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Background The incidence of esophageal and gastric carcinoma (GEC) in elderly patients is increasing, yet patients ≥75 years have historically been underrepresented in clinical trials. We sought to investigate palliative chemotherapy administration patterns and survival outcomes in older adults. Materials and Methods A retrospective analysis identified patients aged 65-74 (young-old) and ≥75 years (older-old) diagnosed with advanced GEC. Patient and tumor characteristics were recorded, with descriptive analysis, time-to-event data analysis using Kaplan-Meier curves and multivariate Cox proportional hazards regression analysis performed. Results One hundred and ninety-eight "young-old" and 109 'older-old' patients were identified. Patient characteristics were similar between groups except for Charlson Co-morbidity Index (CCI), with lower co-morbidities in the "young-old" compared to "older-old" cohort (P  < .001; CCI = 0 in 103 (52%) "young-old" vs 31 (28%) "older-old"). The primary diagnosis in both groups was adenocarcinoma. 119 (60%) "young-old" and 25 (23%) "older-old" patients received chemotherapy (P  < .001). Performance status was the primary explanation for chemotherapy non-receipt in both cohorts; age was the explanation in 21 (25%) "older-old" patients and none in the "young-old" patients. PFS for first-line systemic therapy in "young-old" patients was 6.4 (95% CI 5.9-7.6) versus 7.5 months (95% CI 5.1-11.3) in "older-old" patients (P  = .69) whilst respective OS was 12.3 (95% CI 10.1-15.5) and 10.4 months (95% CI 9.0-14.6) (P  = .0816). Toxicity prompted chemotherapy cessation in 17 (15%) "young-old" and 3 (13%) "older-old" patients (P  = .97). Multivariate analysis identified CCI and ECOG performance status as predictive for PFS and OS, respectively. No causative relationship was identified with other variables. Conclusion Our study of real-world older-adults show that significant number of "older-old" patients with GEC do not receive chemotherapy. Among "older-old" adults who do receive systemic therapy, outcomes are comparable; this underscores the importance of geriatric assessment-guided care and suggests that age alone should not be a barrier to receipt of chemotherapy in patients with advanced GEC. [ABSTRACT FROM AUTHOR]

In this article, the authors examine how low-income Black men in South Africa and the United States work with their kin to secure fathering and ensure the well-being of children. They use ethnographic and life history data on men who fathered children from 1992 to 2005 to demonstrate how fathers' roles as kin workers enable them to meet culturally defined criteria for responsible fatherhood in two contexts marked by legacies of racism, increasing rates of incarceration and HIV/AIDS, and a web of interlocking inequalities that effectively precludes them from accessing employment with good wages. Using a comparative framework based on kin work, the authors identify three common processes in both contexts--negotiation between maternal and paternal kin, pedifocal approach, and flexible fathering--that enable men and their kin networks to secure father involvement in economically marginalized communities. The article concludes with a discussion of the policy implications of the findings.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron subvariants are expected to be resistant to Bebtelovimab (BEB) monoclonal antibody (MAb) and the real-world experience regarding its effectiveness is scarce. This retrospective cohort study reports a data analysis in Banner Healthcare System (a large not-for-profit organization) between 4/5/2022 and 8/1/2022 and included 19,778 Coronavirus disease-19 (COVID-19) positive (by PCR or direct antigen testing) patients who were selected from Cerner-Electronic Health Record after the exclusions criteria were met. The study index date for cohort was determined as the date of BEB MAb administration or the date of the first positive COVID-19 testing. The cohort consist of COVID-19 infected patients who received BEB MAb (N = 1,091) compared to propensity score (PS) matched control (N = 1,091). The primary composite outcome was the incidence of 30-day all-cause hospitalization and/or mortality. All statistical analyses were conducted on the paired (matched) dataset. For the primary composite outcome, the event counts and percentages were reported. Ninety-five percent Clopper-Pearson confidence intervals for percentages were computed. The study cohorts were 1:1 propensity matched without replacement across 26 covariates using an optimal matching algorithm that minimizes the sum of absolute pairwise distance across the matched sample after fitting and using logistic regression as the distance function. The pairs were matched exactly on patient vaccination status, BMI group, age group and diabetes status. Compared to the PS matched control group (2.6%; 95% confidence interval [CI]: 1.7%, 3.7%), BEB MAb use (2.2%; 95% CI: 1.4%, 3.3%) did not significantly reduce the incidence of the primary outcome (p = 0.67). In the subgroup analysis, we observed similar no-difference trends regarding the primary outcomes for the propensity rematched BEB MAb treated and untreated groups, stratified by patient vaccination status, age (<65 years or ≥65), and immunocompromised status (patients with HIV/AIDS or solid organ transplants or malignancy including lymphoproliferative disorder). The number needed to treat (1/0.026–0.022) with BEB MAb was 250 to avoid one hospitalization and/or death over 30 days. The BEB MAb use lacked efficacy in patients with SARS-CoV-2 Omicron subvariants (mainly BA.2, BA.2.12.1, and BA.5) in the Banner Healthcare System in the Southwestern United States. [ABSTRACT FROM AUTHOR]

In the United States, feminists within mainstream rape crisis advocacy have been working to address rape by advocating to end the DNA backlog and therefore, the expansion of DNA databases, locally and nationally. Despite criticisms from radical abolition feminists for practicing carceral feminism that incarcerates more Black and Brown people, rape crisis advocates have been continuing their entanglements with criminal justice, fully recognizing the contradictory ends of such investments. In this paper, I explore their continued carceral investments, through underlying logics and justifications based in science and law and the impacts of doing so, as it relates to the problem of racialized policing. Relying on Black feminist epistemologies and interdisciplinary methodologies, my analysis draws upon archived documents, reports, legislations, and ethnographically driven interviews and observations with and amongst state and non-state actors, who are stakeholders in DNA biosurveillance. I argue that carceral feminists continue their carceral investments through two justifications—materiality and recidivism—that results in intensification of policing in communities of color by expanding genome based racialized biosurveillance. The implications of their justifications further harm survivors of violence, and produce a multifaceted recidivism, that is unbounded spacio-temporally, deepening and furthering state reach within communities of color in perpetuity. [ABSTRACT FROM AUTHOR]

The Policing in Chicago Research Group (PCRG) is an activist research collective composed of faculty and graduate students at the University of Illinois at Chicago. We conduct useful and accessible research on policing in support of campaigns organized by abolitionist social movements in Chicago. Beginning as a two-semester graduate research practicum, the PCRG has transitioned to an activist research collective. In this roundtable discussion, six members of the PCRG and four of our community partners reflect on the project's challenges and successes. We consider the pedagogical power and limitations of an activist research practicum, the power dynamics within the research group and between the PCRG and our community partners, and the ability of the PCRG to remain accountable to our partners and the communities they represent. [ABSTRACT FROM AUTHOR]

Peripheral artery disease (PAD) is highly prevalent but is often underdiagnosed and undertreated. Lower extremity PAD can often be life style limiting. Revascularization in carefully selected lower extremity PAD patients improves symptoms and functional status. Surgical revascularization used to be the only available strategy, but in the recent years, endovascular strategies have gained popularity due to faster recovery times with low morbidity and mortality rates. Endovascular procedures have increased significantly in the United States in the past few years. That being said, higher restenosis rates and low long-term patency rates have been the limiting factors for this strategy. Drug eluting stents have been introduced to help with lowering restenosis, however lower extremity PAD involves long segment where the outcomes of stents are suboptimal. Also, the disease often crosses joint line that makes it less ideal for the stents. Drug-coated balloons (DCB) have been introduced to improve patency rates following endovascular intervention for lower extremity PAD. They have gained popularity among endovascular specialists due to its ease of use and the concept of "leave nothing behind". This is a review of scientific evidence supporting DCB use in PAD. [ABSTRACT FROM AUTHOR]

Aim: Opioid abuse/dependence (OAD) is an emerging public health crisis in the USA. The aim of the present study was to estimate the nationwide prevalence of OAD in those hospitalized due to periapical abscess in the USA. Methods: The Nationwide Inpatient Sample for 2012-2014 was used. All patients who were hospitalized due to periapical abscess were selected for analysis. In this cohort, OAD was identified and used as the outcome variable. A mix of patient and geographic factors were used as independent variables. The simultaneous association between outcome and independent variables was examined by a multivariable logistic regression model. Clustering of outcomes within hospitals was adjusted. Odds of OAD were computed for all independent variables. Results: During the study period, 30 040 patients were hospitalized due to periapical abscess; 1.5% of these had OAD. Those aged 18-29 years (odds ratio [OR] = 3.69, 95% confidence interval [CI] = 1.76-7.72, P < 0.01) and 30-44 years (OR = 3.19, 95% CI = 1.77-5.76, P < 0.01) were associated with higher odds for OAD compared to those aged 45-64 years. Blacks were associated with lower odds for OAD compared to whites (OR = 0.52, 95% CI = 0.28-0.95, P = 0.03). Those covered by Medicare (OR = 4.08, 95% CI = 1.458-11.44, P = 0.01), Medicaid (OR = 5.86, 95% CI = 2.22-15.47, P < 0.01), and those who were uninsured (OR = 3.68, 95% CI = 1.30-10.45, P = 0.01) were associated with higher odds for OAD compared to those covered by private insurance. The odds of OAD increased with comorbid burden (OR = 1.66, 95% CI = 1.50-1.84, P < 0.01). Conclusions: High-risk groups that are likely to have OAD were identified among those hospitalized due to periapical abscess. [ABSTRACT FROM AUTHOR]

Introduction: Stoutness is most generally brought about by a mix of extreme sustenance consumption, absence of physical action, and hereditary susceptibility. A couple of cases are caused fundamentally by qualities, endocrine issue, prescriptions, or mental disorder. The view that large individuals eat pretty much nothing yet put on weight because of a moderate digestion is not medicinally supported. Materials and Methods: This was a questionnaire-based study using an online survey portal called "survey planet." The survey was circulated among children of age group between 15 and 20. Results: The students who took up the survey were given two answers, and the majority that is about 81% answered stop intake of junk food and 19% answered counseling. A large portion of this additional nourishment vitality originated from an expansion in starch utilization as opposed to fat consumption. The essential wellsprings of these additional sugars are improved refreshments, which currently represent very nearly 25% of day by day sustenance vitality in youthful grown-ups in America. Conclusion: Numerous individuals do not understand how harming stoutness can be to the body and for your general well-being. Heftiness is something that is progressively on the ascent today and will keep on rising except if we take care of business like advising individuals of how terrible it truly is and urging individuals to carry on with a well-being upgrading way of life. From this it is well understood that everyone must aware and serious action about obesity in children and its effect on day to day life of growing children. [ABSTRACT FROM AUTHOR]

A critical component of child rearing is time use. There has been a wealth of studies on time use in child rearing focusing on biological parents in the US and western contexts but there is a notable absence of any scholarship on time use that has incorporated extended kin in the African context. This paper examines time use with children in rural South Africa using observational data and incorporates a range of kin and non-kin. The analysis focuses on 24 children under the age of 6 and all the people who interact with them over the course of a week. Through an examination of the composition of care networks, the quantity and quality of time investment, and the relationship between care networks and child outcomes, the findings support a kin-based, socially distributed model of child rearing but also challenge assumptions about the extent of kin involvement and impact on child outcomes. [ABSTRACT FROM AUTHOR]

This article documents the first known in situ electrochemical production of perchlorate within a public water distribution system. In this detailed incident, perchlorate (CIO4--) was detected in the distribution system of Levelland, Texas, and was eventually isolated to one elevated storage tank. Theoretical considerations supported the production of CIO4- by an electrochemical process within the tank. CIO4- was produced (64-113 µg/L in 338 h) in laboratory experiments that simulated the cathodic protection system in place in the storage tank. Because cathodic protection systems are widely used, this research confirms a potentially troubling mechanism of CIO4- generation. [ABSTRACT FROM AUTHOR]

To test alternative explanations for the comorbidity between fibromyalgia (FM), a medically unexplained syndrome involving widespread pain, and posttraumatic stress disorder (PTSD). In contrast to a default “risk factor” hypothesis, tested hypotheses were that: A) The association is due to a sampling bias introduced by the study of care-seeking individuals; B) FM is an additive burden that strains coping resources when confronting life stress; and C) Arousal symptoms of PTSD and FM are confounded. Community-dwelling women in the New York/New Jersey metropolitan area (N=1,312) completed a telephone survey regarding FM-like symptoms prior to September 11, 2001. Approximately 6 months after the World Trade Center terrorist attacks, they again completed the survey, to which questions regarding PTSD symptoms were added. The odds of probable PTSD were more than three times greater in women with FM-like symptoms, both assessed after 9/11. The odds ratio was not reduced by controlling for FM-like symptoms before 9/11 or for the potentially confounded symptoms of PTSD specifically related to arousal. These findings lead us to reject alternate explanations for the comorbidity between FM and PTSD. Speculations that FM and PTSD share psychobiological risk factors remain plausible. [ABSTRACT FROM AUTHOR]

Objectives: Access to oral health care and utilization of available services are important factors in minimizing the oral health disparities among underserved minorities. Our objective was to evaluate the racial and other factors related to 'realized access' to oral health care among Alabama Medicaid children. Methods: Data were obtained from 308 538 Alabama Medicaid claims submitted in 1995-96 and analyzed using regression analyses. Results: A lower proportion of Blacks (24%) and other racial groups (22%) compared to Whites (31%) and a lower proportion of 15-19-year-olds (15%) compared to younger age groups (30%) obtained dental services (P < 0.05). Odds of males obtaining care were slightly lower compared to females (OR = 0.96; 95% CI = 0.94-0.99). However, there was a significant interaction of race with other factors in determining service utilization. Subjects who were continuously eligible for Medicaid throughout the fiscal year were more likely to obtain care (OR = 2.86; 95% CI = 2.78-2.93). About one-fourth of the visits had an emergency procedure included in the treatment rendered. Availability of a participating dentist within the county of residence and the lower reimbursement-to-charge ratio were among the other related factors for underutilization of services. Conclusions: There is a significant racial disparity in utilization of dental services even among the Medicaid-eligible children. However, this was not a simple function of race, but a complex interaction of race with other factors such as age, gender, and location. Acknowledgment: Supported by CDC grant #U48/CCU 409679. [ABSTRACT FROM AUTHOR]

The goals of this study were (a) to explore beliefs about appropriate or normative pain responses among college students in the United States and India and (b) to examine differences in pain tolerance and intensity ratings and the role beliefs play in predicting pain tolerance. Scales to assess beliefs about appropriate pain responses in males and females were completed by college students in both countries. Ratings of pain intensity were then obtained following the cold pressor test. Results indicated that participants in India were less accepting of overt pain expression than those in the United States. Females believed that overt pain expression was more appropriate than did males. Consistent with their beliefs, Indian participants had higher pain tolerance than those in the United States, and males had higher pain tolerance than females. Reported pain intensity predicted 28% of the variance in pain tolerance, whereas beliefs predicted an additional 5%. [ABSTRACT FROM AUTHOR]

Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia with a prevalence of 15% of patients over 80 years. Coronary artery disease co-exists in 20-30% of patients with atrial fibrillation. The need for triple anticoagulation therapy makes the management of these patients challenging following PCI.Methods: Nationwide inpatient sample which is a set of longitudinal hospital inpatient databases was used to evaluate the outcome of patients with AF who underwent PCI. All patients undergoing PCI between 2002 and 2011 were included in the study. Specific ICD-9-CM codes were used to identify the study patients and their outcomes.Results: There were 3,226,405 PCIs during the time period of the study of which 472,609 (14.6%) patients had AF. AF patients were older and predominantly male (60%). The number of PCIs had a declining trend from 2002 to 2011. Age adjusted inpatient mortality was significantly higher in PCI AF group compared to the PCI non-AF group (100.82 ± 9.03 vs 54.07 ± 8.96 per 100,000; P < 0.01). Post PCI predictors of mortality were AF (OR 1.56, CI 1.53-1.59), CKD (OR 1.41, CI 1.37-1.46), PAD (OR 1.20, CI 1.15-1.24), acute myocardial infarction (OR 2.42 CI 2.37-2.46 and cardiogenic shock (OR 13.92 CI 13.60-14.24) P < 0.001.Conclusion: AF is common in patients undergoing PCI and those AF patients have a higher age-adjusted all cause inpatient mortality. There is a decline in total number of PCIs over time in US. Atrial fibrillation, chronic kidney disease, peripheral artery disease, MI and cardiogenic shock were associated with increased mortality following PCI. [ABSTRACT FROM AUTHOR]

This study aimed to measure the value of increasing lung cancer screening rates for high-risk individuals and its impact on health disparities. The model estimated changes in health economic outcomes if low-dose computed tomography screening increased from current to 100% compliance, following clinical guidelines. Current low-dose computed tomography screening rates were estimated by income, education, and race, using 2017-2019 Behavioral Risk Factor Surveillance System data. The model contained a decision tree module to segment the population by screening outcomes and a Markov chain module to estimate cancer progression over time. Model parameters included information on survival, quality of life, and costs related to cancer diagnosis, treatment, and adverse events. Distributional cost-effectiveness analysis estimated the net monetary value from reduced health disparities—measured using quality-adjusted life expectancy—across income, education, and race groups. Outcomes were assessed over 30 years. Lung cancer screening eligibility using US Preventive Services Task Force guidelines was higher for individuals with income <$15 000 (47.2%) and without a high-school education (46.1%) than individuals with income >$50 000 (16.6%) and with a college degree (13.5%), respectively. Increasing lung cancer screening to 100% compliance was cost-effective ($64 654 per quality-adjusted life-year) and produced economic value by up to $560 per person ($182.1 billion for United States overall). Up to 32.2% of the value was due to reductions in health disparities. Significant value in increasing lung cancer screening rates derived from reducing health disparities. Policy makers and clinicians may not be appropriately prioritizing cancer screening if value from reducing health disparities is unconsidered. • Despite the US Preventive Services Task Force recommending annual low-dose computed tomography lung cancer screening for individuals aged 50 to 80 years with ≥20 pack-year smoking history, uptake remains low and may not be sufficiently prioritized by policy makers and clinicians. • Increasing low-dose computed tomography cancer screening rates from current levels (12.5% overall) to full compliance (100% screening) with guidelines would reduce health disparities across education, income, and race/ethnicity groups and generate up to $182.1 billion in additional value in the United States, where up to 32.2% of this value is due to reduction in health disparities. [ABSTRACT FROM AUTHOR]