without performing any other surgical procedure and without complications. Treatment with I131 and thyroid hormones was initiated, and at 11 months of follow-up, the patient is asymptomatic without any evidence of local or distant recurrence. The clinical and histopathological features are discussed, as well as the therapeutic options for this type of uncommon malignant neoplasm.