Spatial social polarization and birth outcomes: preterm birth and infant mortality - New York City, 2010-14.

AIMS: This study assessed the relationship between spatial social polarization measured by the index of the concentration of the extremes (ICE) and preterm birth (PTB) and infant mortality (IM) in New York City. A secondary aim was to examine the ICE measure in comparison to neighborhood poverty. METHODS: The sample included singleton births to adult women in New York City, 2010-2014 ( n=532,806). Three ICE measures were employed at the census tract level: ICE - Income (persons in households in the bottom vs top 20th percentile of US annual household income), ICE -Race/Ethnicity (black non-Hispanic vs white non-Hispanic populations), and ICE - Income + Race/Ethnicity combined. Preterm birth was defined as birth before 37 weeks' gestation. Infant mortality was defined as a death before one year of age. A two-level generalized linear model with random intercept was utilized adjusting for individual-level covariates. RESULTS: Preterm birth prevalence was 7.1% and infant mortality rate was 3.4 per 1000 live births. Women who lived in areas with the least privilege were more likely to have a preterm birth or infant mortality as compared to women living in areas with the most privilege. After adjusting for covariates, this association remained for preterm birth (ICE - Income: Adjusted Odds Ratio (AOR) 1.16 (1.10-1.21); ICE - Race/Ethnicity: AOR 1.41 (1.34-1.49); ICE - Income + Race/Ethnicity: AOR 1.36 (1.29-1.43)) and IM (ICE - Race/Ethnicity (AOR 1.80 (1.43-2.28) and ICE - Income + Race/Ethnicity (AOR 1.54 (1.23-1.94)). High neighborhood poverty was associated with PTB only (AOR 1.09 (1.04-1.14). CONCLUSIONS: These results provide preliminary evidence for the use of the ICE measure in examining structural barriers to healthy birth outcomes.

An 11,000-isolate same plate/same day comparison of the 3 most widely used platforms for analyzing multidrug-resistant clinical pathogens.

Stewardship of the dwindling number of effective antibiotics relies on accurate phenotyping. We sought to conduct the first large-scale, same plate and day comparison of the 3 most widely used bacterial analyzers. A total of 11,020 multidrug-resistant clinical isolates corresponding to more than 485,000 data points were used to compare the 3 major identification and antibiotic susceptibility testing (AST) platforms. Bacterial suspensions, prepared from a single plate, were simultaneously tested on all platforms in the same laboratory. Discrepancies were derived from MIC values using 2014 interpretive guidelines. Molecular methods and manual microbroth dilution were reference standards. Most discrepancies were due to drug-organism-AST platform combination instead of individual factors. MicroScan misidentified Acinetobacter baumannii (P<0.001) and underestimated carbapenem susceptibility in Klebsiella pneumoniae. Vitek-2 and Phoenix had higher discrepancies for blaKPC-containing Enterobacteriaceae (P<0.05) and reported false susceptibilities more often. While all platforms performed according to standards, each had strengths and weaknesses for organism identification, assaying specific drug-organism combinations and inferring carbapenemase production.

A novel Bruton's tyrosine kinase inhibitor CC-292 in combination with the proteasome inhibitor carfilzomib impacts the bone microenvironment in a multiple myeloma model with resultant antimyeloma activity.

Bruton's tyrosine kinase (Btk) modulates B-cell development and activation and has an important role in antibody production. Interestingly, Btk may also affect human osteoclast (OC) function; however, the mechanism was unknown. Here we studied a potent and specific Btk inhibitor, CC-292, in multiple myeloma (MM). In this report, we demonstrate that, although CC-292 increased OC differentiation, it inhibited OC function via inhibition of c-Src, Pyk2 and cortactin, all involved in OC-sealing zone formation. As CC-292 did not show potent in vitro anti-MM activity, we next evaluated it in combination with the proteasome inhibitor, carfilzomib. We first studied the effect of carfilzomib on OC. Carfilzomib did not have an impact on OC-sealing zone formation but significantly inhibited OC differentiation. CC-292 combined with carfilzomib inhibited both sealing zone formation and OC differentiation, resulting in more profound inhibition of OC function than carfilzomib alone. Moreover, the combination treatment in an in vivo MM mouse model inhibited tumor burden compared with CC-292 alone; it also increased bone volume compared with carfilzomib alone. These results suggest that CC-292 combined with carfilzomib augments the inhibitory effects against OC within the bone microenvironment and has promising therapeutic potential for the treatment of MM and related bone disease.

T-matrix methods in acoustic scattering.

Some further refinements are described for the T-matrix approach to acoustic scattering. From the structure of the matrices involved, one can infer the Rayleigh limit explicitly for objects having no density contrast. One finds T(Ray)=iR-R(2), where the R-matrix involves integrals of the regular spherical wave functions over the object's surface. The index of refraction and loss factor can be chosen as desired, and energy balance and reciprocity requirements are found to be met. The derivation can be extended to obtain the Rayleigh expansion, effectively describing T as a series in ascending powers of the ratio of object size to wavelength. In trial cases, the series converges throughout the Rayleigh region and somewhat beyond. Bodies of high aspect ratio are also considered, where difficulties arise due to precision loss during numerical integration. Loss ranges from 4 or 5 significant figures (2:1 spheroid) to 22 figures (40:1 spheroid) or more. A class of surfaces has been found for which this problem can be avoided, however, enabling one to treat a variety of body shapes up to aspect ratios of 100:1 with no difficulty.

The T-matrix revisited.

We consider electromagnetic scattering from penetrable cylinders of general cross section. After summarizing the basic T-matrix equations the low-frequency case is examined, which leads for nonmagnetic materials to the exact result T=iR-R(2) in the Rayleigh limit, satisfying both reciprocity and energy constraints. Here elements of R are given by integrals of regular wave functions over the cylinder surface. A "Rayleigh expansion" is then found that is convergent throughout the Rayleigh region and the lower end of the resonance region and requires no matrix inversion. For bodies of high aspect ratio, there is a problem with significance loss during numerical integration, due to large oscillatory terms. A class of surfaces has now been found for which these terms can be removed, however, enabling us to treat aspect ratios up to 1,000:1. These methods are expected to apply also in three dimensions.

Cytotoxic and antiprotozoal activity of flavonoids from Lonchocarpus spp.

A number of flavonoids isolated from Lonchocarpus spp. were evaluated for their antiprotozoal and cytotoxic activity. Flavone 6 and chalcone 7 were found to be the most active against Leishmania parasites and against cell cultures of Leukemia P388DI and adenocarcinoma prostate PC-3.

A single-blinded case controlled study on effects of cardiopulmonary circulation on hearing during coronary artery bypass grafting.

OBJECTIVES: To evaluate the effect of extra-corporeal (cardiopulmonary) bypass on hearing during coronary artery bypass grafting. DESIGN: Prospective (single-blinded) controlled study. SETTING: District General Hospital. PARTICIPANTS: Fifty-two patients undergoing coronary artery bypass grafting completed this study. Comparison was made between 14 control patients undergoing off-pump coronary artery bypass grafting and 38 study patients undergoing on-pump coronary artery bypass grafting. The age range of patients was 48-81 years, with 50% between 64 and 66 years. MAIN OUTCOME MEASURES: Pure tone audiograms were performed in all patients before and after coronary artery bypass grafting. Data were analysed for any significant difference between pre- and post-operative pure tone audiograms. RESULTS: Mann-Whitney U-test demonstrated no difference between the area generated between mean pre- and post-operative audiograms (P = 0.754). No significant difference between off versus on pump was demonstrated for average differences at 250-500 Hz, 4 kHz, 4-8 kHz and 8 kHz. Wilcoxon matched-pairs signed-rank test demonstrated no difference between right and left ears for each individual frequency. Spearman's test to analyse the effect on vessel number or minutes on bypass pump revealed no significant difference at 4-8 kHz (P = 0.550 for number of vessels and P = 0.276 for minutes on pump.) CONCLUSION: In this study, it was not possible to demonstrate any statistically significant deleterious effect of extra-corporeal (cardiopulmonary) bypass on hearing during coronary artery bypass grafting.

Comparing individual- and area-based socioeconomic measures for the surveillance of health disparities: A multilevel analysis of Massachusetts births, 1989-1991.

The absence of individual-level socioeconomic information in most US health surveillance data necessitates using area-based socioeconomic measures (ABSMs) to monitor health inequalities. Using the 1989-1991 birth weight data from Massachusetts, the authors compared estimates of health disparities detected with census tract- and block group-level ABSMs pertaining to poverty and education, as well as parental education, both independently and together. In separate models, adjusted for infant's sex, mother's age, and parents' race/ethnicity, worst-off categories of census tract ABSMs and parental education had a comparable birth weight deficit of approximately 70 g. Similar results were observed for low birth weight (<2,500 g), with worst-off categories of census tract ABSMs and parental education having an odds ratio of approximately 1.37 (p < 0.001). In mutually adjusted models for birth weight and low birth weight, census tract ABSMs still detected an effect estimate nearly 50% of that detected by parental education. Additionally, census tract ABSMs detected socioeconomic gradients in birth weight among births to mothers aged less than 25 years, an age group in which educational attainment is unlikely to be completed. These results suggest that aptly chosen ABSMs can be used to monitor socioeconomic inequalities in health. The risk, if any, in the absence of individual-level socioeconomic information is a conservative estimate of socioeconomic inequalities in health.

Scattering, absorption, and extinction by thin fibers.

For electromagnetic wave incidence on a thin fiber at an angle theta i with the fiber axis, induced currents are described by linear combinations of driven and traveling waves exp(+/-ikz cos theta i) and exp(+/-imkz), where the complex factor m serves to remove singularities in the normalizing constants of the currents. The fiber may be solid, hollow, or coated, with quite general constitutive parameters. Results are given for scattering, absorption, extinction, and radar cross sections, using energy conservation and reciprocity as consistency checks, and compared with independent computations, including the Born approximation for tenuous conductors and dielectrics. In addition, the far field amplitude of a 50 wavelength conductor is obtained and compared with the well-known long-wire approximation.

Screening of some Australian Flacourtiaceae species for in vitro antioxidant, cytotoxic and antimicrobial activity.

A total of 27 methanol extracts obtained from different plant parts of 10 species of rain forest trees belonging to four genera of the Flacourtiaceae and originating from Australia were investigated. In vitro cytotoxicity was measured by an ATP Lite-M assay method against the mouse P388 lymphocytic leukemia cell line. The total antioxidant activity has been assessed based on scavenging activity of stable ABTS free radicals. The minimum inhibition concentration (MIC) was determined by the dilution method performed in 96 well plates against four different microbes. The leaf extract of Casearia sp. (RB 3051), mature stem extract of Casearia grayi and stem extract of Scolopia braunii were found to have most antioxidant activity (IC50 = 2.9 microg/ml), cytotoxic activity (LC50 = 0.89 microg/ml) and antimicrobial activity against all four different microbes, respectively. The results obtained suggested that among the four genera studied Casearia is the most promising in respect of finding significant antioxidant, cytotoxic and also antimicrobial activity.

Alkaloids and limonoids from Bouchardatia neurococca: systematic significance.

Five alkaloids, four beta-indoloquinazoline and one furoquinoline, and four terpenoids, three limonoids and one modified sesquiterpene, have been obtained from the aerial parts of Bouchardatia neurococca (Rutaceae). Two of the alkaloids, 1,2-dihydroxyrutaecarpine and 2-(2-[3-formylindolyl])-(3H)-quinazolin-4-one (bouchardatine), and two of the limonoids, 23-oxo-21xi-hydroxy-21,23-dihydroveprisone (veprisonic acid) and 21-oxo-23xi-hydroxy-21,23-dihydroveprisone (isoveprisonic acid) are new. The pattern of secondary metabolites isolated is rather unusual in the Rutaceae and is reminiscent of Tetradium, a genus with which Bouchardatia has not previously been associated.

Choosing area based socioeconomic measures to monitor social inequalities in low birth weight and childhood lead poisoning: The Public Health Disparities Geocoding Project (US).

STUDY OBJECTIVES: : To determine which area based socioeconomic measures can meaningfully be used, at which level of geography, to monitor socioeconomic inequalities in childhood health in the US. DESIGN: Cross sectional analysis of birth certificate and childhood lead poisoning registry data, geocoded and linked to diverse area based socioeconomic measures that were generated at three geographical levels: census tract, block group, and ZIP code. SETTING: Two US states: Massachusetts (1990 population=6,016,425) and Rhode Island (1990 population=1,003,464). PARTICIPANTS: All births born to mothers ages 15 to 55 years old who were residents of either Massachusetts (1989-1991; n=267,311) or Rhode Island (1987-1993; n=96 138), and all children ages 1 to 5 years residing in Rhode Island who were screened for lead levels between 1994 and 1996 (n=62,514 children, restricted to first test during the study period). MAIN RESULTS: Analyses of both the birth weight and lead data indicated that: (a) block group and tract socioeconomic measures performed similarly within and across both states, while ZIP code level measures tended to detect smaller effects; (b) measures pertaining to economic poverty detected stronger gradients than measures of education, occupation, and wealth; (c) results were similar for categories generated by quintiles and by a priori categorical cut off points; and (d) the area based socioeconomic measures yielded estimates of effect equal to or augmenting those detected, respectively, by individual level educational data for birth outcomes and by the area based housing measure recommended by the US government for monitoring childhood lead poisoning. CONCLUSIONS: Census tract or block group area based socioeconomic measures of economic deprivation could be meaningfully used in conjunction with US public health surveillance systems to enable or enhance monitoring of social inequalities in health in the United States.

3-Monoterpenyl-2,4-dioxygenated quinoline alkaloids from the aerial parts of Halfordia kendack.

The aerial parts of Halfordia kendack (Rutaceae) have yielded the known alkaloid trans-erioaustralasine ([rel]-1-acetoxymethyl-4.8'-epoxy-3-(1'beta,2'beta-epoxy-3'beta,4'alpha-para-menthyl-3'-yl)quinolin-2-one) together with four new alkaloids. The latter were characterised by spectroscopic methods as trans-deacetoxyerioaustralasine ([rel]-1-methyl-4.8'-epoxy-3-(1'beta,2'beta-epoxy-3'beta,4'alpha-para-menthyl-3'-yl)quinolin-2-one), trans-deacetoxyerioaustralasine hydrate ([rel]-1-methyl-4.8'-epoxy-3-(1'alpha,2'alpha-dihydroxy-3'beta,4'alpha-para-;menthyl-3'-yl)quinolin-2-one), trans-erioaustralasine hydrate ([rel]-1-acetoxymethyl-4.8'-epoxy-3-(1'alpha,2'alpha-dihydroxy-3'beta,4'alpha-para-menthyl-3'-yl)quinolin-2-one) and trans-1-epi-deacetoxyerioaustralasine hydrate ([rel]-1-acetoxymethyl-4.8'-epoxy-3-(1'beta,2'alpha-dihydroxy-3'beta,4'alpha-para-menthyl-3'-yl)quinolin-2-one).

On the wrong side of the tracts? Evaluating the accuracy of geocoding in public health research.

OBJECTIVES: This study sought to determine the accuracy of geocoding for public health databases. METHODS: A test file of 70 addresses, 50 of which involved errors, was generated, and the file was geocoded to the census tract and block group levels by 4 commercial geocoding firms. Also, the "real world" accuracy of the best-performing firm was evaluated. RESULTS: Accuracy rates in regard to geocoding of the test file ranged from 44% (95% confidence interval [CI] = 32%, 56%) to 84% (95% CI = 73%, 92%). The geocoding firm identified as having the best accuracy rate correctly geocoded 96% of the addresses obtained from the public health databases. CONCLUSIONS: Public health studies involving geocoded databases should evaluate and report on methods used to verify accuracy.

Merilactone, an unusual C19 metabolite from the root extract of Chiococca alba.

A C19 metabolite has been isolated from the methanol extract of the roots of Chiococca alba and characterized as a new nor-seco-pimarane, to which we have given the trivial name merilactone (1). The structure and relative stereochemistry of 1 was established by spectral data interpretation.

Flavones and phenylpropenoids in the surface exudate of Psiadia punctulata.

Three flavones, 5,7-dihydroxy-2',3',4',5'-tetramethoxyflavone, 5,4'-dihydroxy-7,2',3',5'-tetramethoxyflavone, and 5,7,4'-trihydroxy-2',3',5'-trimethoxyflavone were isolated from the leaf exudate of Psiadia punctulata, together with the previously reported 5-hydroxy-7,2',3',4',5'-pentamethoxyflavone and 5,7,3'-trihydroxy-2',4',5'-trimethoxyflavone. The two phenylpropenoids, Z-docosyl-p-coumarate and E-docosyl-p-coumarate were also isolated. The structures were determined on the basis of spectroscopic evidence.

Polyphenols from Eucalyptus ovata.

From the leaves of Eucalyptus ovata 13 known compounds, four flavonol glycosides and nine tannins, including the trimer gallocatechin-(4alpha-8)-gallocatechin-(4alpha-8)-catechin (1), were isolated. The spectral data of the peracetate derivative of the trimer are reported.

A new oleanane glycoside from the stem bark of Albizia gummifera.

The stem bark of Albizia gummifera has yielded four triterpenes, lupeol, lupenone, vitalboside-A (1) and vitalboside-A 2'-methylglucuronate (2), the last of which appears to be novel.

Triterpenes of Albizia versicolor and Albizia schimperana stem barks.

Several triterpenes were isolated from stem barks of Albizia versicolor and A. schimperana. Spectral data of acacic acid lactone (1) are presented.

Polyphenols from Eucalyptus consideniana and Eucalyptus viminalis.

From the leaves of Eucalyptus consideniana and E. viminalis, known hydrolysable tannins, galloyl esters and ellagitannins, were isolated. Flavonol glycosides were also isolated from the leaves of E. consideniana. The spectral data of the dimeric ellagitannin, oenothein B (1), are reported.