The predictive utility of attitudes toward hookah tobacco smoking

OBJECTIVE

To determine associations between positive and negative attitudes and hookah tobacco smoking (HTS) among college students.

METHODS

Among a random sample of university students (N = 852), multivariable logistic regression models assessed associations between positive and negative attitudes toward HTS.

RESULTS

Positive attitudes were associated with adjusted odds of 4.32 (95% CI = 3.20, 5.82) for current HTS, whereas negative attitudes were associated with lower adjusted odds for current smoking HTS (AOR = 0.64, 95% CI = 0.53, 0.76). Positive attitudes were also associated with adjusted odds of 9.31 (95% CI = 6.77, 12.80) for intention for future hookah use among non-HTS users.

CONCLUSION

Positive attitudes toward HTS were more strongly associated with HTS compared to negative attitudes. It may be particularly valuable for future research and interventions to focus on decreasing positive attitudes toward HTS.

Improving informed consent with minority participants: results from researcher and community surveys

Strengthening the informed consent process is one avenue for improving recruitment of minorities into research. This study examines that process from two different perspectives, that of researchers and that of African American and Latino community members. Through the use of two separate surveys, we compared strategies used by researchers with the preferences and attitudes of community members during the informed consent process. Our data suggest that researchers can improve the informed consent process by incorporating methods preferred by the community members along with methods shown in the literature for increasing comprehension. With this approach, the informed consent process may increase both participants' comprehension of the material and overall satisfaction, fostering greater trust in research and openness to future research opportunities.

Characterizing researchers by strategies used for retaining minority participants: results of a national survey

Limited attention has been given to the optimal strategies for retaining racial and ethnic minorities within studies and during the follow-up period. High attrition limits the interpretation of results and reduces the ability to translate findings into successful interventions. This study examined the retention strategies used by researchers when retaining minorities in research studies. From May to August 2010, we conducted an online survey with researchers (principal investigators, research staff, and IRB members) and examined their use of seven commonly used retention strategies. The number and type of retention strategies used, how these strategies differ by researcher type, and other characteristics (e.g., funding) were explored. We identified three clusters of researchers: comprehensive retention strategy researchers - utilized the greatest number of retention strategies; moderate retention strategy researchers - utilized an average number of retention strategies; and limited retention strategy researchers - utilized the least number of retention strategies. The comprehensive and moderate retention strategy researchers were more likely than the limited retention strategy researchers to conduct health outcomes research, work with a community advisory board, hire minority staff, use steps at a higher rate to overcome retention barriers, develop new partnerships with the minority community, modify study materials for the minority population, and allow staff to work flexible schedules. This study is a novel effort to characterize researchers, without implying a value judgment, according to their use of specific retention strategies. It provides critical information for conducting future research to determine the effectiveness of using a combination of retention strategies.

Optimal place of a foreign gene in the genome of viral haemorrhagic septicaemia virus (VHSV) for development of VHSV-based viral-vectored vaccines

AIM

As the strength and duration of immune responses can be regulated by the antigen dose, higher expression of foreign antigens in the viral-vectored vaccines would be an important factor for inducing effective immune responses. The aim of this study was to determine the optimal insertion place of a foreign antigen gene in the genome of viral haemorrhagic septicaemia virus (VHSV) for development of VHSV-based viral-vectored vaccines.

METHODS AND RESULTS

Recombinant VHSVs (rVHSVs) harbouring the red fluorescent protein (RFP) gene between N and P (rVHSV-A-RFP), P and M (rVHSV-B-RFP), or M and G genes (rVHSV-C-RFP) in the genome were rescued by reverse genetics. Their replication ability and expression level of RFP were compared according to the inserted locations. The viral titres of each rVHSV were not significantly different. However, Epithelioma papulosum cyprini (EPC) cells infected with rVHSV-A-RFP or rVHSV-B-RFP showed clearly higher fluorescence than cells infected with rVHSV-C-RFP. There was no significant difference in RFP expression between cells infected with rVHSV-A-RFP and rVHSV-B-RFP.

CONCLUSIONS

The present results indicate that insertion of a foreign gene between N and P, or P and M genes of VHSV genome would be advantageous for development of VHSV-based viral-vectored vaccines.

SIGNIFICANCE AND IMPACT OF THE STUDY

The present work is the first report on the optimal location of a foreign gene in VHSV genome for high expression, and the locations identified in this study would be suitable for the development of VHSV-based viral-vectored vaccines.

The course of depression, inflammation in the serum and tumor microenvironment, and survival in the context of advanced cancer

9507

Background: The aims of the present study were to study the course of depression in patients diagnosed with cancer and the link with biomarkers of inflammation in the serum or tumor microenvironment and survival. Methods: A total of 474 patients diagnosed with advanced cancer were administered the Center for Epidemiological Studies-Depression (CES-D) scale every 2-months and blood samples were drawn to assess biomarkers of inflammation in the serum and tumor microenvironment. The course of depression was estimated using a semi-parametric trajectory analyses and cross-lagged panel analyses were performed to assess the link between depression and biomarkers of inflammation. Cox regression analysis was use to test the link between depression and survival while adjusting for demographic and disease specific factors. Results: A three-class solution was chosen based on Bayesian information criterion and theory. The first class, “not depressed,” with a mean CES-D score of 6.7 at baseline contained 32% of patients and no significant change in depression scores across time. The second class, “mildly depressed” (53% of sample) had a significant increase in the mean CES-D from 14.5 at baseline to 18.0 at 12 months and 20.0 at 16 months [B = .35, z = 3.12, p = .002]. The third class, “severely depressed,” with a mean of 31.5 at baseline (15% of patients) and no significant change win depression over 24 months. Depression predicted serum levels of Tumor Necrosis Factor (TNF)-alpha and Interleukin-1alpha at subsequent time points and was associated with High Mobility Group Box 1 in the tumor microenvironment. Trajectory group assignment significantly predicted survival after demographic and disease specific factors were adjusted (p=0.04). The non-depressed trajectory group had a median survival of 13 months (95%CI=8.9-17.1), the mildly depressed group median survival was 10 months (95% CI 7.1-12.9) and the severely depressed group median survival was 6 months (95% CI=7.6-12.4). Conclusions: These findings may facilitate the targeting of psychosocial and biological interventions to reduce depression symptoms, improve quality of life, and potentially slow disease progression.

Characteristics of American young adults with increased risk for type 2 diabetes: a pilot study

PURPOSE

The purpose of the study was to examine the characteristics of American young adults with increased risk for type 2 diabetes (T2D).

METHODS

Participants ages 18 to 29, overweight/obese, and sedentary were recruited from the metro Atlanta area in the United States. Variables included demographics, anthropometric and clinical variables, and physical activity. Of 107 participants, 3 participants had undiagnosed diabetes and 1 participant did not complete the modifiable activity questionnaire. Thus, 103 young adults remained for the final data analysis.

RESULTS

Most participants were females and African Americans. About 30% of participants had prediabetes, either impaired fasting glucose, an A1C of 5.7% to 6.4%, or both. Overall, prediabetes young adults were heavier and did less physical activity than Diabetes Prevention Program (DPP) trial participants. In addition, these young adults had a higher prevalence of parental T2D history and lower level of physical activity compared to young adults with normoglycemia.

CONCLUSIONS

Physical activity and parent T2D history are key risk factors for identifying young adults with prediabetes. Multilevel strategies are necessary to raise awareness of diabetes risk and to prevent T2D in young adults.

Exploring communication, trust in government, and vaccination intention later in the 2009 H1N1 pandemic: results of a national survey

With the growing recognition of the critical role that risk communication plays in a public health emergency, a number of articles have provided prescriptive best practices to enhance such communication. However, little empirical research has examined perceptions of the quality of communication, the impact of uncertainty on changing communication, use of information sources, and trust in specific government spokespersons. Similarly, although there is significant conceptual focus on trust and communication as important in vaccination intent and acceptance, little research has explored these relationships empirically. We conducted an online survey in late January 2010 with a nationally representative sample (N=2,079) that included Hispanic and African American oversamples. The completion rate was 56%. We found that public health officials were the most trusted spokespersons, with President Obama being the most highly trusted elected official. Demographic variables, including race, accounted for 21% of the variance in trust of the president. Perceptions of the quality of communication were high, including significant understanding of uncertainty and appreciation for officials' openness about evolving information. Other factors that contributed to vaccination acceptance were quality of communication, closely following the news, and confidence in the vaccine because of a role model effect of the Obama daughters' immunizations; these factors significantly increased trust in government actions. Because the challenges of communication often vary over the course of a pandemic, there is a consistent need to pay close attention to both communication content and delivery and prepare public health officials at all levels to be effective communicators.

A multi-microbe probiotic formulation processed at low and high drying temperatures: effects on growth performance, nutrient retention and caecal microbiology of broilers

1. Two experiments were conducted to evaluate a multi-microbe probiotic formulation processed at low (LT) or high (HT) drying temperature. 2. In both the experiments, 640 d-old Ross male chicks were randomly allotted to 4 treatments on the basis of initial BW for 35 d experiments. 3. In experiment one, dietary treatments were a negative control (NC; basal diet without any antimicrobial); positive control (PC; basal diet +10 mg/kg avilamycin); basal diet with 0·3% probiotic LT; and basal diet with 0·3% probiotic HT. 4. Improved overall weight gain, FCR and retention of CP were observed in birds fed the PC and probiotic diets when compared with birds fed the NC diet. At d 21, birds fed the probiotic and NC diets had more caecal Bifidobacterium and total anaerobes than birds fed the PC diet; while birds fed the PC and probiotic diets had fewer caecal Clostridium than birds fed the NC diet at d 35. 5. In experiment two, a 2 × 2 factorial arrangement of treatments was employed to evaluate the effects of two concentrations of probiotic HT (0·30 or 0·60%) and avilamycin (0 or 10 mg/kg). 6. Birds fed the 0·60% probiotic HT diet showed improved overall weight gain and CP retention, higher Lactobacillus and Bifidobacterium in the caecum, and reduced Clostridium and coliforms in the caecum. Inclusion of avilamycin improved the overall weight gain and feed intake, and reduced the caecal Clostridium and Bifidobacterium population. 7. In conclusion, high drying temperature had no effect on the efficacy of the multi-microbe probiotic formulation; while the probiotic HT formulation was more effective at the 0·60% level. Moreover, inclusion of avilamycin improved performance of birds but did not have any interaction with probiotics.

Fatty acid biosynthesis and lipogenic enzyme activities in subcutaneous adipose tissue of feedlot steers fed supplementary palm oil or soybean oil

We hypothesized that supplementing finishing diets with palm oil would promote adipocyte differentiation in subcutaneous adipose tissue of feedlot steers, and that soybean oil supplementation would depress adipocyte differentiation. Twenty-eight Angus steers were assigned randomly to 3 groups of 9 or 10 steers and fed a basal diet without additional fat (control), with 3% palm oil (rich in palmitic acid), or with 3% soybean oil (rich in polyunsaturated fatty acids), for 10 wk, top-dressed daily. Palm oil had no effect (P > 0.05) on ADG, food intake, or G:F, whereas soybean oil depressed ADG (P = 0.02), food intake (P = 0.04), and G:F (P = 0.05). Marbling scores tended (P = 0.09) to be greater in palm oil-fed steers (Modest(09)) than in soybean oil-fed steers (Small(55)). Subcutaneous adipocyte mean volume was greater in palm oil-fed steers (515.9 pL) than in soybean-supplemented cattle (395.6 pL; P = 0.01). Similarly, glucose and acetate incorporation into total lipids in vitro was greater in subcutaneous adipose tissue of palm oil-fed steers (119.9 and 242.8 nmol·3h(-1)·10(5) cells, respectively) than adipose tissue of soybean oil-fed steers in (48.9 and 95.8 nmol·3h(-1)·10(5) cells, respectively). Glucose-6-phosphate dehydrogenase and NADP-malate dehydrogenase activities were greater (P ≤ 0.05) in subcutaneous adipose tissue of palm oil-fed steers than in adipose tissue of control steers. Palm oil did not increase palmitic acid or decrease oleic acid in subcutaneous adipose tissue or LM, but decreased (P ≤ 0.05) myristoleic, palmitoleic, and cis-vaccenic acid in adipose tissue, indicating a depression in stearoyl-coenzyme A desaturase activity. Soybean oil increased the proportion of α-linolenic acid in adipose tissue and muscle and increased linoleic acid and 18:1trans-10 in muscle. We conclude that palm oil supplementation promoted lipid synthesis in adipose tissue without depressing feed efficiency or increasing the palmitic acid content of beef.

White and black adolescent females differ in profiles and longitudinal patterns of alcohol, cigarette, and marijuana use

Emerging research suggests that white youth are more likely to show continuity of alcohol use in the year after drinking onset, compared with black youth. Little is known, however, regarding racial differences in year-to-year continuity of alcohol, cigarette, and marijuana use during adolescence, particularly among females, who are at greater risk for certain substance-related harm than males. This study used latent class/transition analysis to identify profiles of past year alcohol, cigarette, and marijuana use at ages 13-17 in a community sample of 1076 adolescent females (57% black, 43% white). Three profiles of past year substance use were identified in separate analyses by race: "no use," "alcohol only," and "polydrug use." Although similar labels describe the profiles, the probability of endorsing use of a particular substance for a given profile differed by race, precluding direct comparison. Latent transition analyses of five annual waves covering ages 13-17 indicated that an intermittent pattern of use (e.g., use in one year, but not the next) was relatively low at all ages among white girls, but among black girls, an intermittent pattern of use began to decline at age 15. Among black girls, conduct problems at age 12 predicted substance using profiles at age 13, whereas among white girls, intentions to use alcohol and cigarettes at age 12 predicted substance using profiles at age 13. Racial differences in girls' substance use profiles suggest the potential utility of culturally tailored interventions that focus on differences in risk for specific substances and relatively distinct early patterns of use.

Secondhand smoke exposure and osteoporosis in never-smoking postmenopausal women: the Fourth Korea National Health and Nutrition Examination Survey

SUMMARY

The association between secondhand smoke (SHS) exposure and lumbar and femoral neck osteoporosis was assessed in postmenopausal never-smoking Korean women. The presence of family members who actively smoked was associated with femoral neck osteoporosis. The number of cigarettes consumed by cohabitant smokers was positively associated with lumbar and femoral neck osteoporosis.

INTRODUCTION

This study aimed to assess the association between SHS and postmenopausal osteoporosis.

METHODS

Of 2,067 postmenopausal women (age, ≥55 years) participating in the Fourth Korea National Health and Nutrition Examination Survey, 925 never-smokers identified through interviews and urinary cotinine level verification were enrolled. Cross-sectional relationships between self-reported SHS exposure and osteoporosis of the lumbar vertebrae and femoral neck (defined using the World Health Organization T-score criteria) were investigated by bone densitometry.

RESULTS

Participants having actively smoking family members showed increased adjusted odds ratio (aOR) for femoral neck osteoporosis compared with participants not exposed to SHS (aOR, 3.68; 95 % confidence interval [CI], 1.23-10.92). Participants whose cohabitant smokers consumed any number of cigarettes per day showed increased occurrences for lumbar and femoral neck osteoporosis compared with the nonexposed group. Participants whose cohabitant smokers consumed ≥20 cigarettes/day showed increased aORs for lumbar (aOR, 5.40; 95 % CI, 1.04-28.04) and femoral neck (aOR, 4.35; 95 % CI, 1.07-17.68) osteoporosis compared with participants not exposed to SHS.

CONCLUSIONS

In postmenopausal never-smoking Korean women, exposure to SHS was positively associated with osteoporosis. This finding further emphasizes a need to identify vulnerable groups exposed to SHS to increase bone health.

Associations of mental health problems with waterpipe tobacco and cigarette smoking among college students

Associations between the emerging trend of waterpipe tobacco smoking and mental health among college students have not been sufficiently explored. This study analyzed data collected from 152 academic institutions that participated in the National College Health Assessment during the 2008-2009 academic year to examine associations between mental health and waterpipe tobacco smoking among college students (N = 100,891). For comparison, cigarette smoking was also examined. Associations with mental health variables were very strong for cigarette smoking but only moderate for waterpipe smoking. Study implications and limitations are noted.

Associations between hookah tobacco smoking knowledge and hookah smoking behavior among US college students

Hookah tobacco smoking is increasing among US college students, including those who would not otherwise use tobacco. Part of hookah's appeal is attributed to the perception that hookah is less harmful than cigarettes. The aims of this study were to assess knowledge of harmful exposures associated with hookah smoking relative to cigarette smoking and to determine associations between this knowledge and hookah smoking outcomes. Students (N = 852) at the University of Florida were randomly sampled via e-mail to obtain information on demographics, hookah smoking behavior and knowledge of five exposures (e.g. tar and nicotine). Multivariable logistic regression models assessed independent associations between knowledge and hookah smoking outcomes. Of the five factual knowledge items asked, 475 (55.8%) of the respondents answered none correctly. In multivariable models, correct responses to any knowledge items were not associated with lower odds of hookah smoking or susceptibility to hookah smoking in the future. Although college students are largely unaware of the toxicant exposures associated with hookah smoking, there is little association between knowledge and hookah smoking behavior.

Genetic variation of FASN is associated with fatty acid composition of Hanwoo

The objective of this study was to identify genetic variants in the bovine fatty acid synthase (FASN) gene and to evaluate associations with fatty acid composition from longissimus lumborum muscle using 90 purebred Hanwoo steers. Sequence alignments observed 6 genetic variants located in exons 20, 24, 32, 34, and 39, and PCR-RFLP analysis confirmed these variations. Genotypes of the g.15532A>C locus were significantly associated with Linolenic acid (C18:3), and genotypes of the g.17924G>A locus were significantly associated with Palmitic (C16:0), Palmitoleic (C16:1), Oleic (C18:1), saturated fatty acids, and unsaturated fatty acids. The analysis revealed that SFA and UFA showed significant correlations with fatty acid composition (Myristic (C14:0), Palmitic (C16:0), Stearic (C18:0), Oleic (C18:1), and Eicosenoic (C20:1) acids). Oleic acid (C18:1) was negatively correlated with Myristic (C14:0), Palmitic (C16:0), and Palmitoleic (C16:1) acids (P<0.001).

Further Evidence of Contrasting Phenotypes Caused by Reciprocal Deletions and Duplications: Duplication of NSD1 Causes Growth Retardation and Microcephaly

Microduplications of the Sotos syndrome region containing NSD1 on 5q35 have recently been proposed to cause a syndrome of microcephaly, short stature and developmental delay. To further characterize this emerging syndrome, we report the clinical details of 12 individuals from 8 families found to have interstitial duplications involving NSD1, ranging in size from 370 kb to 3.7 Mb. All individuals are microcephalic, and height and childhood weight range from below average to severely restricted. Mild-to-moderate learning disabilities and/or developmental delay are present in all individuals, including carrier family members of probands; dysmorphic features and digital anomalies are present in a majority. Craniosynostosis is present in the individual with the largest duplication, though the duplication does not include MSX2, mutations of which can cause craniosynostosis, on 5q35.2. A comparison of the smallest duplication in our cohort that includes the entire NSD1 gene to the individual with the largest duplication that only partially overlaps NSD1 suggests that whole-gene duplication of NSD1 in and of itself may be sufficient to cause the abnormal growth parameters seen in these patients. NSD1 duplications may therefore be added to a growing list of copy number variations for which deletion and duplication of specific genes have contrasting effects on body development.

On the relationship among social anxiety, intimacy, sexual communication, and sexual satisfaction in young couples

This study was conducted to better understand why socially anxious individuals experience less sexual satisfaction in their intimate partnerships than nonanxious individuals, a relationship that has been well documented in previous research. Effective communication between partners is an important predictor of relationship satisfaction. Sexual communication, an important aspect of communication between romantic partners, is especially sensitive for couples given the vulnerability inherent in being open about sexual issues. Because socially anxious individuals characteristically report fear of evaluation or scrutiny by others, we hypothesized that the process of building intimacy by sharing personal information about oneself with one's partner, including when this information relates to one's sexuality and/or the sexual domain of the relationship, would be particularly difficult for socially anxious individuals. The present study examined fear of intimacy and sexual communication as potential mediators of the relationship between higher social anxiety and lower sexual satisfaction. Self-report data were collected from 115 undergraduate students and their partners in monogamous, heterosexual, committed relationships of at least 3 months duration. Multilevel path modeling revealed that higher social anxiety predicted higher fear of intimacy, which predicted lower satisfaction with open sexual communication, which, in turn, predicted lower sexual satisfaction. Additionally, there was evidence of mediation as there were significant indirect effects of the antecedent variables on sexual satisfaction. The path model had excellent fit. Implications for social anxiety, intimate relationships, and couples therapy are discussed.

How different are their experiences and outcomes? Comparing aged out and other child welfare involved youth

This paper adds to the growing body of research examining the experiences of youth aging out of the child welfare system. Through a comparison of youth aging out with two other groups of child welfare-involved youth-those whose families received child welfare services but were never placed out of home and those who were in out-of-home placement but did not age out-it presents a profile of their care careers and other system involvement (e.g., mental health, justice system). Analyses indicate that young people aging out of care have experienced significant amounts of time in out-of-home placement, a great deal of placement instability, and high levels of other system involvement. In general, their involvement is more extensive than that of the two comparison groups. However, the justice system involvement of youth who experienced out-of-home placement but did not age out is just as high as that of youth who have aged out. This finding highlights the importance of devoting resources not only to youth aging out of care but also to similarly-aged young people with prior child welfare involvement.

Effect of co-existing copper and calcium on the removal of As(V) by reused aluminum oxides

Among the various heavy metals, arsenic is frequently found in abandoned mine drainage and the environmental fate of arsenic in real aqueous solutions can be highly dependent on the presence of co-existing ions. In this study, removal of arsenate through adsorption on the reused aluminum oxide or through precipitation was investigated in a single and in a binary system as a function of pH and concentration. Different removal behaviors of arsenate were observed in the presence of different cations as well as a variation of the molar ratios of arsenate to cations. Co-operative effects on arsenate removal by precipitation in solution occurred with an increase of copper concentration, while a decrease of arsenate removal resulted in increasing calcium concentration. It was observed that the arsenate removal in the presence of calcium would be highly dependent on the molar ratios of both elements.

Waterpipe smoking among U.S. university students

INTRODUCTION

While cigarette use is declining, smoking tobacco with a waterpipe is an emerging trend. We aimed to determine the prevalence of waterpipe use in a large diverse sample of U.S. university students and to assess the association of waterpipe use with individual and institution-related characteristics.

METHODS

We assessed students from 152 U.S. universities participating in the National College Health Assessment during 2008-2009. We used multivariable regression models to determine independent associations between individual and institutional characteristics and waterpipe tobacco use in the past 30 days and ever.

RESULTS

Of 105,012 respondents included in the analysis, most were female (65.7%), White (71.2%), and attending public (59.7%) nonreligious (83.1%) institutions. Mean age was 22.1 years. A total of 32,013 (30.5%) reported ever using a waterpipe to smoke tobacco. Rates for current tobacco use were 8.4% for waterpipes, 16.8% for cigarettes, 7.4% for cigars (including cigarillos), and 3.5% for smokeless tobacco. Of current waterpipe users, 51.4% were not current cigarette smokers. Although current waterpipe use was reported across all individual and institutional characteristics, fully adjusted multivariable models showed that it was most strongly associated with younger age, male gender, White race, fraternity/sorority membership, and nonreligious institutions in large cities in the western United States.

CONCLUSIONS

After cigarettes, waterpipe use was the most common form of tobacco use among university students. Because waterpipe use affects groups with a wide variety of individual and institutional characteristics, it should be included with other forms of tobacco in efforts related to tobacco surveillance and intervention.

Inverse relationship of interleukin-6 and mast cells in children with inflammatory and non-inflammatory abdominal pain phenotypes

AIM: To investigate interleukin-6 (IL-6), mast cells, enterochromaffin cells, 5-hydroxytryptamine, and substance P in the gastrointestinal mucosa of children with abdominal pain.

METHODS: Formalin-fixed paraffin-embedded gastrointestinal biopsy blocks from patients (n = 48) with non-inflammatory bowel disease (irritable bowel syndrome and functional abdominal pain) and inflammatory bowel disease were sectioned and stained for IL-6, mast cells, enterochromaffin cells, 5-hydroxytryptamine, and substance P. All children had chronic abdominal pain as part of their presenting symptoms. Biopsy phenotype was confirmed by a pathologist, blinded to patient information. Descriptive statistics, chi-square, and independent sample t tests were used to compare differences between the inflammatory and non-inflammatory groups.

RESULTS: The cohort (n = 48), mean age 11.9 years (SD = 2.9), 54.2% females, 90% Caucasian, was comprised of a non-inflammatory (n = 26) and an inflammatory (n = 22) phenotype. There was a significant negative correlation between substance P expression and mast cell count (P = 0.05, r = -0.373). Substance P was found to be expressed more often in female patient biopsies and more intensely in the upper gastrointestinal mucosa as compared to the lower mucosa. There were significantly increased gastrointestinal mucosal immunoreactivity to IL-6 (P = 0.004) in the inflammatory phenotype compared to non-inflammatory. Additionally, we found significantly increased mast cells (P = 0.049) in the mucosa of the non-inflammatory phenotype compared to the inflammatory group. This difference was particularly noted in the lower colon biopsies.

CONCLUSION: The findings of this study yield preliminary evidence in identifying biomarkers of undiagnosed abdominal pain in children and may suggest candidate genes for future evaluation.

Effects of synchronization of carbohydrate and protein supply in total mixed ration with korean rice wine residue on ruminal fermentation, nitrogen metabolism and microbial protein synthesis in holstein steers

Three Holstein steers in the growing phase, each with a ruminal cannula, were used to test the hypothesis that the synchronization of the hourly rate of carbohydrate and nitrogen (N) released in the rumen would increase the amount of retained nitrogen for growth and thus improve the efficiency of microbial protein synthesis (EMPS). In Experiment 1, in situ degradability coefficients of carbohydrate and N in feeds including Korean rice wine residue (RWR) were determined. In Experiment 2, three total mixed ration (TMR) diets having different rates of carbohydrate and N release in the rumen were formulated using the in situ degradability of the feeds. All diets were made to contain similar contents of crude protein (CP) and neutral detergent fiber (NDF) but varied in their hourly pattern of nutrient release. The synchrony index of the three TMRs was 0.51 (LS), 0.77 (MS) and 0.95 (HS), respectively. The diets were fed at a restricted level (2% of the animal’s body weight) in a 3×3 Latin-square design. Synchronizing the hourly supply of energy and N in the rumen did not significantly alter the digestibility of dry matter, organic matter, crude protein, NDF or acid detergent fiber (ADF) (p>0.05). The ruminal NH₃-N content of the LS group at three hours after feeding was significantly higher (p<0.05) than that of the other groups; however, the mean values of ruminal NH₃-N, pH and VFA concentration among the three groups were not significantly different (p>0.05). In addition, the purine derivative (PD) excretion in urine and microbial-N production (MN) among the three groups were not significantly different (p>0.05). In conclusion, synchronizing dietary energy and N supply to the rumen did not have a major effect on nutrient digestion or microbial protein synthesis (MPS) in Holstein steers.

What is the importance of "halo" phenomenon around bone cement following vertebral augmentation for osteoporotic compression fracture?

We investigated the importance, risk factors, and clinical course of the radiolucent "halo" phenomenon around bone cement following vertebral augmentation for osteoporotic compression fracture. Preoperative osteonecrosis and a lump cement pattern were the most important risk factors for the peri-cement halo phenomenon, and it was associated with vertebral recollapse.

INTRODUCTION

We observed a newly developed radiolucent area around the bone cement following vertebral augmentation for osteoporotic compression fractures. Here, we describe the importance of the peri-cement halo phenomenon, as well as any associated risk factors and long-term sequelae.

METHODS

In total, 175 patients (202 treated vertebrae) were enrolled in this study. The treated vertebrae were subdivided into two groups: Group A (with halo, n = 32) and Group B (without halo, n = 170), and the groups were compared with respect to multiple preoperative (age, sex, BMD, preoperative osteonecrosis) and perioperative factors (operative approach: vertebroplasty or kyphoplasty; cement distribution pattern; cement leakage; cement volume), and postoperative results (VAS score, recollapse). Logistic regression analysis was used to evaluate the relationship between the incidence of the peri-cement halo and all of the parameters described above.

RESULTS

Rates of osteonecrosis were also significantly higher in Group A than in Group B (62.5% vs. 31.2%, p < 0.05), and kyphoplasty (KP) was performed more frequently in Group A (43.8% vs. 17.6%, p < 0.05). Lump cement (93.8% vs. 30.6%, p < 0.05) and recollapse (78.1% vs. 24.7%, p < 0.05) were also more common among individuals in Group A. Logistic regression analysis also showed that preoperative osteonecrosis (OR = 3.679; 95% CI = 1.677-8.073; p = 0.001), KP (OR = 3.630; 95% CI = 1.628-8.095; p = 0.002), lump pattern (OR = 13.870; 95% CI = 2.907-66.188; p = 0.001), and vertebral recollapse (OR = 5.356; 95% CI = 1.897-15.122; p = 0.002) were significantly associated with peri-cement halo.

CONCLUSIONS

The peri-cement halo was found to be associated with vertebral recollapse, this sign likely represents a poor prognostic factor after vertebral augmentation for osteoporotic compression fractures.

Understanding cultural issues in the diabetes self-management behaviors of Korean immigrants

PURPOSE

The purpose of this study was to explore potential factors affecting the self-management behaviors of Korean immigrants with type 2 diabetes mellitus (KIT2Ds).

METHODS

A qualitative descriptive design guided this study. Semistructured interviews lasting 45 to 60 minutes were conducted with 20 KIT2Ds in the participants' preferred language; in all cases, this was Korean. Each interview was audiotaped, transcribed, and analyzed using conventional content analysis. Data analysis was performed in two steps. The data written in Korean were initially analyzed by 3 bilingual researchers. A qualitative researcher then participated in the analysis to refine the findings for presentation to an English-speaking audience while staying true to the data and preserving the nuanced Korean meanings.

RESULTS

The mean age of the sample was 64. 5 ± 11.6 years (9 men and 11 women). The mean years of staying in the United States and age at diabetes mellitus diagnosis were 23.6 ± 9.7 years and 52.5 ± 12.3 years, respectively. Three major ideas were identified: (1) issues on treatment regimen related to medications and diet, (2) resources that helped or hindered ability to manage diabetes, and (3) the physician-patient relationship.

CONCLUSIONS

Important cultural nuances need to be addressed to better prepare KIT2Ds to manage their diabetes more effectively. A culture-specific program should extend beyond a diabetes self-management education delivered in Korean language. Rather, content and education methods need to consider acculturation effects on diabetes management behaviors.

Differences in the risk factors of reflux esophagitis according to age in Korea

The prevalence of gastroesophageal reflux disease in Korea has been believed to be low, but the incidence of gastroesophageal reflux disease in Korea is expected to increase because of the longer life expectancy and more ingestion of westernized food. The aim of this study was to report differences in the risk factors of reflux esophagitis (RE) according to age in Korea. We prospectively recruited the subjects who had RE among those who visited a health promotion center for upper gastrointestinal cancer surveillance at Hallym Medical Center (five institutions) between January 2008 and February 2009. The enrolled study participants comprised 742 subjects with RE and 1484 healthy controls. The independent risk factors of RE in young and adult group were male sex, smoking, coffee, body mass index ≥ 25, hiatal hernia, and Helicobacter pylori negativity. The risk factors of RE in elderly group were smoking, coffee, and hiatal hernia. The risk factors for RE according to age group were found to differ. In elderly group, Helicobacter pylori infection was not a significant protective factor contrary to young and adult groups.

Soluble Non-ammonia Nitrogen in Ruminal and Omasal Digesta of Korean Native Steers Supplemented with Soluble Proteins

An experiment was conducted to study the effect of soluble protein supplements on concentration of soluble non-ammonia nitrogen (SNAN) in the liquid phase of ruminal (RD) and omasal digesta (OD) of Korean native steers, and to investigate diurnal pattern in SNAN concentration in RD and OD. Three ruminally cannulated Korean native steers in a 3×3 Latin square design consumed a basal diet of rice straw and corn-based concentrate (control), and that supplemented (kg/d DM basis) with intact casein (0.24; IC) or acid hydrolyzed casein (0.46; AHC). Ruminal digesta was sampled using a vacuum pump, whereas OD was collected using an omasal sampling system at 2.0 h intervals after a morning feeding. The SNAN fractions (free amino acid (AA), peptide and soluble protein) in RD and OD were assessed using the ninhydrin assay. Concentrations of free AA and total SNAN in RD were significantly (p<0.05) lower than those in OD. Although free AA concentration was relatively high, mean peptide was quantitatively the most important fraction of total SNAN in both RD and OD, indicating that degradation of peptide to AA rather than hydrolysis of soluble protein to peptide or deamination may be the most limiting step in rumen proteolysis of Korean native steers. Diurnal variation in peptide concentration in OD for the soluble protein supplemented diets during the feeding cycle peaked 2 h post-feeding and decreased thereafter whereas that for the control was relatively constant during the entire feeding cycle. Diurnal variation in peptide concentration was rather similar between RD and OD.

Effects of exogenous enzyme supplementation to corn- and soybean meal-based or complex diets on growth performance, nutrient digestibility, and blood metabolites in growing pigs

Two experiments were conducted to determine the effects of dietary supplementation of exogenous enzymes on growth performance, apparent total tract digestibility (ATTD) of energy and nutrients, blood metabolites, fecal VFA, and fecal ammonia-N in growing pigs (Sus scrofa) fed a corn (Zea mays L.)- and soybean [Glycine max (L.) Merr.] meal (SBM)-based diet. In Exp. 1, 240 growing barrows (initial BW: 55.6 ± 0.9 kg) were randomly allotted to 5 treatments on the basis of BW. There were 4 replicates in each treatment with 12 pigs per replicate. The 5 treatments consisted of a corn-SBM-based control diet and 4 additional diets were similar to the control diet, with the exception that 0.05% β-mannanase (M), α-amylase + β-mannanase (AM), β-mannanase + protease (MPr), or α-amylase + β-mannanase + protease (AMP) was added to the diets, which were fed for 28 d. Pigs fed the AM, MPr, or AMP diet had greater (P < 0.05) ADG than pigs fed the control diet. Pigs fed the AMP diet also had greater (P < 0.05) ADG than pigs fed the M, AM, or MPr diet. Pigs fed the AMP diet had greater (P < 0.05) G:F than pigs fed the control diet. The G:F of the pigs fed the M, AM, or MPr diet were not different (P > 0.05) from the G:F in pigs fed the AMP or control diet. The ADFI, ATTD of nutrients, blood metabolites, and fecal VFA and ammonia-N concentrations were not different among treatments. In Exp. 2, 192 growing barrows (initial BW: 56.9 ± 1.0 kg) were allotted to 4 treatments. There were 4 replicates in each treatment with 12 pigs per replicate. Pigs were fed a corn-SBM-based diet (CSD) or a complex diet (CD) that contained corn, SBM, 3% rapeseed (Brassica napus L.) meal, 3% copra (Cocos nucifera L.) meal, and 3% palm (Elaeis guineensis Jacq.) kernel meal. Each diet was prepared without exogenous enzymes or with 0.05% AMP and all diets were fed for 28 d. The ADG and G:F of pigs fed the CSD were greater (P < 0.05) than pigs fed the CD. However, the type of diet had no effect on the ATTD of nutrients, blood metabolites, or fecal VFA and ammonia-N, and there was no diet × enzyme interaction for any of the measured variables. Supplementation of diets with exogenous enzymes resulted in greater (P < 0.05) ADG, G:F, ATTD of DM, GE, and CP, and blood urea nitrogen (BUN) concentration. These results indicate that supplementation of 0.05% of AMP enzymes to a corn-SBM diet or a complex diet may improve the performance of growing pigs.

Synchronized operation by field programmable gate array based signal controller for the Thomson scattering diagnostic system in KSTAR

The Thomson scattering diagnostic system is successfully installed in the Korea Superconducting Tokamak Advanced Research (KSTAR) facility. We got the electron temperature and electron density data for the first time in 2011, 4th campaign using a field programmable gate array (FPGA) based signal control board. It operates as a signal generator, a detector, a controller, and a time measuring device. This board produces two configurable trigger pulses to operate Nd:YAG laser system and receives a laser beam detection signal from a photodiode detector. It allows a trigger pulse to be delivered to a time delay module to make a scattered signal measurement, measuring an asynchronous time value between the KSTAR timing board and the laser system injection signal. All functions are controlled by the embedded processor running on operating system within a single FPGA. It provides Ethernet communication interface and is configured with standard middleware to integrate with KSTAR. This controller has operated for two experimental campaigns including commissioning and performed the reconfiguration of logic designs to accommodate varying experimental situation without hardware rebuilding.

Daily skin care habits and the risk of skin eruptions and symptoms in cancer patients

BACKGROUND

Cancer patients are at high risk for skin problems because rapidly proliferating skin cells are susceptible to anticancer therapies. However, the effects of daily skin care habits on development of skin problems in cancer patients have rarely been studied.

PATIENTS AND METHODS

We conducted a survey of daily skin care habits and the presence of skin problems in 866 cancer patients.

RESULTS

Hot water bath>1 h significantly increased the risk of definite eruptions [odds ratio (OR) 4.09] and the risk of itching or pain on the skin (OR 1.73). Diligent use of moisturizers did not decrease the risk of definite eruptions and symptoms, and daily bathing, scrubbing off the skin while bathing, and sun protection did not influence the risk of definite eruptions and symptoms. Subgroup analysis of 183 breast cancer patients showed results similar to the total results, including that hot water bath>1 h significantly increased the risk of definite eruptions (OR 3.41).

CONCLUSIONS

Being a cross-sectional study, our study could not prove causality. However, at the present stage of knowledge, avoidance of hot water baths of protracted duration should be first emphasized in patient education to prevent skin problems in cancer patients.

Standardization of modified right lobe grafts to minimize vascular outflow complications for adult living donor liver transplantation

BACKGROUND

After >2000 adult living donor liver transplants (LDLTs), we observed minimization of the complication rate using case-by-case modification of venous outflow reconstruction in right liver graft (RLG), standardization seeking intend to provide a hemodynamic- based, regeneration-compliant hepatic outflow reconstruction.

METHODS

We retrospectively examined 100 consecutive adult LDLT using modified RLG before and after application of RLG standardization to compare the 6-month incidences of vascular outflow complications.

RESULT

The right hepatic vein stenting rate for first 6 months was 5% in the customized group and 1% in the standardized group (P=.212). The middle hepatic vein stenting rate for first 6 months was 9% in the customized group and 4% in the standardized group (P=.373). The inferior right hepatic vein stenting rate for first 6 months was 12.8% in the customized group and 7.1% in the standardized group (P=.472). The overall 6-month patient survival rate was 94% in the customized group and 95% in the standardized group (P=.867). The overall incidence of significant RLG venous outflow complications was 19% in the customized group and 8% in the standardized group (P=.023).

CONCLUSION

Standardization as a universal graft model seemed to be more effective and feasible than conventional graft customization requiring individualized case-by-case modification.

De novo malignancies after liver transplantation: incidence comparison with the Korean cancer registry

PURPOSE

De novo malignancy is not uncommon after liver transplantation (OLT). We have compared the incidence of novo malignancy following OLT with those among the general Korean population.

METHODS

Between January 1998 and December 2008, 1952 adult OLT were performed, including 1714 living donor and 238 deceased donor grafts whose medical records were retrospectively reviewed.

RESULTS

Among the 1952 patients, 44 (2.3%) showed de novo malignancies after a mean posttransplant period of 41 months. Among the 14 types of malignancy the most frequent was stomach cancer (n = 11; 25.0%), colorectal cancer (n = 9; 20.5%), breast cancer (n = 4; 9.1%), and thyroid cancer (n = 3; 6.8%). These patients underwent aggressive treatment, including surgery, chemotherapy, and radiotherapy, except for one patient with an aggressive primary liver cancer. Over a mean follow-up of 45 months after diagnosis of de novo malignancy, 13 patients (29.5%) died; the overall 3-year patient survival rate was 67.5%. The relative risk of malignancy following OLT was 7.7-fold higher in men and 7.3-fold higher in women than the Korean general population.

CONCLUSIONS

OLT recipients must be checked periodically for de novo malignancy throughout their lives, especially for cancers common in the general population.

US health policy related to hookah tobacco smoking

OBJECTIVES

Although US cigarette smoking is decreasing, hookah tobacco smoking (HTS) is an emerging trend associated with substantial toxicant exposure. We assessed how a representative sample of US tobacco control policies may apply to HTS.

METHODS

We examined municipal, county, and state legal texts applying to the 100 largest US cities. We developed a summary policy variable that distinguished among cities on the basis of how current tobacco control policies may apply to HTS and used multinomial logistic regression to determine associations between community-level sociodemographic variables and the policy outcome variable.

RESULTS

Although 73 of the 100 largest US cities have laws that disallow cigarette smoking in bars, 69 of these cities have exemptions that allow HTS; 4 of the 69 have passed legislation specifically exempting HTS, and 65 may permit HTS via generic tobacco retail establishment exemptions. Cities in which HTS may be exempted had denser populations than cities without clean air legislation.

CONCLUSIONS

Although three fourths of the largest US cities disallow cigarette smoking in bars, nearly 90% of these cities may permit HTS via exemptions. Closing this gap in clean air regulation may significantly reduce exposure to HTS.

Attributes of researchers and their strategies to recruit minority populations: results of a national survey

Despite NIH mandates for inclusion, recruiting minorities is challenging for biomedical and public health researchers. Little is known about how attributes of researchers affect their choice of recruitment strategies. The purpose of this study was to address this gap by examining how use of recruitment strategies relates to other researcher characteristics. To do this, we conducted an online survey from May to August 2010 with researchers (principal investigators, research staff, and IRB members) in which we measured the number and types of recruitment strategies utilized, along with other characteristics of the researchers and their research. We identified two clusters of researchers: comprehensive researchers who utilized a greater number and more diverse and active recruitment strategies, and traditional researchers, who utilized fewer and more passive strategies. Additional characteristics that distinguished the two groups were that comprehensive researchers were more likely than traditional researchers to 1) report racial and ethnic differences as one of their specific aims or hypotheses, 2) receive federal (CDC and NIH) funding, 3) conduct behavioral or epidemiological research, and 4) have received training in conducting research with and recruiting minorities. Traditional researchers, on the other hand, were more likely to conduct clinical research and a greater (though non-significant) percentage received funding from pharmaceutical sources. This study provides a novel description of how researcher attributes are related to their recruitment strategies and raises a number of future research questions to further examine the implications of this relationship.

Predictive capabilities of serum eosinophil cationic protein, percentage of eosinophils and total immunoglobulin E in allergic rhinitis without bronchial asthma

This study identified cut-off values for allergy markers for use in the diagnosis of allergic rhinitis in the absence of other allergic diseases. Total immunoglobulin E (IgE), eosinophil cationic protein (ECP) and the numbers of eosinophils were measured in serum samples from 442 patients with typical symptoms of allergic rhinitis. A definite diagnosis was made on the basis of the presence of specific IgE levels. Cut-off values with a maximal discrimination to diagnose allergic rhinitis were found to be 98.7 IU/ml, 24.7 μg/ml and 4.0% for total IgE, ECP and eosinophils, respectively. Sensitivity, specificity and odds ratio for these values were 75.2%, 69.7% and 6.93, respectively, for total IgE, 55.7%, 74.4% and 3.70 for ECP, and 57.5%, 72.0% and 3.47 for eosinophils. A composite score representing positive results for all three markers had a positive predictive value of 85.3%, with an odds ratio of 8.55. It was concluded that total serum IgE, ECP and eosinophil percentage are strong predictors of allergic rhinitis and the determination of cut-off values for these markers can aid in the diagnosis of allergic rhinitis in the clinical setting.

Mouse prostate proteome changes induced by oral pentagalloylglucose treatment suggest targets for cancer chemoprevention

Recent in vitro and in vivo preclinical studies have suggested that the Oriental herbal compound penta-1, 2, 3, 4, 6-O-galloyl-beta-D-glucose (PGG) is a promising chemopreventive agent for prostate cancer. Little is known of its safety for chronic chemoprevention use and virtually nothing is known of its in vivo responsive proteins in the target organ. Here we treated male C57BL/6 mice with daily oral administration of PGG at two dosages (1 and 2 mg per mouse) from 7 to 14 weeks of age and profiled proteomic patterns in the prostate with iTRAQ labeling and 2D LC-MS/MS analyses. While neither dose affected feed intake and body weight gain, the 2 mg dose (∼80-100 mg per kg) led to a minor but statistically significant decrease of the weight of prostate and thymus. For proteomic profiling, five prostates were pooled from each group for protein extraction. Proteins were denatured, reduced, alkylated and digested to peptides. The peptides were labeled with iTRAQ reagents, mixed and subjected to 2D LC-MS/MS analyses. PGG consumption suppressed the abundance of oncoproteins (e.g., fatty acid synthase, clusterin) and up-regulated that of tumor suppressor proteins (e.g., glutathione S-transferase M), signifying changes that may contribute to prostate cancer risk reduction.

Reconstructive endovascular treatment of fusiform or ultrawide-neck circumferential aneurysms with multiple overlapping enterprise stents and coiling

BACKGROUND AND PURPOSE

Fusiform aneurysms and ultrawide-neck circumferential aneurysms are still some of the most challenging lesions. The aim of this study was to investigate the efficacy and feasibility of the use of multiple overlapping Enterprise stents with coiling for the treatment of fusiform or ultrawide-neck circumferential aneurysms.

MATERIALS AND METHODS

Twelve consecutive patients (9 men and 3 women; mean age, 56 years) with fusiform (n = 5) or ultrawide-neck circumferential (n = 7) aneurysms were treated with 2-3 overlapping Enterprise stents and coiling. The feasibility of this procedure and the clinical and angiographic outcomes of this technique were retrospectively evaluated.

RESULTS

All patients were successfully treated by using this technique without any complications. Posttreatment angiographic results revealed grade 4 occlusion of the aneurysm in 6, grade 3 in 4, and grade 2 in 2 patients. Clinical follow-up was performed in all patients (mean, 16 months; range, 5-24 months). Nine patients had an mRS score of 0. Two had an mRS score of 1, one of whom had an initial mRS score of 2 due to the mass effect of a giant aneurysm; the other had a recurrent aneurysm presenting with SAH 5 years after clipping. Angiographic follow-up was performed in 10 patients at 6-20 months posttreatment. Nine had stable or improved occlusion, while 1 had a minor recurrence.

CONCLUSIONS

In this small series, multiple overlapping Enterprise stents with coiling were a feasible and effective option for the treatment of fusiform and ultrawide-neck circumferential aneurysms. Further experience and follow-up are required to document the long-term efficacy of this treatment.

Electro-optical properties of nano-thickness polymer film

We report the electro-optical (E/O) characteristics of the Langmuir-Blodgett film of poly(vinylidene fluoride with trifluoroethylene) copolymers. The structural origin of E/O response of nano LB films was discussed with the result of temperature dependent E/O response at a temperature range from 20 to 100 degrees C. Thermal hysteresis of E/O response and the ferroelectric-paraelectric phase transition were observed at a 20 monomolecular layers Langmuir-Blodgett films.

Middle-aged and older men who have sex with men exhibit multiple trajectories with respect to the number of sexual partners

This study aimed to examine trajectories with respect to the number of sexual partners among older men who have sex with men and to determine characteristics associated with trajectory groups. Nagin's group-based modeling was used to identify trajectories for 237 men from the Pitt Men's Study with respect to the number of male intercourse partners from age 50.0 to 59.5. Three distinct trajectory groups were identified. Most men (69.2%) had a median of two sexual partners in the past 6 months across the age range of the study. A smaller group (19.4%) had low or no sex partners. The smallest group (11.4%) had 30 or more sexual partners in the past 6 months at age 50. The groups were statistically different with respect to race, HIV status, drug use (marijuana, poppers, crack cocaine, and Viagra), the number of unprotected anal sex partners, and personal attitudes towards sex.

Endothelin-1 enhances the proliferation of normal human melanocytes in a paradoxical manner from the TNF-α-inhibited condition, but tacrolimus promotes exclusively the cellular migration without proliferation: a proposed action mechanism for combination therapy of phototherapy and topical tacrolimus in vitiligo treatment

BACKGROUND

Vitiligo is an acquired pigmentary disorder caused by the destruction of melanocytes. Two of the major theories regarding the pathogenesis of vitiligo are the autoimmune theory and autocytotoxicity theory, but, the precise pathogenetic mechanism is still not clarified.

OBJECTIVES

We investigated the effects of ET-1, tacrolimus and tumour necrosis factor-α (TNF-α) on proliferation and migration of cultured normal human melanocytes (NHMs). We also sought to clarify the theoretical rationale underlying the topical tacrolimus monotherapy or tacrolimus-UV combination therapy as tools for vitiligo treatment.

METHODS

The effects of ET-1, tacrolimus and TNF-α on proliferation/migration of cultured NHMs were investigated by MTT assay/Boyden chamber transwell migration assay. We also examined roles of CXC-chemokine receptor II (CXCR II) and matrix metalloproteinases (MMPs) in such conditions.

RESULTS

ET-1 exerted a stimulatory effect on melanocyte proliferation and migration, but, tacrolimus exerted a stimulatory effect only on melanocyte migration higher than ET-1. TNF-α inhibited melanocyte proliferation in a dose-dependent manner. Paradoxically, TNF-α-pretreated NHMs exhibited an enhanced proliferative efficiency after being switched to ET-1. We found CXCRII was highly expressed in TNF-α-incubated melanocytes than the agents-free control, and ET-1 treatment after TNF-α preincubation showed the higher levels of CXCRII expression than the condition incubated with TNF-α alone. Moreover, the greater activities of MMP-2 and MMP-9 induced by tacrolimus than ET-1, reflected tacrolimus would enhance migration stimulatory effect in cultured NHMs.

CONCLUSIONS

Topical tacrolimus can be used an effective agent for vitiligo treatment as monotherapy, maybe due to its migration stimulatory action or TNF-α inhibitory property, and also as a component in combination therapy with UV treatment, considering the more upregulated MMPs activities are induced and the more effective migrations are feasible by itself than ET-1.

US public support for vaccine donation to poorer countries in the 2009 H1N1 pandemic

BACKGROUND

During the 2009 H1N1 pandemic, the global health community sought to make vaccine available "in developing nations in the same timeframe as developed nations." However, richer nations placed advance orders with manufacturers, leaving poorer nations dependent on the quantity and timing of vaccine donations by manufacturers and rich nations. Knowledge of public support for timely donations could be important to policy makers during the next pandemic. We explored what the United States (US) public believes about vaccine donation by its country to poorer countries.

METHODS AND FINDINGS

We surveyed 2079 US adults between January 22(nd) and February 1(st) 2010 about their beliefs regarding vaccine donation to poorer countries. Income (p = 0.014), objective priority status (p = 0.005), nativity, party affiliation, and political ideology (p<0.001) were significantly related to views on the amount of vaccine to be donated. Though party affiliation and political ideology were related to willingness to donate vaccine (p<0.001), there was bipartisan support for timely donations of 10% of the US vaccine supply so that those "at risk in poorer countries can get the vaccine at the same time" as those at risk in the US.

CONCLUSIONS

We suggest that the US and other developed nations would do well to bolster support with education and public discussion on this issue prior to an emerging pandemic when emotional reactions could potentially influence support for donation. We conclude that given our evidence for bipartisan support for timely donations, it may be necessary to design multiple arguments, from utilitarian to moral, to strengthen public and policy makers' support for donations.

Adipogenic gene expression and fatty acid composition in subcutaneous adipose tissue depots of Angus steers between 9 and 16 months of age

We have demonstrated that among carcass adipose tissue depots, brisket subcutaneous adipose tissue contains the greatest concentration of MUFA and lowest concentration of SFA. Therefore, we hypothesized that brisket subcutaneous adipose tissue depots would exhibit greater adipogenic gene expression over time than other major subcutaneous adipose tissue depots. Four Angus steers, each at 9, 12, 14, and 16 mo of age, were harvested and fresh subcutaneous adipose tissue samples were collected from over the brisket, chuck, rib, loin, sirloin, round, flank, and plate. Relative gene expression for C/EBPβ, PPARγ, carnitine palmitoyltransferase-1 beta (CPT-1β), stearoyl-coenzyme A desaturase (SCD), AMP-activated protein kinase alpha (AMPKα), and G-coupled protein receptor 43 (GPR43) was analyzed by quantitative real-time PCR. Expression of C/EBPβ, PPARγ, and CPT-1β was greatest at 12 to 14 mo of age (all P < 0.0001) and declined to very low abundance by 16 mo of age in all depots. Expression of PPARγ and CPT-1β was greater (P < 0.03) in flank, rib, and sirloin subcutaneous adipose tissues than in brisket and round adipose tissues. The expression of the SCD gene did not differ among the 4 age groups (P = 0.95). The palmitoleic:stearic acid ratio (an estimate of SCD activity) was greater (P < 0.001) in the subcutaneous adipose tissues from brisket, plate, and round than in the loin, rib, and sirloin. Conversely, subcutaneous adipose tissue from the loin, rib, and sirloin had greater (P < 0.001) SCD gene expression than the brisket, plate, and round. In general, subcutaneous adipose tissues with the highest concentration of MUFA and least SFA consistently exhibited the least SCD gene expression and adipogenic gene expression. We conclude that MUFA in the brisket and other depots with large SCD indices were deposited before 9 mo of age, during a time when the subcutaneous adipocytes were highly differentiated.

Autophagy deficiency in beta cells leads to compromised unfolded protein response and progression from obesity to diabetes in mice

AIMS/HYPOTHESIS

The unfolded protein response (UPR) in endoplasmic reticulum (ER) and autophagy are known to be related. We investigated the role of autophagy in UPR of pancreatic beta cells and the susceptibility of autophagy-deficient beta cells to the ER stress that is implicated in the development of diabetes.

METHODS

Rat insulin promoter (RIP)-Cre(+);autophagy-related 7 (Atg7)(F/W) mice were bred with ob/w mice to derive RIP-Cre(+);Atg7(F/F)-ob/ob mice and to induce ER stress in vivo. GFP-LC3(+)-ob/ob mice were generated to examine in vivo autophagic activity. Real-time RT-PCR was performed to study the expression of the genes of the UPR machinery. Proteolysis was assessed by determining release of incorporated radioactive leucine.

RESULTS

Production of UPR machinery was reduced in autophagy-deficient beta cells, which was associated with diminished production of p85α and p85β regulatory subunits of phosphoinositide 3-kinase. Because of compromised UPR machinery, autophagy-deficient beta cells were susceptible to ER stressors in vitro. When mice with beta cell-specific autophagy deficiency, which have mild hyperglycaemia, were bred with ob/ob mice to induce ER stress in vivo, severe diabetes developed, which was accompanied by an increase in beta cell death and accumulation of reactive oxygen species. The increased demand for UPR present in obesity was unmet in autophagy-deficient beta cells. Autophagy level and autophagic activity were enhanced by lipid, while proteolysis was reduced.

CONCLUSIONS/INTERPRETATION

These results suggest that autophagy is important for intact UPR machinery and appropriate UPR in response to lipid injury that increases demand for UPR. Autophagy deficiency in pancreatic beta cells may contribute to the progression from obesity to diabetes.

Tobacco, marijuana, and alcohol use in university students: a cluster analysis

OBJECTIVE

Segmentation of populations may facilitate development of targeted substance abuse prevention programs. The authors aimed to partition a national sample of university students according to profiles based on substance use.

PARTICIPANTS

The authors used 2008-2009 data from the National College Health Assessment from the American College Health Association. The sample consisted of 111,245 individuals from 158 institutions.

METHODS

The sample was partitioned using cluster analysis according to current substance use behaviors. The association of cluster membership with individual and institutional characteristics was examined.

RESULTS

Cluster analysis yielded 6 distinct clusters. Three individual factors--gender, year in school, and fraternity/sorority membership--were the most strongly associated with cluster membership.

CONCLUSIONS

In a large sample of university students, the authors were able to identify 6 distinct patterns of substance abuse. It may be valuable to target specific populations of college-aged substance users based on individual factors. However, comprehensive intervention will require a multifaceted approach.

Effect of omega-3 fatty acids on the modification of erythrocyte membrane fatty acid content including oleic acid in peritoneal dialysis patients

Erythrocyte membrane fatty acids (FA), such as oleic acid, are related to acute coronary syndrome. There is no report about the effect of omega-3 FA on oleic acid in peritoneal dialysis (PD) patients. We hypothesized that omega-3 FA can modify erythrocyte membrane FA, including oleic acid, in PD patients. In a double-blind, randomized, placebo-controlled study, 18 patients who were treated with PD for at least 6 months were randomized to treatment for 12 weeks with omega-3 FA or placebo. Erythrocyte membrane FA content was measured by gas chromatography at baseline and after 12 weeks. The erythrocyte membrane content of eicosapentaenoic acid and docosahexaenoic acid was significantly increased and saturated FA and oleic acid were significantly decreased in the omega-3 FA supplementation group after 12 weeks compared to baseline. In conclusion, erythrocyte membrane FA content, including oleic acid, was significantly modified by omega-3 FA supplementation for 12 weeks in PD patients.

Biosimulation of acute phonotrauma: an extended model

OBJECTIVES/HYPOTHESIS

Personalized, preemptive, and predictive medicine is a central goal of contemporary medical care. The central aim of the present study was to investigate the utility of mechanistic computational modeling of inflammation and healing to address personalized therapy for patients with acute phonotrauma.

STUDY DESIGN

Computer simulation.

METHODS

Previously reported agent-based models (ABMs) of acute phonotrauma were extended with additional inflammatory mediators as well as extracellular matrix components. The models were calibrated with empirical data for a panel of biomarkers--interleukin (IL)-1β, IL-6, IL-8, IL-10, tumor necrosis factor-α and matrix metalloproteinase-8--from individual subjects following experimentally induced phonotrauma and a randomly assigned voice treatment namely voice rest, resonant voice exercise, and spontaneous speech. The models' prediction accuracy for biomarker levels was tested for a 24-hour follow-up time point.

RESULTS

The extended ABMs reproduced and predicted trajectories of biomarkers seen in experimental data. The simulation results also agreed qualitatively with various known aspects of inflammation and healing. Model prediction accuracy was generally better following individual-based calibration as compared to population-based calibration. Simulation results also suggested that the special form of vocal fold oscillation in resonant voice may accelerate acute vocal fold healing.

CONCLUSIONS

The calibration of inflammation/healing ABMs with subject-specific data appears to optimize the models' prediction accuracy for individual subjects. This translational application of biosimulation might be used to predict individual healing trajectories, the potential effects of different treatment options, and most importantly, provide new understanding of health and healing in the larynx and possibly in other organs and tissues as well.

Randomized controlled trial of a collaborative care intervention to manage cancer-related symptoms: lessons learned

BACKGROUND

Collaborative care interventions to treat depression have begun to be tested in settings outside of primary care. However, few studies have expanded the collaborative care model to other settings and targeted comorbid physical symptoms of depression.

PURPOSE

The aims of this report were to: (1) describe the design and methods of a trial testing the efficacy of a stepped collaborative care intervention designed to manage cancer-related symptoms and improve overall quality of life in patients diagnosed with hepatobiliary carcinoma; and (2) share the lessons learned during the design, implementation, and evaluation of the trial.

METHODS

The trial was a phase III randomized controlled trial testing the efficacy of a stepped collaborative care intervention to reduce depression, pain, and fatigue in patients diagnosed with advanced cancer. The intervention was compared to an enhanced usual care arm. The primary outcomes included the Center for Epidemiological Studies-Depression scale, Brief Pain Inventory, and Functional Assessment of Cancer Therapy (FACT)-Fatigue, and the FACT-Hepatobiliary. Sociodemographic and disease-specific characteristics were recorded from the medical record; Natural Killer cells and cytokines that are associated with these symptoms and with disease progression were assayed from serum.

RESULTS

  and  Discussion The issues addressed include: (1) development of collaborative care in the context of oncology (e.g., timing of the intervention, tailoring of the intervention, ethical issues regarding randomization of patients, and changes in medical treatment over the course of the study); (2) use of a website by chronically ill populations (e.g., design and access to the website, development of the website and intervention, ethical issues associated with website development, website usage, and unanticipated costs associated with website development); (3) evaluation of the efficacy of intervention (e.g., patient preferences, proxy raters, changes in medical treatment, and inclusion of biomarkers as endpoints); and (4) analyses and interpretation of the intervention (e.g., confounding factors, dose and active ingredients, and risks and benefits of collaborative care interventions in chronically ill patients).

LIMITATIONS

The limitations to the study, although not fully realized at this time as the trial is ongoing, include: (1) heterogeneity of the diagnoses and treatments of participants; and (2) inclusion of caregivers as proxy raters but not as participants in the intervention.

CONCLUSIONS

Collaborative care interventions to manage multiple symptoms in a tertiary cancer center are feasible. However, researchers designing and implementing interventions that are web-based, target multiple symptoms, and for oncology patients may benefit from previous experiences.

The impact of workplace policies and other social factors on self-reported influenza-like illness incidence during the 2009 H1N1 pandemic

OBJECTIVES

We assessed the impact of social determinants of potential exposure to H1N1--which are unequally distributed by race/ethnicity in the United States--on incidence of influenza-like illness (ILI) during the 2009 H1N1 pandemic.

METHODS

In January 2010 we surveyed a nationally representative sample (n = 2079) of US adults from the Knowledge Networks online research panel, with Hispanic and African American oversamples. The completion rate was 56%.

RESULTS

Path analysis examining ILI incidence, race, and social determinants of potential exposure to H1N1 demonstrated that higher ILI incidence was related to workplace policies, such as lack of access to sick leave, and structural factors, such as number of children in the household. Hispanic ethnicity was related to a greater risk of ILI attributable to these social determinants, even after we controlled for income and education.

CONCLUSIONS

The absence of certain workplace policies, such as paid sick leave, confers a population-attributable risk of 5 million additional cases of ILI in the general population and 1.2 million cases among Hispanics. Federal mandates for sick leave could have significant health impacts by reducing morbidity from ILI, especially in Hispanics.