Viewing the US presidential electoral map through the lens of public health

Health, disease, and mortality vary greatly at the county level, and there are strong geographical trends of disease in the United States. Healthcare is and has been a top priority for voters in the U.S., and an important political issue. Consequently, it is important to determine what relationship voting patterns have with health, disease, and mortality, as doing so may help guide appropriate policy. We performed a comprehensive analysis of the relationship between voting patterns and over 150 different public health and wellbeing variables at the county level, comparing all states, including counties in 2016 battleground states, and counties in states that flipped from majority Democrat to majority Republican from 2012 to 2016. We also investigated county-level health trends over the last 30+ years and find statistically significant relationships between a number of health measures and the voting patterns of counties in presidential elections. Collectively, these data exhibit a strong pattern: counties that voted Republican in the 2016 election had overall worse health outcomes than those that voted Democrat. We hope that this strong relationship can guide improvements in healthcare policy legislation at the county level.

Rifamycin congeners kanglemycins are active against rifampicin-resistant bacteria via a distinct mechanism

Rifamycin antibiotics (Rifs) target bacterial RNA polymerases (RNAPs) and are widely used to treat infections including tuberculosis. The utility of these compounds is threatened by the increasing incidence of resistance (RifR). As resistance mechanisms found in clinical settings may also occur in natural environments, here we postulated that bacteria could have evolved to produce rifamycin congeners active against clinically relevant resistance phenotypes. We survey soil metagenomes and identify a tailoring enzyme-rich family of gene clusters encoding biosynthesis of rifamycin congeners (kanglemycins, Kangs) with potent in vivo and in vitro activity against the most common clinically relevant RifR mutations. Our structural and mechanistic analyses reveal the basis for Kang inhibition of RifR RNAP. Unlike Rifs, Kangs function through a mechanism that includes interfering with 5'-initiating substrate binding. Our results suggest that examining soil microbiomes for new analogues of clinically used antibiotics may uncover metabolites capable of circumventing clinically important resistance mechanisms.

Proton tracks and the formation of pores in poly[diethylene glycol bis-(allyl carbonate)]

Modern dosimetry needs efficient detectors for registering light ions, especially light ions having energies of up to 10 MeV/amu. That is why this research pays attention to the development of materials for such a task. In this work, a CR-39 detector, which is the most efficient detector, was used. It was irradiated with low-energy protons. Using sensitive electrolytic etching and electron scanning microscopy, a complete analysis was carried out of the process of the formation of a pore starting from its opening to the final stage of its formation. The process of sequential track breakthroughs was observed. The data obtained on the shape of the pore and the parameters of its formation allow simulation of the process of etching. The etch rates and sensitivity of etching are determined. The influence of energy losses on the geometry of the pore is considered.

Effect of aging on bladder function and the response to outlet obstruction in female rats

Bladder dysfunction in the aging population is a significant problem. However the concomitant presence of other diseases in many patients can make it difficult to distinguish between changes in bladder function and other influences. The present study was designed to study, in aging rats, bladder function and the effect of partial bladder outlet obstruction (BOO) on bladder function. Cystometrics were performed in awake, female Fischer 344 rats of four age groups (6, 12, 18 and 24 months) following subcutaneous implantation of a mediport catheter. Cystometric evaluations were carried out in control rats or those subject to three weeks of BOO. Bladder compliance significantly decreased with aging, which reflected an increase in threshold pressure without changes in bladder capacity. Partial BOO caused development of severe bladder instability. Following BOO, bladder capacity and compliance were significantly increased in all age groups. Threshold pressure was lower in obstructed animals, except for 6-month rats. Younger animals were able to generate a higher contraction pressure to compensate for the BOO, whereas older animals did not. Using an awake model of cystometric measurement, we have demonstrated that aging, by itself can affect bladder function. Furthermore, aged animals respond differently to BOO than younger animals. These results demonstrate that both aging and disease can contribute to bladder dysfunction, and suggest that treatment of bladder dysfunction may require a combination of therapies targeted to multiple etiologies.

Predictive accuracy of transrectal ultrasound-guided prostate biopsy: correlations to matched prostatectomy specimens

OBJECTIVES

To characterize observed differences in Gleason score between prostate biopsy and corresponding radical retropubic prostatectomy (RRP) specimens.

METHODS

One hundred consecutive clinically localized prostate cancers diagnosed by transrectal ultrasound-guided biopsy (TRUS-Bx) and treated with RRP were reviewed. All specimens were evaluated in blinded review by a single expert uropathologist and contrasted with the initial histologic analysis, performed by multiple pathologists.

RESULTS

Mean Gleason score of TRUS-Bx specimens for blinded review and at initial evaluation were 6.6 +/- 0.1 and 6.0 +/- 0.1 (P < 0.001). Corresponding RRP values were 6.8 +/- 0.1 and 6.5 +/- 0.1 (P < 0.03). Differences in Gleason score between TRUS-Bx and RRP at initial evaluation were significant (P < 0.02), but not in blinded review (P = NS). In blinded review, TRUS-Bx correctly predicted RRP histology for 88% of men with lesions scored as Gleason 5 to 7 and 41% of men with well-(Gleason score of 2 to 4) or poorly differentiated (Gleason score of 8 to 10) lesions (P < 0.01).

CONCLUSIONS

TRUS-Bx does not accurately reflect RRP histology when predicting well- or poorly differentiated lesions. Prostate cancer treatment algorithms should not be predicated upon biopsy histology alone. Histologic interpretation is more accurate and precise when performed by a single experienced uropathologist.