Man's Burden Research Articles

Circulating anti-Müllerian hormone levels and markers of subclinical cardiovascular disease in middle-aged and older men

ContextRecent research suggests that higher circulating anti-Müllerian hormone (AMH) levels are associated with less frequent occurrence of (subclinical) cardiovascular disease (CVD) in women, but evidence in men is limited. ObjectiveWe investigated whether circulating AMH levels are associated with measures of subclinical CVD in middle-aged and older men. DesignProspective cohort study with a median follow-up time of 8.7 years. Serum AMH was measured at baseline. We assessed both cross-sectional and longitudinal associations using linear regression models adjusted for confounders. SettingDutch middle-aged and older men from the community. Participants394 men (aged 40–80 years) with an available AMH measurement at baseline. Main outcome measuresAt baseline (2001−2002): carotid intima-media thickness (CIMT), pulse wave velocity (PWV), abdominal aortic diameter, and Framingham risk score (FRS) predictions. At follow-up (2010−2011): CIMT, mean carotid aortic plaque score, PWV, and FRS predictions. All outcomes were transformed using rank-based inverse normal transformation to meet the normality assumption. ResultsHigher AMH levels were associated with lower CIMT at baseline (β = −0.04; 95%CI = 0.07, −0.01), but not with the other measures of subclinical CVD at baseline. Longitudinal analyses suggested that higher baseline AMH levels were associated with lower mean plaque scores at follow-up (β = −0.03, 95%CI = −0.07, 0.00), but not with the other follow-up outcomes. ConclusionsOur results suggest that AMH is associated with current CIMT and future carotid aortic plaque burden in men, implying that circulating AMH levels are potentially associated with local atherosclerosis rather than with total aortic stiffness.

Influence of the COVID-19 Lockdown and Restart on the Injury Incidence and Injury Burden in Men’s Professional Football Leagues in 2020: The UEFA Elite Club Injury Study

BackgroundStudies on football and the coronavirus disease 2019 (COVID-19) have mainly focused on the lockdown consequences for player fitness, the resumption of football training, and how to safely restart the league play, but injury data are scarce.ObjectiveTo describe the injury incidence and injury burden in men’s professional football teams during the pandemic year of 2020.MethodsNineteen teams in 12 countries prospectively registered data on player-exposure and time-loss injuries throughout 2020. All major football leagues were paused as a direct response to the pandemic in March 2020 and were thereafter completely cancelled or restarted after a lockdown interval of at least two months. Historical data from 43 teams in the same cohort during the five preceding years (2015–2019) were used as reference. Between-season and within-season comparisons were made for injury incidence (number of injuries per 1000 h) and injury burden (number of absence days per 1000 h) with 95% confidence intervals and interquartile ranges.ResultsThere was no increased match injury incidence or injury burden following the restart in 2020 compared with other time periods of 2020 and the corresponding periods 2015–2019. There was an increased training injury incidence and injury burden immediately during the lockdown in 2020, and they remained elevated also following the restart, being higher in 2020 compared with 2015–2019, respectively. The injury characteristics during the first months of the new 2020/21 season (August/September–December) were similar between the five teams that cancelled their 2019/20 season in March 2020 and the 14 teams that restarted their season in May/June 2020.ConclusionsThere was no increased match injury incidence or injury burden following the COVID-19 lockdown and restart of the football season in 2020, but training injury incidence and injury burden were elevated and higher than in 2015–2019.

Factors associated with premature ejaculation might influence the female sexual function

ABSTRACT Introduction Premature ejaculation (PE) is a multifactorial disease with complicated etiology, and has detrimental effects on the female partners’ sexual function. However, our country are lack of studies on the relationship between the factors related to PE and female sexual dysfunction (FSD) presently. Objective To investigate factors associated with premature ejaculation which might influence the female sexual function Methods From January 2018 to January 2019, an observational and cross-sectional field survey was conducted in the first affiliated hospital of Anhui medical university in Anhui province of China. A total of 761 couples that met our criteria made up our study population. Subjects were divided into two groups, including group with PE complaint and group without PE complaint. The survey was conducted by a professional Andrology doctor through the face-to-face guidance. All subjects were required to complete a questionnaire, including demographic information (e.g, age, education level and employment status), duration of PE and medical and sexual histories (e.g, Intravaginal ejaculation latency time [IELT], sexual desire,sexual frequency per month). In addition, we also investigated men's characters, incidence of men's negative psychology burden and different attitude toward to PE problem. Female partner of the patient were also evaluated by the Chinese vision of female sexual function index (FSFI), which included six dimensions (sexual desire, arousal, lubrication, orgasm, satisfaction and pain). Results The A total of 761 couples’ information were collected in this study, including 445 couples with PE complaint and 316 without PE complaint. In PE complaint group, the mean ages of men in PE and without PE complaint were 6.29 ± 9.87 years and 34.26 ± 8.83 years. Female partners in group with PE complaint reported lower total and sub-domain scores of FSFI, and approximately 65% of them were diagnosed with FSD (vs. control group: 31.96%). Duration of PE more than 14 months, self-estimated IELT less than 2 minutes, negative attitude toward PE problem, and men's introversion character and depression were the risk factors of FSD in PE complaint group. Conclusions In summary, PE and related factors are closely related to FSD, which implied that the focus of treatment for PE should transmit from men to the both sides and intensely emphasize the combination between mental behavioral therapy combined and drug therapy. Disclosure Work supported by industry: no.

Missionary Cosmopolitanism in Nineteenth-Century British Literature by Winter Jade Werner

Reviewed by: Missionary Cosmopolitanism in Nineteenth-Century British Literature by Winter Jade Werner Cheri L. Larsen Hoeckley (bio) Missionary Cosmopolitanism in Nineteenth-Century British Literature Winter Jade Werner The Ohio State University Press, 2020. xi + 210 pp. $79.95 cloth, $24.95 paperback. Missionary Cosmopolitanism surprises in the most satisfying ways. While drawing broadly and deeply from religious, imperial, and literary archives, Winter Jade Werner resists relentless condemnation of nineteenth-century missionaries for their occasionally enthusiastic complicity in colonialism's exploitation and oppression. Yet she also avoids an apologia for the missionary project's participation in empire. As Werner recounts her early research questions, she found herself drawn in by missionary claims to cosmopolitanism, asking what would happen if she "commenced a study of imperial history and literature not with a presumption of missionary backwardness but rather with a careful consideration of those values that missionaries [End Page 224] themselves claimed to be central to their work? What might history tell us about how religion and imperialism together influenced cosmopolitanism in the nineteenth century and beyond?" (3). Forging a meticulously researched path in scholarship prompted by these questions, her argument explores the interweaving of Enlightenment humanist ideals with Christian doctrine and practice as these ideologies cross to undergird missionary activity across the empire. Along the way, Werner offers fresh analyses of some of the most frequently read Victorian novels and recovers forgotten works that bear re-reading in our current moment. Readers expecting umbrage for missionary complicity in colonial exploitation will quickly note Werner's minimal usage of terms like "racism" or even "xenophobia," though her attentive readings persistently highlight power structures that missionaries supported, often to the detriment of indigenous populations. Her summary of Robert Southey's Tales of Paraguay, for instance, might be encapsulated as the narrative of the Jesuit-induced death of a Guarani family. Reading Southey through missionary society publications, Werner offers nuanced support for her conclusion that by "adopting the language of natural theology, proto-ethnography, and cosmopolitanism…missionaries distinguished their Christianity as 'rational,' painting a flattering portrait of their own faith as uniquely 'enlightened' when compared to superstitious 'heathen'" belief systems (81). When Werner combines her reading of Southey's defense of empire with her argument for his secularization of Christian education in Sir Thomas More, we see white supremacy's early roots that are better remembered in literary texts, such as Kipling's "White Man's Burden." Throughout, Werner stays fruitfully in conversation with previous scholars on both empire and cosmopolitanism, from Patrick Brantlinger to Amanda Anderson, James Buzard, and Tanya Agathocleous. Taking her scholarly strategies into consideration, it is not surprising that Missionary Cosmopolitanism opens with the words of missionary John Williams and his claim that the missionary is "the only true cosmopolite" (1). Werner grounds her argument by considering Williams's statement in the context both of missionary society documents and of Kant's writings on cosmopolitanism. From that foundation, she turns to literary texts, seeking "to complicate the often under-examined binaries that govern understandings of religion, imperialism, and cosmopolitanism in literary scholarship" (37). Her analysis of Bleak House builds convincing parallels between Mrs. Jellyby's renowned telescopic philanthropy and Harold Skimpole's "dangerous moral indifference" (61) as two sides of the cosmopolitan coin that emerges from the mint of Kantian philosophy. Werner concludes that the [End Page 225] similarities of these two apparently disparate characters reveal "the novel's keenly historic sense of cosmopolitanism: its savvy recovery of early nineteenth-century conservative fears of missionaries' (supposedly) depoliticized, re-Christianized cosmopolitanism in order to critique the 'cosmopolitan' fervor surrounding the Great Exhibition" (43). The mid-century missionary movement, that's to say, plays its part in a broader Dickensian turn toward the domestic, bolstering conservative anxieties about more secular forms of cosmopolitanism. Attuned as she is by her attention to missionary tracts and letters alongside Kantian discourse, when Werner turns to Jane Eyre, she shifts the focus of the novel's racial discourse from its debasing representation of creole Bertha Mason. Instead, Werner examines mid-century missionaries' racial controversies that ground St. John's impassioned demand that Jane marry him. Werner's analysis of what is arguably the Victorian period...

Atlas and Talus.

This article explores the history of the terms atlas and talus and discusses the unexpected implications of their use in human anatomy. Renaissance anatomists decided to call the first cervical vertebra the atlas. But the name atlas was first used by the ancient Romans for the seventh cervical vertebra. The most common explanation why the first cervical vertebra is called atlas is that the vertebra holds up the globe of the cranium the way Atlas holds up the globe of the heavens. However, an important part of the myth of Atlas is that the Titan was being punished. The seventh cervical vertebra was so named due to its suitability for supporting burdens. (Pollux, 1900) Switching the designation atlas from the seventh to the first cervical vertebra in human anatomy implies that the point of man's burden has shifted from his shoulders to his head. What an anatomist is saying by making, or accepting, this change is that man's true burden is not a physical load, but rather, it is his mind. We explore the implications of this switch, and how it is represented in Renaissance anatomy diagrams. Long before the first cervical vertebra was called atlas it was known as the astragalus, the same term used for the talus, or ankle bone. We examine the many different terms that were used for the ankle bone during the Middle Ages and Renaissance, as well as the connection of the term talus with Greek mythology.

Stability of health-related quality of life and morbidity burden from 18\xa0months after diagnosis of prostate cancer: results of a UK-wide population-based outcome cohort

ObjectiveTo evaluate the dynamic nature of self-reported health-related quality of life (HRQL) and morbidity burden in men diagnosed with prostate cancer, we performed a follow-up study of the Life After Prostate Cancer Diagnosis (LAPCD) study cohort 12 months after initial survey.MethodsThe LAPCD study collected information from 35,823 men across the UK who were 18–42 months post-diagnosis of prostate cancer. Men who were still alive 12 months later were resurveyed. Generic HRQL (EQ-5D-5L plus self-assessed health rating) and prostate cancer-specific outcomes (EPIC-26) were assessed. Treatment(s) received was self-reported. Previously defined clinically meaningful differences were used to evaluate changes in outcomes over time.ResultsA total of 28,450 men across all disease stages completed follow-up surveys (85.8% response). Of the 21,700 included in this study, 89.7% reported no additional treatments since the first survey. This group experienced stable urinary and bowel outcomes, with good function for most men at both time points. On-going poor (but stable) urinary issues were associated with previous surgery. Sexual function scores remained low (mean: 26.8/100). Self-assessed health ratings were stable over time. The largest declines in HRQL and functional outcomes were experienced by men reporting their first active treatment between surveys.DiscussionThe results suggest stability of HRQL and most specific morbidities by 18–42 months for men who report no further treatment in the subsequent 12 months. This is reassuring for those with good function and HRQL but re-enforces the need for early intervention and support for men who experience poor outcomes.

International relations theory, perspectives from India

ABSTRACT Recent voices have challenged the Eurocentric gaze in IR . Western hegemony over the discipline has been accounted due to structural, disciplinary, language, institutional reasons, and the monopoly over knowledge production by the West. The big bangs of IR, 1919 and 1648, have played a role in the construction of a Eurocentric IR discipline which is still presumed to be a ‘White man's burden' which needs to theorize the non-West. Conversations within the IR academe to recalibrate IR are incestuous, and the ‘dialogue' is going on within the ‘conclaves' of the various national schools, rather than across the various ‘silos' within the IR community. A more appropriate ‘lens’ to make the study of IR ' Global' would be to adopt an eclectic model and to strengthen perspectives like postcolonialism, Contrapuntal reading, and Marxist perspectives to bridge the gap between the core and the periphery and reign in the silenced narratives.

Directly quantified abdominal subcutaneous adipose tissue volume is negatively associated with subclinical coronary artery disease in men with psoriasis

Abstract Background Psoriasis is a common chronic inflammatory condition associated with an increased risk of obesity and higher coronary atherosclerosis burden by coronary computed tomography angiography (CCTA). Prior studies have shown that the ability to expand subcutaneous adipose tissue (SAT) may serve to identify individuals at a lower risk of atherosclerotic cardiovascular disease. However, the relationship between abdominal SAT and high-risk subclinical coronary artery disease requires exploration. Purpose To characterize the relationship between abdominal SAT volume measured on low-dose computed tomography, and coronary artery disease assessed as noncalcified and lipid-rich necrotic core burden by CCTA in psoriasis. Methods We performed a cross-sectional study of 232 participants with psoriasis and without known cardiovascular disease. All participants underwent CCTA to characterize coronary artery disease burden and low dose abdominal computed tomography to quantify subcutaneous adipose tissue volumes. Fat depot volumes were first adjusted in a sex specific manner for each participant's body mass index in a linear regression model. The residual values from the sex stratified linear regression models were used for analyses. Coronary artery disease burden was quantified in the three main coronary arteries (QAngio, Medis, The Netherlands) and averaged. Analyses were performed with StataIC 16 (Stata Corp., College Station, TX, USA). Results Of the 232 participants, 92 (40%) were women and the average age was 50 years. In women, there was a positive correlation between abdominal SAT and systemic inflammation as assessed by hs-CRP (r=0.30; p=0.004) and GlycA (r=0.29; p=0.007) as well as total cholesterol (r=0.24; p=0.02) and LDL cholesterol (r=0.22; p=0.04). In men, abdominal SAT correlated with hs-CRP (r=0.18; p=0.04) and insulin resistance as assessed by the homeostatic model for insulin resistance (r=0.17; p=0.04). In models fully adjusted for traditional cardiovascular risk factors, abdominal SAT volume negatively associated with noncalcified and lipid-rich necrotic core burden in men (β=−0.17; p=0.03, β=−0.21; p=0.02, respectively), but not women (β=−0.04; p=0.72, β=0.05; p=0.68, respectively) with psoriasis (Table). Conclusions In psoriasis, for a given body mass index, abdominal SAT negatively associated with coronary atherosclerosis burden in men. The observed sex-specific effects on subclinical coronary artery disease warrant further study of abdominal SAT in states of chronic inflammation. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Heart, Lung and Blood Institute Intramural Research Program in Bethesda, Maryland

Impact of socioeconomic position on coronary artery disease burden in men and women with de-novo symptoms suggestive of chronic coronary syndrome

Abstract Background Low socioeconomic position (SEP) is associated with shorter life expectancy and one of the main drivers is an increase in cardiovascular deaths. A higher prevalence of risk factors only partly explains the complex multifactorial pathogenesis. The aim of this study was to investigate the association between SEP and the development of coronary artery disease (CAD) assessed as calcium score (CACS) at coronary computed tomography angiography (CCTA) as well as stenosis at downstream invasive coronary angiography (ICA) in a population presenting with symptoms suggestive of chronic coronary syndrome (CCS). A secondary aim was to establish whether SEP affects men and women differently. Methods We included 50,561 patients (Mean age 57.35±11.50, 53.7% women) from the Western Denmark Heart Registry (WDHR) with no previous CAD undergoing CCTA from 2008–2019 for suspected CCS. ICA was conducted in patients where obstructive CAD was not excluded at CCTA. Outcome measures was level of CACS and haemodynamically significant stenosis at ICA defined as either fractional flow reserve <0.80 or visually assed diameter stenosis of ≥50% stenosis. Odds Ratio of haemodynamically significant stenosis at ICA was calculated using multiple logistic regression and models adjusted for risk factors (smoking, medical treatment for hypertension, medical treatment for high cholesterol, diabetes and family history of CAD). Information on SEP was obtained from national registries. We included mean individual income at age 30–60 or until CCTA (quintiles); and length of education (<10 years, 10–13 years or >13 years). Information on risk factors was obtained from the WDHR registry. Results Mean number of risk factors are presented in each educational group in Figure 1. Median CACS for women with <10 years of education is 2 [0–82] vs. 0 [0–15] for women with >13 years of education (p<0.001). For men <10 years of education median CACS is 10 [0–143] vs. 8 [0–118] for men with >13 years of education (p=0.05) (Figure 1). Mean number of risk factors are presented at each level of income in Figure 2. For women with low income median CACS was 6 [0–103] vs. 0 [0–3] for women with high income (p<0.001). For men with low income median CACS is 8 [0–144] vs. 5 [0–105] for men with high income (p=0.002) (Figure 2). The odds ratio (OR) of a stenosis at downstream ICA was 1.47 (p=0.004) for women with <10 years of education vs. >13 years of education and 1.17 for men (p=0.122). OR of stenosis at ICA was 2.40 (p<0.001) for women with low income (1 quintile) using high income (5 quintile) as reference and 1.12 for men (p=0.321). Conclusion In de-Novo patients referred for CAD rule-out both coronary calcium score and the prevalence of stenosis at ICA is strongly correlated to low income and short education. The correlation seems to be stronger in women compared to men and calls for further research into the mechanism behind low SEP and atherosclerosis. Funding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Hospital Unit West Jutland Research foundation Figure 2

Onset and burden of lower limb lymphedema after radical prostatectomy: a cross-sectional study.

To explore men's onset and burden of lower limb lymphedema (LLL) after radical prostatectomy (RP) with pelvic lymph node dissection(PLND). A cross-sectional survey-based study was conducted nation-wide and web-based in Germany. Part 1 included 15 multidisciplinary compiled questions with three questions from the Short Form 12 Health Survey (SF-12) and the WHO activity recommendation and part 2 included the validated German Lymph-ICF-Questionnaire (Lymph-ICF-LL). Subgroup comparisons and simple regression analyses were used to identify factors associated with therapy and burden of LLL, followed by multiple regression analyses to explain variance in impairment in the patients' daily life. Fifty-four patients completed the survey. Median time of LLL-onset was reported with 2.0 (0.5-9.75) months after RP. Nineteen patients (35.2%) reported bilateral lymphedema, 28 (51.9%) the use of individually fitted compression stockings (CS), 25 (46.3%) of manual lymphatic drainage (LD), and 26 (48.1%) complete regression. The Lymph-ICF-LL revealed a higher total burden for patients with an active LLL compared to complete regression (total score: 25.5 vs. 11.9, p = 0.01) especially for "physical function" (28.3 vs. 12.9, p < 0.01) and "mental function" (26.2 vs. 6.7, p < 0.01). In multiple linear regression analysis, a higher BMI (β = 0.28), lower subjective general health (β = -0.48), and active lymphedema (β = 0.28) were significant predictors of higher reported impairments in the Lymph-ICF-LL, accounting for 45.4% of variance. Men with LLL after RP with PLND report a significant burden in daily life. Basic therapy needs to be offered early. Postoperative onset of LLL is variable, which should be considered when assessing complications after RP.

In-silico identification of frequently mutated genes and their co-enriched metabolic pathways associated with Prostate cancer progression.

Prostate cancer (PCa) has emerged as a significant health burden in men globally. Several genetic anomalies such as mutations and also epigenetic aberrations are responsible for the heterogeneity of this disease. This study identified the 20 most frequently mutated genes reported in PCa based on literature and database survey. Further gene ontology and functional enrichment analysis were conducted to determine their co-modulated molecular and biological pathways. A protein-protein interaction network was used for the identification of hub genes. These hub genes identified were then subjected to survival analysis. The prognostic values of these identified genes were investigated using GEPIA and HPA. Gene Ontology analysis of the identified genes depicted that these genes significantly contributed to the cell cycle, apoptosis, angiogenesis and TGF-β receptor signalling. Further, the research showed that high expressions of identified mutated genes led to a reduction in the long-term survival of PCa patients, which was supported by immunohistochemical and mRNA expression level data. Our results suggest that identified panel of mutated genes viz., CTNNB1, TP53, ATM, AR and KMT2D play crucial roles in the onset and progression of PCa, thereby providing candidate diagnostic markers for PCa for individualised treatment in the future.

Abdominal subcutaneous adipose tissue negatively associates with subclinical coronary artery disease in men with psoriasis

ObjectiveUnderstand the relationship between abdominal subcutaneous adipose tissue (ASAT) and coronary atherosclerosis defined as noncalcified and lipid-rich necrotic core burden in psoriasis. MethodsWe performed a cross-sectional study of 232 participants (92 women) with psoriasis and without known cardiovascular disease. Participants underwent coronary computed tomography angiography to characterize coronary atherosclerosis burden and low dose abdominal computed tomography to quantify subcutaneous and visceral adipose tissue. Fat depot volumes were first adjusted for each participant's BMI (ASATadjBMI). ResultsIn women, there was a positive correlation between ASATadjBMI and systemic inflammation as assessed by hs-C-reactive protein (r=0.30; p=.004) and GlycA (r=0.29; p=.007) as well as total cholesterol (r=0.24; p=.02) and low-density lipoprotein cholesterol (r=0.22; p=.04). In men, ASATadjBMI correlated with hs-C-reactive protein (r=0.18; p=.04) and insulin resistance (r=0.17; p=.04). In models fully adjusted for traditional cardiovascular risk factors, ASATadjBMI negatively associated with noncalcified and lipid-rich necrotic core burden in men (β= -0.17; p=.03, β= -0.20; p=.03, respectively), but not women (β= -0.06; p=.57, β= 0.09; p=.49, respectively) with psoriasis. ConclusionsFor a given BMI, ASAT negatively associated with coronary atherosclerosis burden in male participants with psoriasis. The observed sex-specific effects warrant further study of ASAT in states of chronic inflammation.

Abstract 782: Exploring the contribution of introgressed ancient DNA to prostate cancer racial disparity

Abstract Introduction: Prostate cancer is the most common cancer in men and there is racial disparity in prostate cancer incidence and mortality globally, with greater disease burden in men of African ancestry, followed by European ancestry and least in men of Asian ancestry. The etiology of prostate cancer is not fully understood, but includes genetic and environmental factors. Present day non-Africans are reported to have introgressed DNA from Neanderthal and Denisovan ancestors. Over 170 prostate cancer associated single nucleotide polymorphisms (SNPs) have been identified from several genome-wide association studies (GWAS), with SNPS on chromosomes 2, 8 and 22 reported as showing variation between African and non-African men with prostate cancer. We performed analysis of prostate cancer associated SNPs on chromosomes 2, 8 and 22 to determine if DNA introgression could explain the racial variation. Methods: We obtained data on prostate cancer associated SNPs from the GWAS catalog (https://www.ebi.ac.uk/gwas) and from reports that were not included in the catalog. Using an Ancient Genome Browser provided by the Max Plank Institute (https://www.eva.mpg.de/genetics/genomeprojects/neandertal/index.html), we determined whether SNPs on chromosomes 2, 8 and 22 were present in African, Neanderthal or Denisovan genomes. Based on the results, we inferred that SNPs were introgressed if they were present in Neanderthal or Denisovan genomes but absent from African genomes. Results: 49, 59 and 17 prostate cancer SNPs were reported in chromosomes 2, 8 and 22 respectively. 23/49 in ch2, 25/59 in ch8 and 9/17 in ch22 were present in Neanderthal and or Denisovan genomes. SNPs in ch2 (rs13403657, rs12621278) and ch8 (rs7825414) were present in Neanderthal or Denisovan genomes but absent in African genomes. These SNPs lie in regions that have previously been reported to harbor introgressed DNA. Conclusion: Our analyses identified prostate cancer associated SNPs that are likely to have been introgressed into present day non-Africans by extinct Neanderthal and Denisovan ancestors. Phenotypic changes caused by introgressed DNA could be contributing to racial disparities in prostate cancer in present day humans. Citation Format: Evi O. Useh, Suresh Venugopal, Chidi N. Molokwu. Exploring the contribution of introgressed ancient DNA to prostate cancer racial disparity [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 782.

British India, White Australia: Overseas Indians, intercolonial relations and the empire by Kama Maclean

Reviewed by: British India, White Australia: Overseas Indians, intercolonial relations and the empire by Kama Maclean Margaret Allen British India, White Australia: Overseas Indians, intercolonial relations and the empire By Kama Maclean. Sydney: UNSW Press, 2020. This volume sets out to write a history of relationships between India and Indians and Australia and Australians in the first half of the twentieth century, through the "framework of the [British] empire, and later the commonwealth." The period begins with the federation of the Australian colonies, based upon restrictive immigration policies directed, in part, at the Crown's Indian subjects. Federated Australia became a self-governing entity within the empire, while India was unable to progress to a similar position, remaining largely under direct British rule until the growing nationalist movement was able to effect independence in 1947. This study builds upon and makes a contribution to the small but growing literature on the histories of Indians resident in Australia during the heyday of the restrictive White Australia policy. But it does much more than that. The focus upon the "awkward triangular dynamic that developed between Britain, India and Australia in the early twentieth century" allows larger questions to be explored. Clearly the racially restrictive immigration policies were an important barrier to cordial relationships between these two very differently situated parts of the British Empire. Indeed Indians saw the White Australia policy as a "permanent characteristic of Australia." The British government was very critical of Australian racism, but Maclean argues for "the similarities between the White Australia policy and the White Man's Burden, the very premise of British imperialism in India." The British castigation of Australian racial thinking around immigration diverted attention from British rule in India. An important focus of this volume is upon political history and intercolonial/international relations but it also delves into popular culture and histories of representation. An exploration of the categorization of the naming practices of Indians in Australia reveals a litany of mostly derogatory terms: Hindoos, Asiatics, aliens, Natives, coolies, and Indians. Many of these were used on the Certificate Exempting the Dictation Test, an identity document which resident Indians needed to negotiate Australian entry ports. Maclean also traces the origins and meanings of the name "Charlie," often applied indiscriminately to Indian men resident in Australia, arguing it was a further manifestation of Indians being distanced by the Australian community. Politicians and press promoted an undesirable view of India and Indians which, along with the pervasiveness of works by Kipling and his ilk, served to maintain racial prejudices, but by delving into an archive of Australian family photographs, which included images of Indian hawkers, who were so often crucial to the rural communities they served, Maclean finds that some "individual Indian hawkers were able to transcend the stereotypes that were so dominant in the public sphere": their "acceptance" was both "limited and conditional." Maclean argues that as the nationalist movement built in the first decades of the twentieth century, Australian knowledge of India's hopes and aspirations was limited, especially as works expressing pro-Indian views including Palme Dutt's India Today (1940) were largely kept from the Australian public. The Australian public was fed a stream of pro-imperial propaganda as "the government of India continued to covertly influence global opinion about Gandhi and the Congress." Indeed even as Indian independence neared, the British were still intervening in the India-Australia relationship and even seeking to censure the speeches of India's first High Commissioner in Australia, R. Paranjpye. Maclean brings to light individuals such as Winston Burchett who sought to enlighten the Australian public. He attended the 1937 conference of the Indian National Congress, and hearing Nehru and other leaders speak, became committed to breaking through the veil of misinformation about India and to informing the Australian public about the nationalist movement and its aspirations. However, missing from this study is any discussion of Australian Christian missionary activity in India and such missionary influence on Australian views of India. India was a favoured field for Australian missionaries and many people and organizations formed long and deep associations with India and Indians. It is easy to see Christian missions merely as an arm of...

Profile of elderly patients receiving antiretroviral therapy at Newlands Clinic in 2020: A cross-sectional study.

BackgroundPeople living with HIV (PLWH) face new challenges such as accelerated ageing and higher rates of comorbidities including cardiovascular, renal and metabolic diseases as they age.ObjectivesTo profile the demographic and clinical characteristics of elderly patients receiving HIV care at Newlands Clinic (NC), Harare, Zimbabwe, as of 01 October 2019.MethodsA cross-sectional analysis was conducted using clinic data. All patients who were 50 years and older on 01 October 2019 were enrolled. Descriptive statistics (medians, interquartile ranges [IQRs] and proportions) were used to describe patient demographic and clinical characteristics.ResultsOut of 6543 patients undergoing care at NC, 1688 (25.8%) were older than 50 years. The median duration of antiretroviral therapy (ART) was 10.9 years (IQR: 7.1–13). Over 90% of all patients had an HIV viral load below 50 copies/mL. Women were more likely than men to be overweight and obese (32% and 25% vs. 18% and 7%, respectively). Hypertension (41.2%), arthritis (19.9%) and chronic kidney disease (11.6%) were common comorbidities differently distributed based on sex. The most common malignancy diagnosed in women was cervical intra-epithelial neoplasia (68% of cancer burden in women) and Kaposi sarcoma was the leading malignancy in men (41% of cancer burden in men). Nearly 20% of patients had at least two chronic non-communicable comorbidities and 5.6% had at least three.ConclusionA high burden of comorbidities was observed amongst HIV-positive elderly patients receiving ART. Age-appropriate monitoring protocols must be developed to ensure optimum quality of care for elderly HIV-positive individuals.

Sex and cognition: Relationships with tau PET across the Alzheimer’s disease spectrum

AbstractBackgroundRecent evidence suggests that tau accumulates differently in the brains of men and women with Alzheimer’s disease (AD), with greater neurofibrillary tangles in women especially in the MCI stage. Women show a reserve in verbal memory but then more rapid decline in this domain once they are symptomatic. Since regional tau deposition is closely tethered to cognitive symptoms, we were interested in how relationships between tau distribution and cognition might differ by sex.MethodData were extracted from the AD Neuroimaging Initiative database for participants (136 women, 139 men) who were amyloid PET positive and had flortaucapir (“tau”) PET, across clinical diagnoses of normal cognition (NC), mild cognitive impairment (MCI) and AD. Vertex‐wise analyses were conducted in FreeSurfer, quantifying the vertices with above‐threshold SUVR and assessing regional distribution. We compared overall burden in men and women, and further investigated results by ApoE status and diagnosis and assessed how regional tau burden related to different cognitive scores.ResultsWomen and men did not differ on overall amount of tau PET uptake, but there was a sex by diagnosis interaction on overall tau SUVr. On further analysis (figure 1) this was driven by higher SUVr in women in the MCI stage (F(1, 85) = 7.313, p = .008). Furthermore, women with a higher tau burden scored worse across verbal memory measures, whereas men with higher tau burdens demonstrated worse performance on processing speed and executive measures. This was reflected in topological representation of the tau burden by cognitive test (figure 2).ConclusionSex differences in the expression of AD correspond to differences in tau especially at the MCI stage. Higher tau in women is reflected in reduced performance in verbal memory, while higher tau in men reflects worse performance on executive measures. These findings point to the differences in trajectories of tau deposition in men and women and the relationship of tau to sex differences in cognitive findings.

Abstract PO-192: Exploring the contribution of introgressed ancient DNA to prostate cancer racial disparity

Abstract Introduction Prostate cancer is the most common cancer in men and there is racial disparity in prostate cancer incidence and mortality globally, with greater disease burden in men of African ancestry, followed by European ancestry and least in men of Asian ancestry. The etiology of prostate cancer is not fully understood but includes genetic and environmental factors. Present day non-Africans are reported to have introgressed DNA from Neanderthal and Denisovan ancestors. Over 170 prostate cancer associated single nucleotide polymorphisms (SNPs) have been identified from several genome-wide association studies (GWAS), with SNPS on chromosomes 2, 8 and 22 reported as showing variation between African and non-African men with prostate cancer. We performed analysis of prostate cancer associated SNPs on chromosomes 2, 8 and 22 to determine if DNA introgression could explain the racial variation. Methods We obtained data on prostate cancer associated SNPs from the GWAS catalog (https://www.ebi.ac.uk/gwas) and from reports that were not included in the catalog. Using an Ancient Genome Browser provided by the Max Plank Institute (https://www.eva.mpg.de/genetics/genome-projects/neandertal/index.html), we determined whether SNPs on chromosomes 2, 8 and 22 were present in African, Neanderthal or Denisovan genomes. Based on the results, we inferred that SNPs were introgressed if they were present in Neanderthal or Denisovan genomes but absent from African genomes. Results 49, 59 and 17 prostate cancer SNPs were reported in chromosomes 2, 8 and 22 respectively. 23/49 in ch2, 25/59 in c 8 and 9/17 in ch22 were present in in Neanderthal and or Denisovan genomes. SNPs in ch2 (rs13403657, rs12621278) and ch8 (rs7825414) were present in Neanderthal or Denisovan genomes but absent in African genomes. These SNPs lie in regions that have previously been reported to harbour introgressd DNA. Conclusion Our analyses identified prostate cancer associated SNPs that are likely to have been introgressed into present day non-Africans by extinct Neanderthal and Denisovan ancestors. Phenotypic changes caused by introgressed DNA could be contributing to racial disparities in prostate cancer in present day humans. Citation Format: Evi O. Useh, Suresh Venugopal, Chidi N. Molokwu. Exploring the contribution of introgressed ancient DNA to prostate cancer racial disparity [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-192.

Chronic Pain in Relation to Depressive Disorders and Alcohol Abuse

Chronic pain disorders have been associated separately with neuropsychiatric conditions such as depression and alcohol abuse. However, in individuals who suffer from non-cancer chronic pain disorders, it is not clear if the burden of depressive disorders is similar for those with and without a history of alcohol abuse. Using data from the Collaborative Psychiatric Epidemiology Surveys (CPES), we found depressive disorders to have a high burden in men and women with a history of alcohol abuse, independently of the presence or absence of chronic pain. We also found that, although the incidence of persistent depressive disorder was comparable in men and women with a history of alcohol abuse, and significantly higher than in control men and women, the incidence of a major depressive episode was higher in women with a history of alcohol abuse independently of the presence or absence of chronic pain. The age of onset of depressive disorders, independently of pain status, was younger for individuals with a history of alcohol abuse. The findings of this study have important implications for the clinical management of individuals who suffer from chronic pain comorbidly with depression and/or alcohol abuse.

Technology-Based Psychosocial Intervention to Improve Quality of Life and Reduce Symptom Burden in Men with Advanced Prostate Cancer: Results from a Randomized Controlled Trial.

Men with advanced prostate cancer (APC) face multiple challenges including poor prognosis, poor health-related quality of life (HRQOL), and elevated symptom burden. This study sought to establish the efficacy of a tablet-delivered, group-based psychosocial intervention for improving HRQOL and reducing symptom burden in men with APC. We hypothesized that men randomized to cognitive-behavioral stress management (CBSM) would report improved HRQOL and reduced symptom burden relative to men randomized to an active control health promotion (HP) condition. Condition effects on intervention targets and moderators of these effects were explored. Men with APC (N = 192) were randomized (1:1) to 10-week tablet-delivered CBSM or HP, and followed for 1year. Multilevel modeling was used to evaluate condition effects over time. Changes in HRQOL and symptom burden did not differ between groups. Men in both groups improved across several intervention targets; men in the CBSM condition reported greater increases in self-reported ability to relax, and both conditions showed improvements in cancer-related anxiety, cancer-related distress, and feelings of cohesiveness with other patients over time. Moderating factors included baseline interpersonal disruption, fatigue, and sexual functioning. Tablet-delivered CBSM and HP were well received by men with APC. The hypothesized effects of CBSM on HRQOL and symptom burden were not supported, though improvements in intervention targets were observed across conditions. Participants reported high-baseline HRQOL relative to cancer and general population norms, possibly limiting intervention effects. The identified moderating factors should be considered in the development and implementation of interventions targeting HRQOL and symptom burden. ClinicalTrials.gov Identifier: NCT03149185.

"It Makes a Fellow Feel Responsible!": Anglo-American Imperial Vistas and "The White Man's Burden" in McClure's Magazine, 1898–99

"It Makes a Fellow Feel Responsible!"Anglo-American Imperial Vistas and "The White Man's Burden" in McClure's Magazine, 1898–99 Laura Jeffries While Rudyard Kipling's immeasurably famous poem "The White Man's Burden" generally is seen as an example of British imperial literature, looking at the material context of its publication in American periodicals also illustrates how it contributed to and mirrored American discourse about empire just after the conclusion of the Spanish-American War. First published in the February 1899 issue of McClure's Magazine, advertised on the cover and replacing the customary frontispiece, "The White Man's Burden" also appeared in newspapers across the United States within a few days.1 In the poem, the de facto literary voice of the British Empire, speaking directly to the American public, encouraged the United States to annex the Philippines after expelling Spain from the islands less than a year earlier.2 Kipling—a transnational figure with powerful connections in the American political and media landscape—and his poem energized this conversation while also reflecting rhetoric that was already pervasive in the U.S., and in mass-market magazines like McClure's in particular.3 The six issues of McClure's volume twelve (November 1898 to April 1899) offer a portrait of the milieu into which an influential English author and a powerful American publisher inserted this imperialist poem. As we will see, the poem and its famous author-as-cultural-symbol were very much at home in the pages of McClure's, reifying a collection of ideas about manifest destiny, Anglo-American identity, and the realities of white imperialism abroad. Examples throughout this volume of the affordable and advertisement-laden McClure's suggest a large readership that envisioned a beneficently Anglo-American and Christian global future while the nation—which had recently realized its first "manifest destiny" across much of North America—began expanding into spaces disconnected from the mainland. In this [End Page 169] paper, I sift through these unexplored primary sources, thickening our description of the poem's provenance by reconstructing the conversation of a segment of culture that participated—publishing, writing, reading—in one side of the debate over American imperial expansion.4 Combining a transnational perspective with scholarship on the cultural impacts of turn-of-the-century publishing and American Anglo-Saxonism after the rapprochement, this extended case study adds to a growing collection of inter-imperial histories of the United States and Great Britain.5 Ian Tyrrell's important work on American empire encourages the "study of the transnational spaces—mental and material—that individuals and groups created outside of nation."6 McClure's is just such a space. The selected 1898–99 volume provides a convenient boundary since the poem, the only part that has received attention so far, appeared virtually in the middle of the volume and within a week of the ratification of the Treaty of Paris. Thus, volume twelve provides a partial snapshot of American culture—insofar as one magazine can portray it and convey it—at a moment that has, for so many historians, marked the beginning of US overseas imperial history. Though the significance of the McClure's magazine context for "The White Man's Burden" has not been well explored, recent discussions of how imperial literature in English was circulated and received and of Kipling's role in global opinion-making provide a critical backdrop. John Lee's 2014 article "King Demos and His Laureate" uses newspaper archives to clarify an important point for scholarship, that the poem was initially published in McClure's and a few other American newspapers on the first day of February, several days before it was reprinted in England.7 Lee is concerned with Kipling's calculated use of the newspaper poem as a transatlantic medium, but his discussion of the magazine's national reach and enormous circulation of about 369,000 copies—as well as his use of recent biographical scholarship to discuss Kipling's presence in America—help to establish the poem's influence in American culture and its essentially American identity.8 For my purposes, this matters because McClure's is so often mentioned as a secondary...