Community Health Navigators for Cancer Screening Among Deaf, Deafblind, and Hard of Hearing Adults Who Use American Sign Language

Deaf, deafblind, and hard of hearing (DDBHH) individuals experience barriers to accessing cancer screening, including ineffective patient-physician communication when discussing screening recommendations. For other underserved communities, culturally and linguistically aligned community health navigators (CHNs) have been shown to improve cancer screening and care. A needs assessment study was conducted to identify barriers and gather recommendations for CHN training resources. A community-based participatory needs assessment was conducted from May 2022 to June 2022 using three focus groups. Eight were cancer survivors, six advocates/navigators, and three clinicians. All questions were semi-structured and covered screening barriers, observations or personal experiences, perceived usefulness of having a CHN to promote cancer screening adherence, and training resources that may be useful to American Sign Language (ASL)-proficient CHNs, who are also culturally and linguistically aligned. Out of 20 focus group participants, seven self-identified as persons of color. Data highlighted systemic, attitudinal, communication, and personal-level barriers as recurrent themes. The most frequently cited barrier was access to training that supports the role and competencies of CHNs, followed by cultural considerations, access to cancer guidelines in ASL, dialect diversity in sign language, and the health system itself. Unaddressed barriers can contribute to health disparities, such as lower preventive cancer screening rates amongst DDBHH individuals. The next step is to translate recommendations into actionable tasks for DDBHH CHN training programs. As a result, CHNs will be well-equipped to help DDBHH individuals navigate and overcome their unique barriers to cancer screening and healthcare access.

Population and Conservation Status of Bighorn Sheep in the State of Baja California, Mexico

The bighorn sheep in Mexico is classified as at-risk by the Mexican federal government. In the state of Baja California, wild sheep can be observed throughout the length of the state from the USA-Mexico border south to the Agua de Soda mountain range. This research aimed to document the historical trend of the bighorn population based on aerial surveys conducted in 1992, 1995, 1999, 2010, and 2021, and the abundance, distribution, and structure of bighorn sheep populations in Baja California, based on an aerial survey conducted from 8-14 November 2021, covering thirteen mountain ranges. The estimated sheep population in 2021 was based on the number of individuals observed; the sightability of the animals; the area sampled; and the total area of habitat available. In 30.5 flight hours, 456 bighorn sheep were observed, with an estimated population of 1697 ± 80 individuals. The observation rate was 16 sheep sighted per hour of flight, and the ram:ewe:lamb ratio was 62:100:19. When the results of the 2021 flight were compared to the results of the previous aerial surveys, there was a large variation between the data, which was related to the lack of consistency between the sampling designs used in each study. Nevertheless, a statistical test of the results of aerial surveys conducted in the state suggest that the Baja California bighorn sheep population remained stable between 1992 and 2021. This study highlights the need to standardize wild sheep aerial surveys by defining flight paths and establishing a consistent duration of flights. On the other hand, Baja California authorities should consider modifying the current conservation strategy for bighorn sheep to increase the species' population in the state by initiating community-based wildlife conservation programs in rural communities.

Animal behavior informed by history: Was the Asiatic cheetah an obligate gazelle hunter?

Understanding key ecological adaptations, such as foraging, when a predator is almost extinct is complex. Nonetheless, that information is vital for the recovery of the persisting individuals. Therefore, reviewing historical, ethnobiological and recent records can assist in exploring the species behavioral ecology. We applied this approach to Asiatic cheetahs (Acinonyx jubatus venaticus), which once roamed most west and central Asian countries but now is confined to a few dozens in Iran, at historical (pre-1970) and recent (post-1970) scales. We addressed a widely popular perception that Asiatic cheetahs were subjected to prey shifts from gazelles (Gazella spp.) in open plains areas to urial (Ovis vignei) in mountains because of gazelle populations declines due to anthropogenic influences. We also quantified recent prey choice of Asiatic cheetahs and their behavioral plasticity in foraging different prey species types. Although ethnobiological and historical records suggested that gazelle species were the main prey for cheetahs across their Asian range. However, urial were also commonly reported to be hunted by cheetahs across their historical Asian range, showing that the predation on mountain ungulates is not an emerging hunting behavior in Asiatic cheetahs. We found spatiotemporal plasticity in recent hunting behavior of cheetahs with selective predation on adult urial males. There was temporal overlap in hunting times for plains dwelling versus mountain ungulates, albeit with some minor differences with morning mostly for gazelles while the predation on mountain ungulates was predominantly post-midday. We provided three management implications for the recovery and restoration of cheetahs in Asia. Our work highlighted the importance of historical studies in informing the behavioral ecology of rare species.

Expert range maps of global mammal distributions harmonised to three taxonomic authorities

AIM

Comprehensive, global information on species' occurrences is an essential biodiversity variable and central to a range of applications in ecology, evolution, biogeography and conservation. Expert range maps often represent a species' only available distributional information and play an increasing role in conservation assessments and macroecology. We provide global range maps for the native ranges of all extant mammal species harmonised to the taxonomy of the Mammal Diversity Database (MDD) mobilised from two sources, the Handbook of the Mammals of the World (HMW) and the Illustrated Checklist of the Mammals of the World (CMW).

LOCATION

Global.

TAXON

All extant mammal species.

METHODS

Range maps were digitally interpreted, georeferenced, error-checked and subsequently taxonomically aligned between the HMW (6253 species), the CMW (6431 species) and the MDD taxonomies (6362 species).

RESULTS

Range maps can be evaluated and visualised in an online map browser at Map of Life (mol.org) and accessed for individual or batch download for non-commercial use.

MAIN CONCLUSION

Expert maps of species' global distributions are limited in their spatial detail and temporal specificity, but form a useful basis for broad-scale characterizations and model-based integration with other data. We provide georeferenced range maps for the native ranges of all extant mammal species as shapefiles, with species-level metadata and source information packaged together in geodatabase format. Across the three taxonomic sources our maps entail, there are 1784 taxonomic name differences compared to the maps currently available on the IUCN Red List website. The expert maps provided here are harmonised to the MDD taxonomic authority and linked to a community of online tools that will enable transparent future updates and version control.

Growth, weights, and measurements of female wild sheep from Iran

Wild sheep (Ovis spp.) are of conservation concern throughout the Middle East. Little is known, however, about the natural history or ecology of this taxon. To better understand size relationships among wild sheep occupying Iran, we analyzed results from 120 females collected from widely separated ecosystems. Morphometrics and body weights for all age categories of females occupying the Khosh-Yeilagh Wildlife Refuge in northeastern Iran were larger than those for the same age classes of females occupying Bamou National Park in southwestern Iran. Females from Bamou National Park, however, obtained adult body weight (x̅ = 25.8 ± 2.47 [SD] kg) at an earlier age than those from the Khosh-Yeilagh Wildlife Refuge (x̅ = 36.6 ± 3.21 kg). Ecological differences between these two areas suggest that net primary productivity, which is a function of numerous climatic and geographical factors, has been a primary force contributing to these results. Weights and measurements reported here provide the basic information for additional, more detailed research necessary to fully understand the evolutionary significance and management implications of these differences in body size and emphasize the conservation value of even the most basic natural history information.

Oral Health Literacy in Migrant and Ethnic Minority Populations: A Systematic Review

Cultural background influences how migrants and ethnic minority populations view and assess health. Poor oral health literacy (OHL) may be a hindrance in achieving good oral health. This systematic review summarizes the current quantitative evidence regarding OHL of migrants and ethnic minority populations. The PubMed database was searched for original quantitative studies that explore OHL as a holistic multidimensional construct or at least one of its subdimensions in migrants and ethnic minority populations. 34 publications were selected. Only 2 studies specifically addressed OHL in migrant populations. Generally, participants without migration background had higher OHL than migrant and ethnic minority populations. The latter showed lower dental service utilization, negative oral health beliefs, negative oral health behavior, and low levels of oral health knowledge. Due to its potential influence on OHL, oral health promoting behavior, attitudes, capabilities, and beliefs as well as the cultural and ethnic background of persons should be considered in medical education and oral health prevention programs.

Prevalence and determinants of dental visits among older adults: findings of a nationally representative longitudinal study

BACKGROUND

The first aim was to present descriptive data on the frequency of dental visits among older adults in Germany. The second aim was to identify the determinants of the number of dental visits using a longitudinal approach.

METHODS

Longitudinal data were derived from the German Ageing Survey, which is a nationally representative sample of community-dwelling individuals ≥40 years in Germany. The frequency of dental visits in the past 12 months was recorded in the years 2002, 2008 and 2011. In order to control for time-constant unobserved heterogeneity, Poisson fixed effects regressions were used.

RESULTS

While the mean number of dental visits was 2.3 (SD: 2.0) in 2002, it was 2.0 (SD: 1.7) in 2008 and 2.1 (SD: 1.7) in 2011. The frequency of dental visits declined with age (total sample and women), transitions from normal weight to overweight (total sample), changes from divorced/widowed/single/married, living separated from spouse to 'married, living together with spouse' in women and with a decrease in the number of physical illnesses (total sample and men).

CONCLUSIONS

The frequency of dental visits declines with age in older adults. While some of the determinants of frequency are non-modifiable (e.g., ageing and worsening of general health), others are modifiable (e.g., change in weight category).

Dexamethasone downregulates expression of several genes encoding orphan nuclear receptors that are important to steroidogenesis in stallion testes

Glucocorticoids impair testosterone synthesis by an unknown mechanism. Stallions treated with the synthetic glucocorticoid dexamethasone had testes collected at 6 or 12 hours postinjection. The testicular expression of selected genes encoding nuclear receptors and steroidogenic enzymes was measured. At 6 hours, dexamethasone treatment decreased levels of NR0B2, NR4A1, NR5A1, and NR5A2 messenger RNAs (mRNAs) and NR5A2 mRNA levels remained depressed at 12 hours. In contrast, dexamethasone increased levels of NFKBIA mRNA at both time points. At 6 hours, dexamethasone did not alter levels of NR0B1, NR2F1, NR2F2, NR3C1, CYP11A1, CYP17A1, CYP19A1, DHCR24, GSTA3, HSD3B2, HSD17B3, LHCGR, or STAR mRNAs. In primary cultures of Leydig cells, 10 ^-9 and 10 ^-7 M dexamethasone decreased levels of NR4A1 and NR5A1 mRNAs and increased those of NFKBIA mRNA. Our discovery that dexamethasone downregulates NR4A1, NR5A1, and NR5A2 genes, known to be important for testicular functions, may be part of the mechanism by which glucocorticoids acutely decreases testosterone.

Waterhole detection using a vegetation index in desert bighorn sheep (Ovis canadensis cremnobates) habitat

In arid ecosystems, desert bighorn sheep are dependent on natural waterholes, particularly in summer when forage is scarce and environmental temperatures are high. To detect waterholes in Sierra Santa Isabel, which is the largest area of desert bighorn sheep habitat in the state of Baja California, Mexico, we used the normalized difference vegetation index (NDVI) and normalized difference water index (NDWI) from Sentinel-2 satellite images. Waterhole detection was based on the premise that sites with greater water availability, where NDVI was higher, can be identified by their density of vegetation greenness. For the detected waterholes, we estimated the escape terrain (presence of cliffs or steep, rocky slopes) around each by the vector ruggedness measure to determine their potential use by desert bighorn sheep based on the animals’ presence as documented by camera traps. We detected 14 waterholes with the NDVI of which 11 were known by land owners and 3 were unrecorded. Desert bighorn were not detected in waterholes with high values of escape terrain, i.e., flat areas. Waterhole detection by NDVI is a simple method, and with the assistance and knowledge of the inhabitants of the Sierra, it was possible to confirm the presence each waterhole in the field.

Habitat assessment of Marco Polo sheep (Ovis ammon polii) in Eastern Tajikistan: Modeling the effects of climate change

Identifying the factors predicting the high-elevation suitable habitats of Central Asian argali wild sheep and how these suitable habitats are affected by the changing climate regimes could help address conservation and management efforts and identify future critical habitat for the species in eastern Tajikistan. This study used environmental niche models (ENMs) to map and compare potential present and future distributions of suitable environmental conditions for Marco Polo argali. Argali occurrence points were collected during field surveys conducted from 2009 to 2016. Our models showed that terrain ruggedness and annual mean temperature had strong correlations on argali distribution. We then used two greenhouse gas concentration trajectories (RCP 4.5 and RCP 8.5) for two future time periods (2050 and 2070) to model the impacts of climate change on Marco Polo argali habitat. Results indicated a decline of suitable habitat with majority of losses observed at lower elevations (3,300-4,300 m). Models that considered all variables (climatic and nonclimatic) predicted losses of present suitable areas of 60.6% (6,928 km2) and 63.2% (7,219 km2) by 2050 and 2070, respectively. Results also showed averaged habitat gains of 46.2% (6,106 km2) at much higher elevations (4,500-6,900 m) and that elevational shifts of habitat use could occur in the future. Our results could provide information for conservation planning for this near threatened species in the region.

Status and population structure of a hunted population of Marco Polo Argali Ovis ammon polii (Cetartiodactyla, Bovidae) in Southeastern Tajikistan

Marco Polo sheep (

TMPRSS2:ERG blocks neuroendocrine and luminal cell differentiation to maintain prostate cancer proliferation

The biological outcome of TMPRSS2:ERG chromosomal translocations in prostate cancer (PC) remains poorly understood. To address this, we compared the transcriptional effects of TMPRSS2:ERG expression in a transgenic mouse model with those of ERG knockdown in a TMPRSS2:ERG-positive PC cell line. This reveals that ERG represses the expression of a previously unreported set of androgen receptor (AR)-independent neuronal genes that are indicative of neuroendocrine (NE) cell differentiation-in addition to previously reported AR-regulated luminal genes. Cell sorting and proliferation assays performed after sustained ERG knockdown indicate that ERG drives proliferation and blocks the differentiation of prostate cells to both NE and luminal cell types. Inhibition of ERG expression in TMPRSS2:ERG-positive PC cells through blockade of AR signaling is tracked with increased NE gene expression. We also provide evidence that these NE cells are resistant to pharmacological AR inhibition and can revert to the phenotype of parental cells upon restoration of AR/ERG signaling. Our findings highlight an ERG-regulated mechanism capable of repopulating the parent tumor through the transient generation of an anti-androgen therapy-resistant cell population, suggesting that ERG may have a direct role in preventing resistance to anti-androgen therapy.

Fabry disease in Argentina: an evaluation of patients enrolled in the Fabry Registry

AIMS

Fabry disease (FD) is an X-linked inborn error of metabolism caused by alpha-galactosidase A deficiency. The Fabry Registry is an ongoing, global observational database that compiles clinical data from patients with FD.

METHODS

Demographic and baseline clinical characteristics of Fabry Registry patients enrolled in Argentina were analysed and compared with patients enrolled in the rest of the world (ROW). Baseline clinical parameters included chronic kidney disease (CKD) stage, urine protein-to-creatinine ratio and left ventricular posterior wall thickness. Only data from untreated patients were included.

RESULTS

As of 1 October 2010, 3752 patients were enrolled in the Registry, 70 patients from Argentina and 3682 from the ROW. Argentinean male subjects were younger than Fabry Registry male subjects enrolled in ROW: mean current age 32.5 years vs. 39.0 years for men (p = 0.0257 by t-test). The current age (mean ± standard deviation) of female subjects enrolled in Argentina was not significantly different from that of female subjects enrolled in the ROW: 40.1 ± 17.28 vs. 43.2 ±17.95 years respectively (p = 0.2967). Overall, a smaller percentage of patients from Argentina received ERT compared with patients in the ROW (54% vs. 58% respectively). When evaluated by gender, more men and fewer women in Argentina received ERT compared with ROW (85% vs. 79% for men and 27% vs. 38% for women). A larger proportion of patients in ROW had severe CKD (stage 4 or 5) compared with Argentina (9.8% vs. 0%), most likely because of the older age of the ROW population.

CONCLUSIONS

The enrolment of Argentinean patients into the Fabry Registry has steadily increased, as has the inclusion of female and paediatric patients with FD. The medical community in Argentina should be aware of FD in these populations, as awareness will facilitate prompt diagnosis and initiation of treatment, thus leading to improved outcomes.

Intragraft regulatory T cells in protocol biopsies retain foxp3 demethylation and are protective biomarkers for kidney graft outcome

Presence of subclinical rejection (SCR) with IF/TA in protocol biopsies of renal allografts has been shown to be an independent predictor factor of graft loss. Also, intragraft Foxp3+ T(reg) cells in patients with SCR has been suggested to differentiate harmful from potentially protective infiltrates. Nonetheless, whether presence of Foxp3 T(reg) cells in patients with SCR and IF/TA may potentially protect from a deleterious graft outcome has not yet been evaluated. This is a case-control study in which 37 patients with the diagnosis of SCR and 68 control patients with no cellular infiltrates at 6-month protocol biopsies matched for age and time of transplantation were evaluated. We first confirmed that numbers of intragraft Foxp3-expressing T cells in patients with SCR positively correlates with Foxp3 demethylation at the T(reg) -specific demethylation region. Patients with SCR without Foxp3+ T(reg) cells within graft infiltrates showed significantly worse 5-year graft function evolution than patients with SCR and Foxp3+ T(reg) cells and those without SCR. When presence of SCR and IF/TA were assessed together, presence of Foxp3+ T(reg) could discriminate a subgroup of patients showing the same graft outcome as patients with a normal biopsy. Thus, presence of Foxp3+ T(reg) cells in patients with SCR even with IF/TA is associated with a favorable long-term allograft outcome.

The role of landowners in jaguar conservation in Sonora, Mexico

The northernmost known breeding population of jaguars occurs in the municipality of Nácori Chico, Sonora, Mexico about 270 km from the United States-Mexico border and may be the source from which jaguars sighted in the United States dispersed. Since 1999 at least 11 jaguars (Panthera onca) had been illegally killed in the area due to predator control programs. We initiated a jaguar landowner-based conservation plan in 2004. The eight participating landowners agreed to suspend predator control programs targeting jaguars and pumas (Puma concolor) only if cattle losses were compensated. A private outfitter, with the consent of landowners, initiated white-tailed deer (Odocoileus virginianus) hunts in 2004 and agreed to pay the group of participating landowners US$1500 for every deer hunt permit sold. The funds paid to the landowners from deer hunts were sufficient to convince landowners to suspend all predator-control efforts of jaguars and pumas. The involvement of landowners in the jaguar conservation program in northeastern Sonora is a successful, private, wildlife-conservation initiative that provides an example for jaguar conservation efforts in northern Mexico.

Family history of diabetes and prevalence of the metabolic syndrome in U.S. adults without diabetes: 6-year results from the National Health and Nutrition Examination Survey (1999-2004)

BACKGROUND/AIMS

Type 2 diabetes and cardiovascular disease share risk factors. The influence of family history of diabetes on the odds of having metabolic syndrome has not been estimated for the U.S. population. Our objective was to quantify this association in a national sample of U.S. adults without diabetes.

METHODS

The sample included 4,937 individuals from the National Health and Nutrition Examination Survey (NHANES) (1999-2004). Familial risk of diabetes was classified in 3 strata according to the combination of relatives affected. Metabolic syndrome was defined according to guidelines issued by 4 groups or organizations. The prevalence and odds of this syndrome were compared among familial risk strata after controlling for relevant risk factors.

RESULTS

Overall, depending on the definition and after controlling for key variables, people with a moderate familial risk of diabetes, and people with a high familial risk of diabetes were between 1.4 and 1.6, and 1.6 and 1.8 times as likely, respectively, to have metabolic syndrome compared to people with average familial risk.

CONCLUSION

In a nationally representative sample of U.S. adults without diabetes, family history of diabetes shows a significant, independent association with metabolic syndrome and its traits. This association supports the idea that shared genes and environment contribute to the expression of complex traits such as diabetes and the metabolic syndrome.

Association between diabetes mellitus and hypertension with anthropometric indicators in older adults: results of the Mexican Health Survey, 2000

OBJECTIVE

To determine the association between anthropometric indicators of adiposity with type 2 diabetes mellitus (T2DM) and hypertension (HTN) in older adults.

DESIGN

Cross-sectional study of participants of the Mexican Health Survey 2000 (MHS).

SETTING

Mexico, subjects recruited from the general community.

PARTICIPANTS

The analytic sample included 7,322 adults who were > or = 60 years of age at the time of the survey. T2DM data were available on 6,994 individuals, who represent 95.5% of the original sample; data on HTN was available on 6,268 subjects, which accounted for 86.5% of the original sample.

MEASUREMENTS

Type 2 diabetes mellitus and hypertension, as well as anthropometric indicators including body mass index (BMI), waist circumference (WC), and conicity index (CI).

RESULTS

The prevalence of T2DM and HTN in this age group was 34.3% and 73.9%, respectively. After adjusting for other variables, the association between high WC and T2DM (OR = 1.59 95%CI = 1.26-2.01, P < 0.001) was stronger than the association with overweight (OR = 1.26, 95%CI = 1.01-1.58, P = 0.04) and obesity (OR = 1.38, 95%CI = 1.08-1.79, P < 0.01) using BMI, and slightly higher than tertile 2 of the CI (OR = 1.49, 95%CI = 1.20-1.88, P < 0.01), while tertile 3 showed a stronger association with T2DM (OR = 1.60, 95%CI = 1.22-2.08, P < 0.001). However, the association between obesity and HTN measured by BMI (OR = 1.98, 95%CI = 1.48-2.65, P < 0.001) was stronger than what was observed with overweight (OR = 1.42, 95%CI 1.13-1.77, P < 0.01), with high WC (OR = 1.62, 95%CI = 1.25-2.10, P < 0.001) and tertiles 2 and 3 of the CI (OR = 1.23, 95%CI = 0.99-1.55, P = 0.09); (OR = 1.53, 95%CI = 1.16-2.03, P < 0.01) respectively.

CONCLUSIONS

BMI and abdominal obesity are significantly and independently associated with an increase in the prevalence of T2DM and HTN among older Mexican adults.

Twenty-three novel HLA-B alleles identified during intermediate-resolution testing

Twenty-three novel human leukocyte antigen-B alleles are described: B*070204, *0738, *0742, *0821, *130202, *1312, *1575, *1598, *1599, *270507, *2728, *350104, *3558, *3811, *3931, *3932, *4045, *4107, *420501, *4812, *510106, *5520, and *5616. Thirteen of the variants are single-nucleotide substitutions from their most homologous allele, eight resulting in amino acid changes (B*0742, *1312, *1598, *1599, *3558, *3931, *4107, and *5616) and five with silent substitutions (B*070204, *130202, *270507, *350104, and *510106). Three alleles (B*0738, *4812, and *5520) differ by five nucleotide changes, altering four amino acids. The remaining seven alleles differ from their most similar alleles by two to three nucleotides, altering from one to two amino acids.

Effects of brief yoga exercises and motivational preparatory interventions in distance runners: results of a controlled trial

OBJECTIVE

To examine the efficacy of two preparatory interventions on one mile run performance in 90 high school long distance runners.

METHOD

After participants had completed a one mile baseline run, they were randomly assigned to participate in either one of two interventions (brief yoga exercises, motivational shouting exercises) or a no intervention control condition. Experimental conditions were implemented one week after the baseline run about 20 minutes before a second one mile trial.

RESULTS

Participants assigned to the motivational intervention improved their running performance significantly more than those assigned to the other two conditions. Although the magnitude of the effect was small, participants assigned to yoga exercises showed significant improvements in running performance relative to control condition participants. Consumer satisfaction ratings indicated that participants who were assigned to the motivational and yoga exercise groups liked their interventions more than those assigned to the control group.

CONCLUSION

Motivational and yoga interventions designed to improve long distance running performance were equally acceptable to the participants, but the former had a greater effect.

Differences in food habits and cardiovascular disease risk factors among Native Americans with and without diabetes: the Inter-Tribal Heart Project

OBJECTIVE

To examine differences in food habits among Native Americans with and without diabetes.

DESIGN

A cross-sectional epidemiological study in which participants underwent a physical examination and answered an extensive interviewer-administered questionnaire to assess differences in food servings, preparation and eating habits.

SETTING/PARTICIPANTS

Participants aged >/=25 years were randomly selected from three reservations in Minnesota and Wisconsin. There were 990 persons without diabetes, 294 with a prior diagnosis of diabetes, and 80 with fasting glucose >125 mg dl(-1) but no prior diabetes diagnosis.

RESULTS

Persons with prior diabetes diagnosis were less likely than those without diabetes to report eating fast-food meals two or more times per week, eat visible fat on meat or the skin on poultry, eat fried chicken or fried fish, to add fat to cooked vegetables and drink whole milk. Persons with previously undiagnosed diabetes were more likely than previously diagnosed persons to report eating fast-food meals two or more times per week, eat visible fat on meat and the skin on poultry, drink whole milk and eat fried fish, but were less likely to drink low-fat milk. Previously undiagnosed persons were more likely than either diagnosed persons or persons without diabetes to consume lard from cooked foods and use it when cooking.

CONCLUSION

Persons with diagnosed diabetes showed healthier eating patterns than those without diabetes, while undiagnosed persons showed some less favourable patterns. Because virtually all persons with diabetes in these communities receive nutrition education, the results suggest that nutrition education programmes for diabetics may be associated with healthier eating patterns.

INFECTIOUS DISEASE SURVEY OF GEMSBOK IN NEW MEXICO

Exotic wildlife can introduce new diseases or act as reservoirs of endemic diseases. On White Sands Missile Range, New Mexico (USA), significant declines in populations of native ungulates generally correspond to increases in range and population density of the exotic gemsbok (Oryx gazella gazella), introduced beginning in 1969. We surveyed gemsbok in 2001 for exposure to a variety of diseases potentially important for native ungulates. High seroprevalence was found for malignant catarrhal fever virus (49 [98%] of 50 sera; 43 [96%] of 45 plasma samples), blue-tongue virus (48 [96%] of 50), bovine respiratory syncytial virus (33 [66%] of 50), and parainfluenza-3 virus (10 [20%] of 50). Low numbers of Nematodirus spp. eggs in a few individuals were the only parasites detected in gemsbok. Exposure to the above diseases in gemsbok is of interest to managers because of potential implications for recovery of desert bighorn sheep (Ovis canadensis mexicana) and desert mule deer (Odocoileus hemionus crooki) in the White Sands area because each has been implicated in mortality in these species either in the White Sands area or elsewhere in the western/southwestern United States.

Signaling lymphocytic activation molecule expression and regulation in human intracellular infection correlate with Th1 cytokine patterns

Induction of Th1 cytokines, those associated with cell-mediated immunity, is critical for host defense against infection by intracellular pathogens, including mycobacteria. Signaling lymphocytic activation molecule (SLAM, CD150) is a transmembrane protein expressed on lymphocytes that promotes T cell proliferation and IFN-gamma production. The expression and role of SLAM in human infectious disease were investigated using leprosy as a model. We found that SLAM mRNA and protein were more strongly expressed in skin lesions of tuberculoid patients, those with measurable CMI to the pathogen, Mycobacterium leprae, compared with lepromatous patients, who have weak CMI against M. leprae. Peripheral blood T cells from tuberculoid patients showed a striking increase in the level of SLAM expression after stimulation with M. leprae, whereas the expression of SLAM on T cells from lepromatous patients show little change by M. leprae stimulation. Engagement of SLAM by an agonistic mAb up-regulated IFN-gamma production from tuberculoid patients and slightly increased the levels of IFN-gamma in lepromatous patients. In addition, IFN-gamma augmented SLAM expression on M. leprae-stimulated peripheral blood T cells from leprosy patients. Signaling through SLAM after IFN-gamma treatment of Ag-stimulated cells enhanced IFN-gamma production in lepromatous patients to the levels of tuberculoid patients. Our data suggest that the local release of IFN-gamma by M. leprae-activated T cells in tuberculoid leprosy lesions leads to up-regulation of SLAM expression. Ligation of SLAM augments IFN-gamma production in the local microenvironment, creating a positive feedback loop. Failure of T cells from lepromatous leprosy patients to produce IFN-gamma in response to M. leprae contributes to reduced expression of SLAM. Therefore, the activation of SLAM may promote the cell-mediated immune response to intracellular bacterial pathogens.

Waldenström macroglobulinemia caused by extranodal marginal zone B-cell lymphoma: a report of six cases

Waldenström macroglobulinemia (WM) and its associated hyperviscosity syndrome (HVS) are generally caused by lymphoplasmacytoid lymphoma or other small B-cell lymphoproliferative disorders. WM associated with extranodal marginal zone B-cell-mucosa-associated lymphoid tissue lymphoma (EMZL/MALT-type) has not been emphasized. We describe 4 men and 2 women (age, 40-79 years) with clinical and laboratory manifestations of WM and EMZL/MALT-type involving one or more sites: lung, pericardium/pleura, ocular adnexa, nasopharynx, minor salivary gland, glossopharyngeal fold, skin, and stomach. The following immunophenotypic patterns were observed: CD20+, 6; CD43+, 3; kappa light chain restriction, 5; and lambda light chain restriction, 1. All were negative for CD5, CD10, and cyclin D1 expression. A clonal paraproteinemia was present in each (IgM kappa, 4; IgM lambda, 1; biclonal IgM kappa/IgA kappa, 1). All 4 patients tested had elevated plasma viscosity; clinical HVS occurred in 3, and 2 required emergency plasmapheresis. These findings suggest that EMZL/MALT-type can cause WM and that the laboratory evaluation of EMZL/MALT-type should include serum protein electrophoresis/immunofixation, and plasma viscosity measurements and urine immunofixation in select cases. EMZL/MALT-type should be considered in the differential diagnosis in patients with clinicopathologic features of WM.

Impaired fasting glucose, diabetes mellitus, and cardiovascular disease risk factors are associated with prolonged QTc duration. Results from the Third National Health and Nutrition Examination Survey

BACKGROUND

Impaired glucose tolerance and diabetes mellitus have been associated with a prolonged QT interval among select populations. However, these associations remain unclear among the general population.

METHODS

We examined these relationships using data from 5833 adults aged 40-90 years from NHANES III (1988-1994). Univariate differences in cardiovascular disease (CVD) risk factors were examined across tertiles of heart rate corrected QT (QTc). The association between glucose intolerance, CVD risk factors and a prolonged QTc (> or = 0.440 s) was also assessed with logistic regression adjusting for age, race, gender, education, and heart rate.

RESULTS

Prolonged QTc was observed among 22.0% of persons with normal glucose tolerance (NGT), 29.9% of those with impaired fasting glucose (IFG), and among 42.2% of persons with diabetes. Hypertension, serum cholesterol, obesity, heart rate, and fasting C-peptide and serum insulin levels were associated with prolonged QTc (all: P < or = 0.05). After multivariate adjustment, persons with IFG were 1.2 times (95% CI=0.7-2.0) as likely and persons with diabetes 1.6 times (95% CI=1.1-2.3) as likely to have a prolonged QTc as persons with NGT. In addition, persons with diabetes and two or more additional CVD risk factors were 2.3 times (95% CI=1.3-4.0) as likely to have a prolonged QTc as persons with NGT and no CVD risk factors after multivariate adjustment.

CONCLUSION

Diabetes was associated with an increased likelihood of prolonged QTc independent of age, race, gender, education, and heart rate. In addition, persons with diabetes and multiple CVD risk factors were more likely to have a prolonged QTc than those with NGT and no additional risk factors, suggesting that these persons may be at increased risk for cardiac arrhythmia and sudden death.

The first example of a paraben-dependent antibody to an Rh protein

BACKGROUND

Parabens are added to a commercial LISS (C-LISS) to retard microbial growth. Paraben-dependent anti-Jk(a) has been detected by the use of C-LISS.

CASE REPORT

Serum from a D+ woman reacted in antiglobulin tests with RBCs stored (2-4 hours, 22-25 degrees C) in C-LISS (Löw and Messeter formulation, Immucor). Freshly prepared C-LISS-suspended RBCs did not react; nor did RBCs stored in LISS-additive reagents, PEG, saline, or homemade LISS.

RESULTS

Studies using C-LISS-stored RBCs revealed an antibody that reacted with D+ and rrV+ RBCs, but not with r'r, r"r, or rrV-VS- RBCs. All partial D RBC phenotypes tested reacted, as did D+LW-, rGr, r"Gr, r(y)r, r'(s)rV+VS+, and r'(s)rV-VS+ RBCs. The active ingredient in C-LISS was propylparaben. Other LISS ingredients were not required; saline solutions of propylparaben, ethylparaben, methyl salicylate, 2-phenoxyethanol, and butylparaben were active. Methylparaben and methyl-m-hydroxybenzoate were inactive. Reactivity to C-LISS-stored RBCs could not be inhibited by propylparaben. Reactivity with D+V- and D-V+VS+ RBCs was not separable by adsorption-elution.

CONCLUSIONS

This antibody likely detects a neoantigen formed between active compounds and RBC membranes. Review of the structure of active compounds suggests that proximity between methyl and hydroxyl groups is important for binding with RBC membranes. The role of RhD is unclear; no single portion of RhD protein appears to be implicated.

Fingerprint ridge-count difference between adjacent fingertips (dR45) predicts upper-body tissue distribution: evidence for early gestational programming

Fingerprint ridge counts, which remain constant from the 19th week of pregnancy, are related to fingertip growth during early gestation. Each finger corresponds neurologically to a spinal-cord segment ranging from C6 (thumb, relatively cephalad) to C8 (fifth finger, relatively caudad). The authors hypothesized that large ridge-count differences between fingertips (cephalad > caudad) might reflect fetal inhibition of caudal growth. Among 69 male Atlanta, Georgia, military recruits (1994-1997; aged 17-22 years), they tested associations of the anthropometric waist-to-thigh ratio with 20 ridge-count differences. Waist-to-thigh ratio was associated with the ridge-count difference between the right fourth and fifth fingertips only (dR45; r = 0.36, p = 0.003). The race-adjusted standardized regression coefficient was 0.22 (95% confidence interval: 0.03, 0.41). Since upper-body tissue distribution indicates disease risk, the authors then tested the association of age (an indicator of survivorship) with dR45 in a sample of 135 male patients from Bangalore, India (1989-1990; aged 38-82 years). Age was inversely associated with dR45 (r = -0.17, p = 0.04), notably among the 75 men with diabetes (r = -0.22, p = 0.06). An increased dR45 predicts an upper-body tissue distribution originating before the midpoint of pregnancy. The cause of this developmental pattern is unknown, but it may lead to reduced survivorship.

Diffuse duodenitis associated with ulcerative colitis

Backwash ileitis and postcolectomy pouchitis are well-recognized complications of ulcerative colitis (UC), whereas inflammation of the proximal small intestine is not. In contrast, small intestinal disease at any level is common in Crohn's disease (CD). Despite this well-established and accepted dogma, rare cases of histologically proven diffuse duodenitis (DD) associated with UC appear in the literature. In this study, we report our experience with similar cases exhibiting this unusual inflammatory phenomenon. Routine histologic sections from four cases of DD associated with well-documented UC were reviewed and the findings correlated with all available medical records. Multiple endoscopic biopsies showing histologic features of UC and colectomy specimens confirming severe ulcerative pancolitis were available for all cases. Varying degrees of active chronic inflammation and architectural mucosal distortion identical to UC were observed in pre- and postcolectomy duodenal biopsies of one of four and four of four cases, respectively. Similar inflammatory patterns were present postoperatively in the ileum in three of four cases and in the jejunum in one case. Endorectal pull-through (ERPT) procedures were performed in three of four patients and an end-to-end ileorectal anastomosis was done in one patient. Despite extensive upper gastrointestinal tract involvement, none of the patients developed postsurgical Crohn's-like complications during a follow-up period of 12 to 54 months. This suggests that patients with pancolitis and DD do not necessarily have CD, but rather may have UC and, most importantly, that successful ERPT procedures may be performed in these patients.