Background:A shift from self-reports to wearable sensors for global physical activity(PA)surveillance has been recommended.The conventional use of a generic cut-point to assess moderate-to-vigorous PA(MVPA)is problema...Background:A shift from self-reports to wearable sensors for global physical activity(PA)surveillance has been recommended.The conventional use of a generic cut-point to assess moderate-to-vigorous PA(MVPA)is problematic as these cut-points are often derived from non-representative samples under non-ecological laboratory conditions.This study aimed to develop age-and sex-(age-sex)specific cut-points for MVPA based on population-standardized values as a feasible approach to assess the adherence to PA guidelines and to investigate its associations with all-cause mortality.Methods:A total of 7601 participants(20-85+years)were drawn from the 2003-2004 and 2005-2006 National Health and Nutrition Examination Surveys(NHANES).Minutes per week of MVPA were assessed with a hip-worn accelerometer.Counts per minute(CPM)were used to define an age-sex specific target intensity,representing the intensity each person should be able to reach based on their age and sex.Age-sex specific MVPA cut-points were defined as any activity above 40%of the target intensity.These population-and free-living-based age-sex specific cut-points overcome many of the limitations of the standard generic cut-point approach.For comparison,we also calculated MVPA with a generic cut-point of 1952 CPM.Both approaches were compared for assessing adherence to PA guidelines and association of MVPA with allcause mortality(ascertained through December 2015).Results:Both approaches indicated that 37%of the sample met the 150+min/week guideline.The generic cut-point approach showed a trend to inactivity with age,which was less pronounced using the age-sex specific cut-points.Overall mortality rates were comparable using generic cutpoint(hazard ratio(HR)=0.61,95%confidence interval(95%CI):0.50-0.73)or age-sex specific cut-points(HR=0.57,95%CI:0.50-0.66)for the entire sample.The generic cut-point method revealed an age-and sex-related gap in the benefits of achieving 150+min/week of MVPA,with older adults showing an 18%greater reduction in mortality rates than younger adults,and a larger difference in women than in men.This disparity disappeared when using age-sex specific cut-points.Conclusion:Our findings underscore the value of age-sex specific cut-points for global PA surveillance.MVPA defined with age-sex specific thresholds was associated with all-cause mortality and the dose-response was similar for all ages and sexes.This aligns with the single recommendation of accumulating 150+min/week MVPA for all adults,irrespective of age and sex.This study serves as a proof of concept to develop this methodology for PA surveillance over more advanced open-source acceleration metrics and other national and international cohorts.展开更多
Background:Physicalfitness in childhood and adolescence is associated with a variety of health outcomes and is a powerful marker of current and future health.However,inconsistencies in tests and protocols limit interna...Background:Physicalfitness in childhood and adolescence is associated with a variety of health outcomes and is a powerful marker of current and future health.However,inconsistencies in tests and protocols limit international monitoring and surveillance.The objective of the study was to seek international consensus on a proposed,evidence-informed,Youth Fitness International Test(YFIT)battery and protocols for health monitoring and surveillance in children and adolescents aged 618 years.Methods:We conducted an international modified Delphi study to evaluate the level of agreement with a proposed,evidence-based,YFIT of core health-relatedfitness tests and protocols to be used worldwide in 6-to 18-year-olds.This proposal was based on previous European and North American projects that systematically reviewed the existing evidence to identify the most valid,reliable,health-related,safe,and feasiblefitness tests to be used in children and adolescents aged 618 years.We designed a single-panel modified Delphi study and invited 216 experts from all around the world to answer this Delphi survey,of whom one-third are from low-to-middle income countries and one-third are women.Four experts were involved in the piloting of the survey and did not participate in the main Delphi study to avoid bias.We pre-defined an agreement of 80%among the expert participants to achieve consensus.Results:We obtained a high response rate(78%)with a total of 169fitness experts from 50 countries and territories,including 63 women and 61 experts from low-or middle-income countries/territories.Consensus(>85%agreement)was achieved for all proposed tests and protocols,supporting the YFIT battery,which includes weight and height(to compute body mass index as a proxy of body size/composition),the 20-m shuttle run(cardiorespiratoryfitness),handgrip strength,and standing long jump(muscularfitness).Conclusion:This study contributes to standardizingfitness tests and protocols used for research,monitoring,and surveillance across the world,which will allow for future data pooling and the development of international and regional sex-and age-specific reference values,health-related cut-points,and a global picture offitness among children and adolescents.展开更多
Outdoor air pollution is a known risk factor for mortality and morbidity.The type of air pollutant most reliably associated with disease is particulate matter（PM）,especially finer particulate matter that can reach d...Outdoor air pollution is a known risk factor for mortality and morbidity.The type of air pollutant most reliably associated with disease is particulate matter（PM）,especially finer particulate matter that can reach deeper into the lungs like PM_（2.5）（particulate matter diameter 〈 2.5 μm）.Some subpopulations may be particularly vulnerable to PM pollution.This review focuses on one subgroup,long-term stroke survivors,and the emerging evidence suggesting that survivors of a stroke may be at a higher risk from the deleterious effects of PM pollution.While the mechanisms for mortality are still under debate,long-term stroke survivors may be vulnerable to similar mechanisms that underlie the well-established association between PM pollution and cardiovascular disease.The fact that long-term stroke survivors of ischemic,but not hemorrhagic,strokes appear to be more vulnerable to the risk of death from higher PM pollution may also bolster the connection to ischemic heart disease.Survivors of an ischemic stroke may be more vulnerable to dying from higher concentrations of PM pollution than the general population.The clinical implications of this association suggest that reduced exposure to PM pollution may result in fewer deaths amongst stroke survivors.展开更多
In the race to deliver clean water to communities through potable water reuse, disinfection and water quality assessment are and will continue to be fundamental factors. There are over 700 disinfection byproducts(DBPs...In the race to deliver clean water to communities through potable water reuse, disinfection and water quality assessment are and will continue to be fundamental factors. There are over 700 disinfection byproducts(DBPs) in water;evaluating each compound is practically impossible and very time consuming. A bioanalytical approach could be an answer to this challenge. In this work, the response of four major classes of DBPs toward mitochondrial membrane potential( Δψm) and cytoplasmic adenosine triphosphate(C-ATP) was investigated with human carcinoma(Hep G2) cells. Within 90 min of cell exposure, only the haloacetic acid(HAA) mixture caused a cytotoxic response as measured by C-ATP. All four groups(haloacetonitriles(HANs), trihalomethanes(THMs), nitrosamines(NOAs), and HAAs) responded well to Δψm, R 2 > 0.70. Based on the half-maximum concentration that evoked a 50% response in Δψm, the response gradient was HANs >> HAAs ~ THM > NOAs. The inhibition of the Δψm by HANs is driven by dibromoacetonitrile(DBAN), while dichloroacetonitrile(DCAN) did not cause a significant change in the Δψm at less than 2000 μM. A mixture of HANs exhibited an antagonistic behavior on the Δψm compared to individual compounds. If water samples are concentrated to increase HAN concentrations, especially DBAN, then Δψm could be used as a biomonitoring tool for DBP toxicity.展开更多
Background: We recently evaluated four laboratory assays, vascular endothelial growth factor D (VEGF-D), E-cadherin, lymphatic vessel density (LVD) measured by podoplanin, and intra-lymphatic tumor emboli (ILTE), whic...Background: We recently evaluated four laboratory assays, vascular endothelial growth factor D (VEGF-D), E-cadherin, lymphatic vessel density (LVD) measured by podoplanin, and intra-lymphatic tumor emboli (ILTE), which showed notable differences between inflammatory breast cancer (IBC) and non-inflammatory locally advanced breast cancer (LABC). In this study we investigated the potential of the three most quantitatively measured markers, E-cadherin, LVD and VEGF-D, to predict survival in the IBC patients. Materials and Methods: This study involved the 100 cases identified in the Inflammatory Breast Cancer Registry (IBCR) whose tumors were previously evaluated for the four assays noted above. Living patients were recontacted and survival data were available for up to 17 years. Overall survival (OS) was analyzed through the Kaplan-Meier method stratified by E-cadherin, LVD, VEGF-D, and response to chemotherapy. The differences in OS curves were compared using the log-rank test. Results: The median OS for patients with high LVD was 6.63 years (95% CI: 4.06 to 10.14), compared to median at 10 years not reached in those with low LVD (p = 0.03). There was a trend towards a longer median OS in patients with high E-cadherin (10.14, 95% CI: 6.63 to 11.67), compared with those with low E-cadherin (6.26, 95% CI: 3.42 to undeterminable). VEGF-D levels showed no correlation with survival. Conclusion: Low LVD significantly predicts better survival. High E-cadherin expression, as with non-IBC breast cancer and several other malignancies, tends to be associated with a better prognosis.展开更多
Haloacetamides（HAMs） are cytotoxic, genotoxic, and mutagenic byproducts of drinking water disinfection. They are soft electrophilic compounds that form covalent bonds with the free thiol/thiolate in cysteine residue...Haloacetamides（HAMs） are cytotoxic, genotoxic, and mutagenic byproducts of drinking water disinfection. They are soft electrophilic compounds that form covalent bonds with the free thiol/thiolate in cysteine residues through an S_N2 reaction mechanism.Toxicity of the monohalogenated HAMs（iodoacetamide, IAM; bromoacetamide, BAM;or chloroacetamide, CAM） varied depending on the halogen substituent. The aim of this research was to investigate how the halogen atom affects the reactivity and toxicological properties of HAMs, measured as induction of oxidative/electrophilic stress response and genotoxicity. Additionally, we wanted to determine how well in silico estimates of electrophilic softness matched thiol/thiolate reactivity and in vitro toxicological endpoints.Each of the HAMs significantly induced nuclear Rad51 accumulation and ARE signaling activity compared to a negative control. The rank order of effect was IAM 〉 BAM 〉 CAM for Rad51, and BAM ≈ IAM 〉 CAM for ARE. In general, electrophilic softness and in chemico thiol/thiolate reactivity provided a qualitative indicator of toxicity, as the softer electrophiles IAM and BAM were more thiol/thiolate reactive and were more toxic than CAM.展开更多
Objective:To explore the seroprevalence,spatial distribution and risk factors for Leishmania seropositivity in Jordan.Methods:Blood samples from 872 apparently healthy participants were randomly selected from 11 gover...Objective:To explore the seroprevalence,spatial distribution and risk factors for Leishmania seropositivity in Jordan.Methods:Blood samples from 872 apparently healthy participants were randomly selected from 11 governorates in Jordan and tested for anti-Leishmania K39 IgG.Risk factors(animal ownership and agriculture practices)and demographic data were also collected using pre-tested and validated questionnaire.Results:Overall,2.52% of participants were seropositive for Leishmania spp.Participants living in the Jordan Valley plateau had significantly greater odds(adjusted odds ratio= 3.70,95% CI 1.37-9.93)of seropositivity than those living in the Highlands after adjustment for age.Conclusions:This study supports the intermittent reports of cutaneous leishmaniasis outbreaks in the Jordan Valley.Vector control measures in the Jordan Valley should be considered,including insecticide treated bed nets,sugar baits and using flowering plants to attract and trap Phlebotomus papatasi sand flies.Active surveillance in the Jordan Valley is also recommended in light of this and other reports.展开更多
The U.S.Department of Health and Human Services convened the 2018 Physical Activity Guidelines Advisory Committee(PAGAC)and charged it with reviewing and summarizing the current scientific evidence linking physical ac...The U.S.Department of Health and Human Services convened the 2018 Physical Activity Guidelines Advisory Committee(PAGAC)and charged it with reviewing and summarizing the current scientific evidence linking physical activity to human health and function.The 2018 PAGAC Scientific Report1 serves as the basis for the Physical Activity Guidelines for Americans,2nd edition3 The 2018 Scientific Report extends the findings of the 2008 Scientific Report3 by examining a broader range of health outcomes and special populations that benefit from increased physical activity.In addition,the 2018 Scientific Report more closely examined the specific types,volumes,and intensities of physical activity that are associated with those benefits and now describes novel strategies for physical activity promotion at the population level.展开更多
In the United States, children are not meeting daily recommendationsfor 60 min of moderate・to・vigorous activity.1Because children spend a large portion of their days in school, ithas been further recommended that chil...In the United States, children are not meeting daily recommendationsfor 60 min of moderate・to・vigorous activity.1Because children spend a large portion of their days in school, ithas been further recommended that children accumulate 30 minof their physical activity (PA) during school hours.2 Our previousresearch has demonstrated with objective measures that only8%—9% of elementary school children meet this goal, with anaverage accumulation of 18 min/day.3,4 This finding is of concerngiven the numerous benefits that PA has not only on healthoutcomes,5-8 but also on academic achievement.9 For example,there is heightened awareness that children benefit from PAthroughout the school day in terms of attention to task, memory,behavior, and, ultimately, academic performance.10 Schooladministrators acknowledge this link, but still face barriers toincorporating PA for schoolchildren, including limited time andresources for physical education (PE) and recess.展开更多
INTRODUCTION Respiratory syncytial virus(RSV)is the leading cause of severe acute lower respiratory tract infection(LRTI)in infants and young children,resulting in an estimated 33 million infections annually,>3 mil...INTRODUCTION Respiratory syncytial virus(RSV)is the leading cause of severe acute lower respiratory tract infection(LRTI)in infants and young children,resulting in an estimated 33 million infections annually,>3 million hospitalizations,and>100000 deaths in children under 5 years globally,with a mortality rate of up to 9%in low-resource countries,which have 99%of the global RSV mortality.1 RSV infection is associated with an increased risk of respiratory failure,admission to the ICU,mechanical ventilation,use of oxygen therapy,and death.2,3 Severe RSV-LRTI in early childhood increases the risk of long-term respiratory disorders such as repeated wheezing or asthma.展开更多
Objective Exercise is Medicine(EIM)is a global initiative encouraging healthcare providers to routinely assess and promote physical activity(PA)among patients.The objective of this study was to evaluate the feasibilit...Objective Exercise is Medicine(EIM)is a global initiative encouraging healthcare providers to routinely assess and promote physical activity(PA)among patients.The objective of this study was to evaluate the feasibility,adoption,implementation and effectiveness of EIM from patient,clinician and healthcare staff perspectives using a combination of electronic health record(EHR),survey and interview data.Design This study used a combination of the Practical Robust Implementation and Sustainability Model(PRISM)and the Learning Evaluation model to implement EIM.Data captured from the EHR,including Physical Activity Vital Sign(PAVS)scores,and data collected from qualitative surveys and interviews were used to evaluate the programme’s Reach,Effectiveness,Adoption,Implementation,Maintenance(RE-AIM,which is embedded within PRISM)from provider,staff and patient perspectives.Setting Five primary care clinics within a large academic health system.Participants A total of 24443 patients from all participating clinics had at least one PAVS score during the study period.A total of 17 clinicians completed surveys,and 4 clinicians,8 medical assistants and 9 patients completed interviews.Results Implementation fidelity metrics varied widely between components and across clinics but were generally consistent over time,indicating a high degree of programme maintenance.Fidelity was highest during the first 6 months of the COVID-19 pandemic when most visits were virtual.Mean PAVS scores increased from 57.7(95%CI:56 to 59.4)to 95.2(95%CI:91.6 to 98.8)min per week at 6 months for patients not meeting PA guidelines at baseline and decreased from 253.84(95%CI:252 to 255.7)to 208.3(95%CI:204.2 to 212.4)min per week at 6 months for patients meeting PA guidelines at baseline.After EIM implementation,clinician-estimated time spent discussing PA with patients increased for 35%of providers and stayed the same for 53%.Conclusion Overall,this study established EIM’s feasibility,adoption,implementation and maintenance in routine primary care practice within a large academic health system.From a population health perspective,EIM is a model to emulate to help primary care providers efficiently address healthy lifestyle behaviours in routine primary care visits.展开更多
Background:Schistosomiasis is a common parasitic disease designated as a neglected tropical disease by the World Health Organization.Schistosomiasis mansoni is a form of the disease that is caused by the digenean trem...Background:Schistosomiasis is a common parasitic disease designated as a neglected tropical disease by the World Health Organization.Schistosomiasis mansoni is a form of the disease that is caused by the digenean trematode Schistosoma mansoni,transmitted through Biomphalaria spp.as an intermediate host.Biomphalaria was introduced to Hong Kong,China in aquatic plants shipments coming from Brazil and the snail rapidly established its habitats in southern China.Earlier studies of Biomphalaria spp.introduced to southern China identified the snails as Biomphalaria straminea,one of the susceptible species implicated in S.mansoni transmission in South America.However,recent molecular investigations also indicated the presence of another South American species,B.kuhniana,which is refractory to infection.As such,it is important to identify accurately the species currently distributed in southern China,especially with emerging reports of active S.mansoni infections in Chinese workers returning from Africa.Methods:We combined morphological and molecular taxonomy tools to precisely identify Biomphalaria spp.distributed in Guangdong Province,southern China.In order to clearly understand the molecular profile of the species,we constructed a phylogeny using mtDNA data(COI and 16S rRNA sequences)from six populations of Biomphalaria spp.from Shenzhen City in Guangdong Province.In addition,we examined the external morphology of the shell and internal anatomy of the reproductive organs.Results:Both morphological and molecular evidences indicated a close affinity between Biomphalaria spp.populations from Guangdong and B.straminea from Brazil.The shell morphology was roughly identical in all the populations collected with rounded whorls on one side and subangulated on the other,a smooth periphery,an egg-shaped aperture bowed to one side,and a deep umbilicus.The shape and number of prostate diverticula(ranged from 11.67 to 17.67)in Guangdong populations supports its close affinity to B.straminea rather than B.kuhniana.Molecular analysis did not conflict with morphological analysis.Little genetic differentiation was observed within Biomphalaria populations collected.Phylogenetic analysis of COI and 16S rRNA haplotypes from snails collected and B.straminea sequences from Brazil and China using Bayesian inference revealed that Guangdong populations were clustered in one clade with B.straminea from Hong Kong of China and B.straminea from Brazil indicating their close affinity to each other.Conclusions:Data obtained in the current study clearly show that the populations of Biomphalaria spp.investigated are B.straminea,and we assume that those snails were either introduced via passive dispersal from Hong Kong of China or as a result of multiple introduction routes from Brazil.展开更多
Objective:Determine uptake of prostate-specific antigen(PSA)testing in Medicare benefi-ciaries according to previous receipt of PSA testing.Methods:A 5%random sample of men aged 67 years or older without a previous di...Objective:Determine uptake of prostate-specific antigen(PSA)testing in Medicare benefi-ciaries according to previous receipt of PSA testing.Methods:A 5%random sample of men aged 67 years or older without a previous diagnosis of prostate cancer was identified through 2009-2012 Medicare claims.We measured the annualized frequency of PSA screening among men due for PSA testing,stratified by PSA testing use in the previous 2 years,and clustered by ordering provider.Results:Throughout the study period,PSA testing use was consistently higher for men with previous screening than for men without previous screening.For men without previous screening,there was a decline in testing that was most pronounced in 2012.Compared with 2009,the cor-responding odds ratios were 0.98[95%confidence interval(CI)(0.96-1.00)]in 2010,0.94[95%CI(0.92-0.95)]in 2011,and 0.66[95%CI(0.65-0.68)]in 2012.In contrast,for men with previous screening,PSA testing frequency was stable from 2009 to 2011,and declined to a lesser extent in 2012[odds ratio 0.80,95%CI(0.79-0.81)].Conclusion:Receipt of PSA testing is highly dependent on whether an individual was tested in the recent past.In previously unscreened men,the largest decrease occurred in 2012,which may reflect in part the publication of US Preventive Services Task Force guidelines,but there was much less impact among men already being screened.展开更多
基金supported in part by the intramural research programs at the National Institute on Aging and National Cancer Institute(USA)supported by the Spanish Ministry of Science,Innovation and Universities under Beatriz Galindo's 2022 fellowship program(BG22/00075).
文摘Background:A shift from self-reports to wearable sensors for global physical activity(PA)surveillance has been recommended.The conventional use of a generic cut-point to assess moderate-to-vigorous PA(MVPA)is problematic as these cut-points are often derived from non-representative samples under non-ecological laboratory conditions.This study aimed to develop age-and sex-(age-sex)specific cut-points for MVPA based on population-standardized values as a feasible approach to assess the adherence to PA guidelines and to investigate its associations with all-cause mortality.Methods:A total of 7601 participants(20-85+years)were drawn from the 2003-2004 and 2005-2006 National Health and Nutrition Examination Surveys(NHANES).Minutes per week of MVPA were assessed with a hip-worn accelerometer.Counts per minute(CPM)were used to define an age-sex specific target intensity,representing the intensity each person should be able to reach based on their age and sex.Age-sex specific MVPA cut-points were defined as any activity above 40%of the target intensity.These population-and free-living-based age-sex specific cut-points overcome many of the limitations of the standard generic cut-point approach.For comparison,we also calculated MVPA with a generic cut-point of 1952 CPM.Both approaches were compared for assessing adherence to PA guidelines and association of MVPA with allcause mortality(ascertained through December 2015).Results:Both approaches indicated that 37%of the sample met the 150+min/week guideline.The generic cut-point approach showed a trend to inactivity with age,which was less pronounced using the age-sex specific cut-points.Overall mortality rates were comparable using generic cutpoint(hazard ratio(HR)=0.61,95%confidence interval(95%CI):0.50-0.73)or age-sex specific cut-points(HR=0.57,95%CI:0.50-0.66)for the entire sample.The generic cut-point method revealed an age-and sex-related gap in the benefits of achieving 150+min/week of MVPA,with older adults showing an 18%greater reduction in mortality rates than younger adults,and a larger difference in women than in men.This disparity disappeared when using age-sex specific cut-points.Conclusion:Our findings underscore the value of age-sex specific cut-points for global PA surveillance.MVPA defined with age-sex specific thresholds was associated with all-cause mortality and the dose-response was similar for all ages and sexes.This aligns with the single recommendation of accumulating 150+min/week MVPA for all adults,irrespective of age and sex.This study serves as a proof of concept to develop this methodology for PA surveillance over more advanced open-source acceleration metrics and other national and international cohorts.
基金supported by the Grant PID2020-120249RB-I00PID2023-148404OB-100funded by MCIN/AEI/10.13039/501100011033+4 种基金by the Andalusian Government(Junta de Andalucía,Plan Andaluz de Investigación,ref.P20_00124)by the Erasmus+Sport Programme of the European Union within the project FitBack4Literacy(No.101089829)Additional support is provided by the University of Granada,Plan Propio de Inves-tigación,Units of ExcellenceUnit of Excellence on Exercise,Nutrition and Health(UCEENS)by theCIBERobn Physiopa-thology of Obesity and Nutrition,and by the Spanish Network in Exercise and Health,EXERNET Network(RED2022-134800-Tand EXP_99828).
文摘Background:Physicalfitness in childhood and adolescence is associated with a variety of health outcomes and is a powerful marker of current and future health.However,inconsistencies in tests and protocols limit international monitoring and surveillance.The objective of the study was to seek international consensus on a proposed,evidence-informed,Youth Fitness International Test(YFIT)battery and protocols for health monitoring and surveillance in children and adolescents aged 618 years.Methods:We conducted an international modified Delphi study to evaluate the level of agreement with a proposed,evidence-based,YFIT of core health-relatedfitness tests and protocols to be used worldwide in 6-to 18-year-olds.This proposal was based on previous European and North American projects that systematically reviewed the existing evidence to identify the most valid,reliable,health-related,safe,and feasiblefitness tests to be used in children and adolescents aged 618 years.We designed a single-panel modified Delphi study and invited 216 experts from all around the world to answer this Delphi survey,of whom one-third are from low-to-middle income countries and one-third are women.Four experts were involved in the piloting of the survey and did not participate in the main Delphi study to avoid bias.We pre-defined an agreement of 80%among the expert participants to achieve consensus.Results:We obtained a high response rate(78%)with a total of 169fitness experts from 50 countries and territories,including 63 women and 61 experts from low-or middle-income countries/territories.Consensus(>85%agreement)was achieved for all proposed tests and protocols,supporting the YFIT battery,which includes weight and height(to compute body mass index as a proxy of body size/composition),the 20-m shuttle run(cardiorespiratoryfitness),handgrip strength,and standing long jump(muscularfitness).Conclusion:This study contributes to standardizingfitness tests and protocols used for research,monitoring,and surveillance across the world,which will allow for future data pooling and the development of international and regional sex-and age-specific reference values,health-related cut-points,and a global picture offitness among children and adolescents.
文摘Outdoor air pollution is a known risk factor for mortality and morbidity.The type of air pollutant most reliably associated with disease is particulate matter（PM）,especially finer particulate matter that can reach deeper into the lungs like PM_（2.5）（particulate matter diameter 〈 2.5 μm）.Some subpopulations may be particularly vulnerable to PM pollution.This review focuses on one subgroup,long-term stroke survivors,and the emerging evidence suggesting that survivors of a stroke may be at a higher risk from the deleterious effects of PM pollution.While the mechanisms for mortality are still under debate,long-term stroke survivors may be vulnerable to similar mechanisms that underlie the well-established association between PM pollution and cardiovascular disease.The fact that long-term stroke survivors of ischemic,but not hemorrhagic,strokes appear to be more vulnerable to the risk of death from higher PM pollution may also bolster the connection to ischemic heart disease.Survivors of an ischemic stroke may be more vulnerable to dying from higher concentrations of PM pollution than the general population.The clinical implications of this association suggest that reduced exposure to PM pollution may result in fewer deaths amongst stroke survivors.
基金supported by the National Science Foundation (No. 1833108)。
文摘In the race to deliver clean water to communities through potable water reuse, disinfection and water quality assessment are and will continue to be fundamental factors. There are over 700 disinfection byproducts(DBPs) in water;evaluating each compound is practically impossible and very time consuming. A bioanalytical approach could be an answer to this challenge. In this work, the response of four major classes of DBPs toward mitochondrial membrane potential( Δψm) and cytoplasmic adenosine triphosphate(C-ATP) was investigated with human carcinoma(Hep G2) cells. Within 90 min of cell exposure, only the haloacetic acid(HAA) mixture caused a cytotoxic response as measured by C-ATP. All four groups(haloacetonitriles(HANs), trihalomethanes(THMs), nitrosamines(NOAs), and HAAs) responded well to Δψm, R 2 > 0.70. Based on the half-maximum concentration that evoked a 50% response in Δψm, the response gradient was HANs >> HAAs ~ THM > NOAs. The inhibition of the Δψm by HANs is driven by dibromoacetonitrile(DBAN), while dichloroacetonitrile(DCAN) did not cause a significant change in the Δψm at less than 2000 μM. A mixture of HANs exhibited an antagonistic behavior on the Δψm compared to individual compounds. If water samples are concentrated to increase HAN concentrations, especially DBAN, then Δψm could be used as a biomonitoring tool for DBP toxicity.
文摘Background: We recently evaluated four laboratory assays, vascular endothelial growth factor D (VEGF-D), E-cadherin, lymphatic vessel density (LVD) measured by podoplanin, and intra-lymphatic tumor emboli (ILTE), which showed notable differences between inflammatory breast cancer (IBC) and non-inflammatory locally advanced breast cancer (LABC). In this study we investigated the potential of the three most quantitatively measured markers, E-cadherin, LVD and VEGF-D, to predict survival in the IBC patients. Materials and Methods: This study involved the 100 cases identified in the Inflammatory Breast Cancer Registry (IBCR) whose tumors were previously evaluated for the four assays noted above. Living patients were recontacted and survival data were available for up to 17 years. Overall survival (OS) was analyzed through the Kaplan-Meier method stratified by E-cadherin, LVD, VEGF-D, and response to chemotherapy. The differences in OS curves were compared using the log-rank test. Results: The median OS for patients with high LVD was 6.63 years (95% CI: 4.06 to 10.14), compared to median at 10 years not reached in those with low LVD (p = 0.03). There was a trend towards a longer median OS in patients with high E-cadherin (10.14, 95% CI: 6.63 to 11.67), compared with those with low E-cadherin (6.26, 95% CI: 3.42 to undeterminable). VEGF-D levels showed no correlation with survival. Conclusion: Low LVD significantly predicts better survival. High E-cadherin expression, as with non-IBC breast cancer and several other malignancies, tends to be associated with a better prognosis.
基金partial support from the U.S.Army Engineer Research and Development Center and the Army Environmental Quality Technology program, CESU W9132T-16-2-0005 (MJP)partly supported by the interagency agreement IAG #NTR 12003 from the National Institute of Environmental Health Sciences/Division of the National Toxicology Program to the National Center for Advancing Translational Sciences, National Institutes of Health
文摘Haloacetamides（HAMs） are cytotoxic, genotoxic, and mutagenic byproducts of drinking water disinfection. They are soft electrophilic compounds that form covalent bonds with the free thiol/thiolate in cysteine residues through an S_N2 reaction mechanism.Toxicity of the monohalogenated HAMs（iodoacetamide, IAM; bromoacetamide, BAM;or chloroacetamide, CAM） varied depending on the halogen substituent. The aim of this research was to investigate how the halogen atom affects the reactivity and toxicological properties of HAMs, measured as induction of oxidative/electrophilic stress response and genotoxicity. Additionally, we wanted to determine how well in silico estimates of electrophilic softness matched thiol/thiolate reactivity and in vitro toxicological endpoints.Each of the HAMs significantly induced nuclear Rad51 accumulation and ARE signaling activity compared to a negative control. The rank order of effect was IAM 〉 BAM 〉 CAM for Rad51, and BAM ≈ IAM 〉 CAM for ARE. In general, electrophilic softness and in chemico thiol/thiolate reactivity provided a qualitative indicator of toxicity, as the softer electrophiles IAM and BAM were more thiol/thiolate reactive and were more toxic than CAM.
基金supported by Jordan University of Science and Technology(Deanship of Research Project#162/2016)
文摘Objective:To explore the seroprevalence,spatial distribution and risk factors for Leishmania seropositivity in Jordan.Methods:Blood samples from 872 apparently healthy participants were randomly selected from 11 governorates in Jordan and tested for anti-Leishmania K39 IgG.Risk factors(animal ownership and agriculture practices)and demographic data were also collected using pre-tested and validated questionnaire.Results:Overall,2.52% of participants were seropositive for Leishmania spp.Participants living in the Jordan Valley plateau had significantly greater odds(adjusted odds ratio= 3.70,95% CI 1.37-9.93)of seropositivity than those living in the Highlands after adjustment for age.Conclusions:This study supports the intermittent reports of cutaneous leishmaniasis outbreaks in the Jordan Valley.Vector control measures in the Jordan Valley should be considered,including insecticide treated bed nets,sugar baits and using flowering plants to attract and trap Phlebotomus papatasi sand flies.Active surveillance in the Jordan Valley is also recommended in light of this and other reports.
文摘The U.S.Department of Health and Human Services convened the 2018 Physical Activity Guidelines Advisory Committee(PAGAC)and charged it with reviewing and summarizing the current scientific evidence linking physical activity to human health and function.The 2018 PAGAC Scientific Report1 serves as the basis for the Physical Activity Guidelines for Americans,2nd edition3 The 2018 Scientific Report extends the findings of the 2008 Scientific Report3 by examining a broader range of health outcomes and special populations that benefit from increased physical activity.In addition,the 2018 Scientific Report more closely examined the specific types,volumes,and intensities of physical activity that are associated with those benefits and now describes novel strategies for physical activity promotion at the population level.
基金funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health,Award Number R01HD080180funding was provided by the Boston Foundation
文摘In the United States, children are not meeting daily recommendationsfor 60 min of moderate・to・vigorous activity.1Because children spend a large portion of their days in school, ithas been further recommended that children accumulate 30 minof their physical activity (PA) during school hours.2 Our previousresearch has demonstrated with objective measures that only8%—9% of elementary school children meet this goal, with anaverage accumulation of 18 min/day.3,4 This finding is of concerngiven the numerous benefits that PA has not only on healthoutcomes,5-8 but also on academic achievement.9 For example,there is heightened awareness that children benefit from PAthroughout the school day in terms of attention to task, memory,behavior, and, ultimately, academic performance.10 Schooladministrators acknowledge this link, but still face barriers toincorporating PA for schoolchildren, including limited time andresources for physical education (PE) and recess.
文摘INTRODUCTION Respiratory syncytial virus(RSV)is the leading cause of severe acute lower respiratory tract infection(LRTI)in infants and young children,resulting in an estimated 33 million infections annually,>3 million hospitalizations,and>100000 deaths in children under 5 years globally,with a mortality rate of up to 9%in low-resource countries,which have 99%of the global RSV mortality.1 RSV infection is associated with an increased risk of respiratory failure,admission to the ICU,mechanical ventilation,use of oxygen therapy,and death.2,3 Severe RSV-LRTI in early childhood increases the risk of long-term respiratory disorders such as repeated wheezing or asthma.
基金funded by the Agency for Health Care Research and Quality(K08HS026517(PI:SEL))funded by two internal grants:a UC San Diego Department of FMPH Pilot Award(PI:SEL)an Academic Senate Award(PI:SEL).
文摘Objective Exercise is Medicine(EIM)is a global initiative encouraging healthcare providers to routinely assess and promote physical activity(PA)among patients.The objective of this study was to evaluate the feasibility,adoption,implementation and effectiveness of EIM from patient,clinician and healthcare staff perspectives using a combination of electronic health record(EHR),survey and interview data.Design This study used a combination of the Practical Robust Implementation and Sustainability Model(PRISM)and the Learning Evaluation model to implement EIM.Data captured from the EHR,including Physical Activity Vital Sign(PAVS)scores,and data collected from qualitative surveys and interviews were used to evaluate the programme’s Reach,Effectiveness,Adoption,Implementation,Maintenance(RE-AIM,which is embedded within PRISM)from provider,staff and patient perspectives.Setting Five primary care clinics within a large academic health system.Participants A total of 24443 patients from all participating clinics had at least one PAVS score during the study period.A total of 17 clinicians completed surveys,and 4 clinicians,8 medical assistants and 9 patients completed interviews.Results Implementation fidelity metrics varied widely between components and across clinics but were generally consistent over time,indicating a high degree of programme maintenance.Fidelity was highest during the first 6 months of the COVID-19 pandemic when most visits were virtual.Mean PAVS scores increased from 57.7(95%CI:56 to 59.4)to 95.2(95%CI:91.6 to 98.8)min per week at 6 months for patients not meeting PA guidelines at baseline and decreased from 253.84(95%CI:252 to 255.7)to 208.3(95%CI:204.2 to 212.4)min per week at 6 months for patients meeting PA guidelines at baseline.After EIM implementation,clinician-estimated time spent discussing PA with patients increased for 35%of providers and stayed the same for 53%.Conclusion Overall,this study established EIM’s feasibility,adoption,implementation and maintenance in routine primary care practice within a large academic health system.From a population health perspective,EIM is a model to emulate to help primary care providers efficiently address healthy lifestyle behaviours in routine primary care visits.
基金This work was supported by the National Key Research and Development Program of China(No.2016YFC1202001)Research Fund for the Technical Reserves,National Institute of Parasitic Diseases,Chinese CDC(No.CB-1603)+1 种基金Mohamed R.Habib was supported by a Post-doctoral Programme from the Ministry of Science and Technology of China and National Center for International Research on Tropical Diseases(Shanghai,China)Roberta L.Caldeira is supported by a fellowship from Conselho Nacional de Desenvolvimento Científico e Tecnologico/CNPq(No.304121/2014–2).
文摘Background:Schistosomiasis is a common parasitic disease designated as a neglected tropical disease by the World Health Organization.Schistosomiasis mansoni is a form of the disease that is caused by the digenean trematode Schistosoma mansoni,transmitted through Biomphalaria spp.as an intermediate host.Biomphalaria was introduced to Hong Kong,China in aquatic plants shipments coming from Brazil and the snail rapidly established its habitats in southern China.Earlier studies of Biomphalaria spp.introduced to southern China identified the snails as Biomphalaria straminea,one of the susceptible species implicated in S.mansoni transmission in South America.However,recent molecular investigations also indicated the presence of another South American species,B.kuhniana,which is refractory to infection.As such,it is important to identify accurately the species currently distributed in southern China,especially with emerging reports of active S.mansoni infections in Chinese workers returning from Africa.Methods:We combined morphological and molecular taxonomy tools to precisely identify Biomphalaria spp.distributed in Guangdong Province,southern China.In order to clearly understand the molecular profile of the species,we constructed a phylogeny using mtDNA data(COI and 16S rRNA sequences)from six populations of Biomphalaria spp.from Shenzhen City in Guangdong Province.In addition,we examined the external morphology of the shell and internal anatomy of the reproductive organs.Results:Both morphological and molecular evidences indicated a close affinity between Biomphalaria spp.populations from Guangdong and B.straminea from Brazil.The shell morphology was roughly identical in all the populations collected with rounded whorls on one side and subangulated on the other,a smooth periphery,an egg-shaped aperture bowed to one side,and a deep umbilicus.The shape and number of prostate diverticula(ranged from 11.67 to 17.67)in Guangdong populations supports its close affinity to B.straminea rather than B.kuhniana.Molecular analysis did not conflict with morphological analysis.Little genetic differentiation was observed within Biomphalaria populations collected.Phylogenetic analysis of COI and 16S rRNA haplotypes from snails collected and B.straminea sequences from Brazil and China using Bayesian inference revealed that Guangdong populations were clustered in one clade with B.straminea from Hong Kong of China and B.straminea from Brazil indicating their close affinity to each other.Conclusions:Data obtained in the current study clearly show that the populations of Biomphalaria spp.investigated are B.straminea,and we assume that those snails were either introduced via passive dispersal from Hong Kong of China or as a result of multiple introduction routes from Brazil.
基金This research was supported by a Research Scholar Grant(RSGI-12-218-01-CPHPS)from the American Cancer Society(to G.S.C.),the Case Comprehensive Cancer Center(P30-CA43703-18)the Case Clinical and Translational Science Collaborative(UL1 TR000439).
文摘Objective:Determine uptake of prostate-specific antigen(PSA)testing in Medicare benefi-ciaries according to previous receipt of PSA testing.Methods:A 5%random sample of men aged 67 years or older without a previous diagnosis of prostate cancer was identified through 2009-2012 Medicare claims.We measured the annualized frequency of PSA screening among men due for PSA testing,stratified by PSA testing use in the previous 2 years,and clustered by ordering provider.Results:Throughout the study period,PSA testing use was consistently higher for men with previous screening than for men without previous screening.For men without previous screening,there was a decline in testing that was most pronounced in 2012.Compared with 2009,the cor-responding odds ratios were 0.98[95%confidence interval(CI)(0.96-1.00)]in 2010,0.94[95%CI(0.92-0.95)]in 2011,and 0.66[95%CI(0.65-0.68)]in 2012.In contrast,for men with previous screening,PSA testing frequency was stable from 2009 to 2011,and declined to a lesser extent in 2012[odds ratio 0.80,95%CI(0.79-0.81)].Conclusion:Receipt of PSA testing is highly dependent on whether an individual was tested in the recent past.In previously unscreened men,the largest decrease occurred in 2012,which may reflect in part the publication of US Preventive Services Task Force guidelines,but there was much less impact among men already being screened.
