Seasonal extreme temperatures and short-term fine particulate matter increases pediatric respiratory healthcare encounters in a sparsely populated region of the intermountain western United States.

BACKGROUND: Western Montana, USA, experiences complex air pollution patterns with predominant exposure sources from summer wildfire smoke and winter wood smoke. In addition, climate change related temperatures events are becoming more extreme and expected to contribute to increases in hospital admissions for a range of health outcomes. Evaluating while accounting for these exposures (air pollution and temperature) that often occur simultaneously and may act synergistically on health is becoming more important. METHODS: We explored short-term exposure to air pollution on children's respiratory health outcomes and how extreme temperature or seasonal period modify the risk of air pollution-associated healthcare events. The main outcome measure included individual-based address located respiratory-related healthcare visits for three categories: asthma, lower respiratory tract infections (LRTI), and upper respiratory tract infections (URTI) across western Montana for ages 0-17 from 2017-2020. We used a time-stratified, case-crossover analysis with distributed lag models to identify sensitive exposure windows of fine particulate matter (PM2.5) lagged from 0 (same-day) to 14 prior-days modified by temperature or season. RESULTS: For asthma, increases of 1 µg/m3 in PM2.5 exposure 7-13 days prior a healthcare visit date was associated with increased odds that were magnified during median to colder temperatures and winter periods. For LRTIs, 1 µg/m3 increases during 12 days of cumulative PM2.5 with peak exposure periods between 6-12 days before healthcare visit date was associated with elevated LRTI events, also heightened in median to colder temperatures but no seasonal effect was observed. For URTIs, 1 unit increases during 13 days of cumulative PM2.5 with peak exposure periods between 4-10 days prior event date was associated with greater risk for URTIs visits that were intensified during median to hotter temperatures and spring to summer periods. CONCLUSIONS: Delayed, short-term exposure increases of PM2.5 were associated with elevated odds of all three pediatric respiratory healthcare visit categories in a sparsely population area of the inter-Rocky Mountains, USA. PM2.5 in colder temperatures tended to increase instances of asthma and LRTIs, while PM2.5 during hotter periods increased URTIs.

Seasonal extreme temperatures and short-term fine particulate matter increases child respiratory hospitalizations in a sparsely populated region of the intermountain western United States.

Background: Western Montana, USA, experiences complex air pollution patterns with predominant exposure sources from summer wildfire smoke and winter wood smoke. In addition, climate change related temperatures events are becoming more extreme and expected to contribute to increases in hospital admissions for a range of health outcomes. Few studies have evaluated these exposures (air pollution and temperature) that often occur simultaneously and may act synergistically on health. Methods: We explored short-term exposure to air pollution on childhood respiratory health outcomes and how extreme temperature or seasonal period modify the risk of air pollution-associated hospitalizations. The main outcome measure included all respiratory-related hospital admissions for three categories: asthma, lower respiratory tract infections (LRTI), and upper respiratory tract infections (URTI) across western Montana for all individuals aged 0-17 from 2017-2020. We used a time-stratified, case-crossover analysis and distributed lag models to identify sensitive exposure windows of fine particulate matter (PM2.5) lagged from 0 (same-day) to 15 prior-days modified by temperature or season. Results: Short-term exposure increases of 1 µg/m3 in PM2.5 were associated with elevated odds of all three respiratory hospital admission categories. PM2.5 was associated with the largest increased odds of hospitalizations for asthma at lag 7-13 days [1.87(1.17-2.97)], for LRTI at lag 6-12 days [2.18(1.20-3.97)], and for URTI at a cumulative lag of 13 days [1.29(1.07-1.57)]. The impact of PM2.5 varied by temperature and season for each respiratory outcome scenario. For asthma, PM2.5 was associated most strongly during colder temperatures [3.11(1.40-6.89)] and the winter season [3.26(1.07-9.95)]. Also in colder temperatures, PM2.5 was associated with increased odds of LRTI hospitalization [2.61(1.15-5.94)], but no seasonal effect was observed. Finally, 13 days of cumulative PM2.5 prior to admissions date was associated with the greatest increased odds of URTI hospitalization during summer days [3.35(1.85-6.04)] and hotter temperatures [1.71(1.31-2.22)]. Conclusions: Children's respiratory-related hospital admissions were associated with short-term exposure to PM2.5. PM2.5 associations with asthma and LRTI hospitalizations were strongest during cold periods, whereas associations with URTI were largest during hot periods. Classification: environmental public health, fine particulate matter air pollution, respiratory infections.

Sex Differences in Neurological Emergencies Presenting to Multiple Urban Level 1 Trauma Centers.

Previous studies have suggested that there are sex differences in the treatment and outcome of neurological emergencies; however, research identifying the role these sex differences play in the management of neurological emergencies is lacking. More knowledge of the way sex factors into the pathophysiology of neurological emergencies will be helpful in improving outcomes for these patients. The aim of this cross-sectional study was to assess the prevalence and management of neurological emergencies while evaluating sex differences in the diagnosis and treatment of these emergencies. We analyzed a cohort of 530 adult patients from four level 1 trauma centers over a period of 4 weeks who had a chief complaint of a neurological emergency, including seizures, cerebrovascular events, headache disorders, traumatic brain injuries, and central nervous system infections. Among patients with neurological emergencies, a significantly lower proportion of female patients underwent neurosurgery and were admitted to the intensive care unit compared to male patients, but there were no significant differences between sexes in the time of symptom onset, type of hospital transportation, amount of neuroimaging performed, admission rates, hospital length of stay, and disposition from the emergency department. Although female patients were more likely to have a chief complaint of headache compared to traumatic injuries in male patients, this was not statistically significant. A significantly higher proportion of female patients had health insurance coverage than male patients.

Invasive Micropapillary Carcinoma: A Rare Case of Male Breast Cancer.

Invasive micropapillary carcinoma (IMPC) is a rare form of breast cancer, accounting for 3.8-5.9% of all breast cancer types. Less than 1% of all breast cancer occurs in men and there have been only nine other cases of IMPC specifically in male patients reported in the literature. This case presents a 77-year-old Caucasian man who was found to have IMPC of the left breast after presenting for a painless mass in the left lower subareolar region. After a left modified radical mastectomy, the patient was found to have only one metastatic lymph node with his variant of IMPC being less aggressive requiring no further treatment other than annual surveillance with mammography.

A Mixed-Methods Analysis of Barriers to and Facilitators of Human Papillomavirus Vaccination Among Adolescents in Montana.

OBJECTIVES: Human papillomavirus (HPV) vaccination rates among adolescents are lower in rural areas than in urban areas of the United States. The objective of this study was to identify barriers to and facilitators of adolescent HPV vaccination in Montana, a large, primarily rural state. METHODS: Using a mixed-methods design, we integrated quantitative analyses of Montana's National Immunization Survey-Teen (NIS-Teen) data from 2013-2017 with qualitative data collected at a statewide meeting in October 2018 and from stakeholder interviews conducted from October 2018 through June 2019. Using NIS-Teen data, we identified trends and estimated adjusted prevalence ratios (aPRs) to identify factors associated with vaccine uptake. Using directed content analysis of qualitative data, we identified themes related to vaccine uptake. RESULTS: In Montana, initiation of the HPV vaccine series among adolescents aged 13-17 increased from 34.4% in 2013 to 65.5% in 2017. We identified 6 themes related to HPV vaccination from qualitative analyses, including medical providers' recommendation style as a facilitator of vaccination and parental vaccine hesitancy as a barrier to vaccination. In NIS-Teen 2017 data (n = 326 adolescents), receiving a medical provider recommendation was significantly associated with series initiation (aPR = 2.3; 95% CI, 1.5-3.6). Among parents who did not intend to initiate the vaccine series for their adolescent within 12 months (n = 71), vaccine safety was the top concern (aPR = 24.5%; 95% CI, 12.1%-36.9%). CONCLUSIONS: HPV vaccination rates have increased in Montana but remain lower than rates for other adolescent vaccines. Future work should focus on reducing missed opportunities, increasing parents' knowledge of and confidence in vaccination, and training medical providers on addressing common vaccine concerns.

Gendered Packaging of a STEM Toy Influences Children's Play, Mechanical Learning, and Mothers' Play Guidance.

To study effects of the gender-packaging of science, technology, engineering, and mathematics (STEM) toys, mother-child dyads (31 daughters; 30 sons; M = 5.2 years) were randomly assigned to play with a mechanical toy packaged for girls (GoldieBlox) or boys (BobbyBlox). When familiarizing themselves with the toy to prepare for play, mothers given BobbyBlox built more with toy pieces than did mothers given GoldieBlox. During dyadic play, mothers with sons built more; mothers with daughters read the toy's narrative instructions more. Children's independent play likewise varied with game packaging. Girls learned the mechanical belt-drive principle better from playing with BobbyBlox; boys learned the principle better from playing with GoldieBlox. Implications for gender-schema theories, STEM interventions, and toy marketing are discussed.

Sissies, Mama's Boys, and Tomboys: Is Children's Gender Nonconformity More Acceptable When Nonconforming Traits Are Positive?

The evaluation of gender nonconformity in children was examined in two studies. In Study 1, 48 young adults evaluated the positivity of culturally popular labels for gender nonconformity, including "tomboy," "sissy," and two new labels generated in a pilot study, "mama's boy" and "brat." The "mama's boy" was described as a boy who has positive feminine traits (gentle and well-mannered) as opposed to the "sissy" who was described as having negative feminine traits (crying and easily frightened). In Study 2, 161 young adults read descriptions of gender-typical and nonconforming children, evaluating them in several domains. The label "mama's boy" was considered negative in Study 1 but an unlabeled positive nonconforming boy was rated as likable and competent in Study 2. However, participants worried about nonconforming boys, saying they would encourage them to behave differently and describing such children with derogatory sexual orientation slurs. "Tomboy" was generally considered a positive label in Study 1. In Study 2, gender nonconforming girls were considered neither likable nor dislikeable, and neither competent nor incompetent, reflecting ambivalence about girls' nonconformity. It may be that we use gender nonconformity labels as indicators of sexual orientation, even in young children. Therefore, even when an individual displays objectively positive traits, the stigma associated with homosexuality taints judgments about their nonconforming behavior.

Affecting Girls' Activity and Job Interests Through Play: The Moderating Roles of Personal Gender Salience and Game Characteristics.

Gender schema theory (GST) posits that children approach opportunities perceived as gender appropriate, avoiding those deemed gender inappropriate, in turn affecting gender-differentiated career trajectories. To test the hypothesis that children's gender salience filters (GSF-tendency to attend to gender) moderate these processes, 62 preschool girls (M = 4.5 years) were given GSF measures. Two weeks later, they played a computer game about occupations that manipulated the game-character's femininity (hyperfeminized Barbie vs. less feminized Playmobil Jane). Following game play, girls' interests in feminine activities showed an interaction of game condition and GSF: High-GSF girls showed intensified feminine activity interests only with Barbie; low-GSF girls showed no change with either character. Neither GSF nor game condition affected occupational interests. Implications for GST, individual differences, and occupational interventions are discussed.

Developmental interventions to address the STEM gender gap: exploring intended and unintended consequences.

Women and girls in the United States continue to be underrepresented in STEM, particularly in engineering and technology fields. This gap has been attracting recent attention from those motivated to ensure that girls and women have access to a full range of personally satisfying careers as well as from those concerned with developing a rich talent pool to meet national workforce needs. This chapter is focused on interventions that have been designed to address this STEM gender gap. We begin by documenting the STEM gender gap and then review change mechanisms emerging from theories of gender development that may be harnessed in intervention efforts. In addition, we pro vide a taxonomy of intervention goals which we then use to organize an illustrative review of sample interventions. After commenting on some of the findings and limitations of past work, we offer suggestions for enhancing the systematic evaluation of intervention programs that include careful selection of comparison groups, a broad array of STEM outcome measures, assessment of potentially unintended consequences, and meta-analyses.

Breadwinner and caregiver: a cross-sectional analysis of children's and emerging adults' visions of their future family roles.

Participants were 150 school-age boys and girls, 58 high school students, and 145 university students drawn from communities in the Southeastern United States. In this cross-sectional study, family role attitudes and expectations were examined across development. Parental work traditionality (occupational prestige and traditionality, and employed hours) predicted daughters' social role attitudes and plans for future family roles, such that daughters' envisioned families resembled that of their parents. Sons' and daughters' own attitudes about adult family roles predicted their plans to work or stay home with their future children; however, mothers' work traditionality predicted daughters' future plans over and above daughters' own attitudes. The only exception to this was in the case of university daughters, where university women's attitudes about social roles fully mediated this relationship. It may be that, as young women approach adulthood and the formation of families, they adjust their vision of their future self to match more closely their own attitudes about the caregiving role.

Practical applications of high-affinity, albumin-binding proteins from a group G streptococcal isolate.

Binding proteins that have high affinities for mammalian plasma proteins that are expressed on the surface of bacteria have proven valuable for the purification and detection of several biologically important molecules from human and animal plasma or serum. In this study, we have isolated a high affinity albumin-binding molecule from a group G streptococcal isolate of bovine origin and have demonstrated that the isolated protein can be biotinylated without loss of binding activity and can be used as a tracer for quantification of human serum albumin (HSA). The binding protein can be immobilized and used as a selective capture reagent in a competitive ELISA format using a biotinylated HSA tracer. In this assay format, the sensitivity of detection for 50% inhibition of binding of HSA was less than 1 microg/ml. When attached to the bacterial surface, this binding protein can be used to deplete albumin from human plasma, as analyzed by surface-enhanced laser desorption ionization time of flight mass spectrometry.