bluuebunny/crossref_metadata_2025 huggingface dataset:
Adipocyte‐Specific Ablation of Long‐Chain Acyl‐CoA Synthetase‐4 (ACSL4) in Mice Protects Against Diet‐Induced Obesity‐Associated Decreases in White Adipocyte Oxygen Consumption and Whole Body Energy Expenditure
Authors: Killion Elizabeth A. , Kong Dong , Greenberg Andrew S.
Published: June 2021

Obesity‐associated alterations in adipocyte metabolism are important to the development of metabolic disorders, including type 2 diabetes, a leading cause of chronic disease and death in the United States. However, we have limited understanding of the role of white adipocyte oxygen consumption in the development of obesity and its complications. Of particular interest, long‐chain acyl‐CoA synthetases (ACSL) catalyze the addition of a coenzyme‐A group to fatty acids (FA) within cells and have been hypothesized to direct FA to distinct fates within cells. Intriguingly, the ACSL4 isoform is suggested to preferentially activate polyunsaturated fatty acids, but little is known about its function in regulating adipocyte metabolism. Previously, we have demonstrated that mice with adipocyte‐specific ACSL4 ablation (Ad‐KO) on a high fat diet (HFD) are protected against obesity‐associated body weight & fat mass gain and insulin resistance compared to their wildtype littermates (ACSL4floxed) without any phenotypic differences on a low fat diet (Killion et al., FASEB Journal, 2015; 29:743.1). The purpose of the current research is to investigate the role of ACSL4 in regulating obesity‐associated adipocyte dysfunction, including adipocyte oxygen consumption and systemic energy expenditure. Energy expenditure in ACSL4floxed and Ad‐KO mice was measured by TSE metabolic chamber system before mice were switched to HFD, 3 weeks of HFD, and 7 weeks of HFD (before body composition differences are observed between ACSL4floxed and Ad‐KO mice). Interestingly, after 7 weeks on HFD, but not earlier, rates of energy expenditure (kcal/gram lean mass/day) were 10% higher in Ad‐KO mice than ACSL4floxed littermates without differences in food intake or activity. To specifically determine the role of white adipocyte oxygen consumption, gonadal white adipocytes were isolated from mice after 12 weeks of HFD and ex vivo oxygen consumption of isolated adipocytes was measured using a Clark electrode. Remarkably, isolated adipocytes from Ad‐KO mice have 4‐fold higher rates of basal respiration in the presence of glucose (nmol O2/min/106 adipocytes) without differences in FCCP uncoupled respiration or changes in UCP1 expression compared to ACSL4floxed littermates. In conclusion, adipocyte ablation of ACSL4 significantly protects against diet‐induced obesity‐associated decreases in adipocyte oxygen consumption and whole body energy expenditure without beiging of white adipocytes.

Support or Funding Information

Funding for this work is supported by NIH Training Grant 5T32DK062032‐20, DK098606‐02, P30‐DK‐46200, USDA agreement #58‐1950‐7‐70, and NIH K01DK094943.
Fasting plasma metabolomics reveal specific dietary patterns in sow‐fed neonatal piglets compared to soy‐ or dairy‐based formula feeding.
Authors: Piccolo Brian D , Diaz‐Rubio Maria Elena , Mercer Kelly E , Yeruva Laxmi
Published: June 2021

The beneficial effects of breastfeeding on infant health is well‐known; however, the mechanisms underlying these effects have not been fully elucidated. To characterize the impact of formula‐vs. sow‐feeding on metabolic pathways, we used untargeted metabolomics on fasting sera samples from neonatal piglets to compare effects of sow‐fed and infant formula‐based diets. A total of 36 piglets were weaned exclusively on ad‐libitum sow‐feeding for 2 days after birth and then equally split into 3 exclusive dietary groups for 21 consecutive days: continuation of ad‐libitum sow‐feeding, dairy‐, or soy‐based infant formula fed diets. Total energy intake in dairy‐and soy‐based infant formula diets were given to match weight gain in ad‐libitum sow‐fed piglets (i.e., piglets were matched by digestible energy intake). Fasting serum samples were collected at the end of the feeding period and analyzed using LC‐MS. Partial least squares‐discriminant analysis (PLS‐DA) models were used to identify ions that discriminate dietary group differences. Data were split into model training and test datasets to determine PLS‐DA model accuracy and only training data was used for model development and feature selection. Optimal cross‐validation accuracy was reached with 21 metabolites included in the model, and permutations of final model revealed a significant difference between nested cross‐validated model accuracy relative to nested permuted accuracy (P < 0.01). Classification of data held out in test set was correctly predicted using 2 latent variables. Amino acids and amino acid derivatives, including phenylalanine, arginine, kynurenine, dimethylglycine, urea, and pipecolic acid, were selected in the final model and found to be significantly different among dietary groups (all P < 0.05; 1‐way ANOVA; Benjamini and Hochberg adjusted). Phosphoric acid, citric acid, and sphingosin‐1‐phosphate were also featured in final PLS‐DA model. Other phospholipid species were identified in the final model and validation of these species are ongoing. Our data suggest that amino acid and lipid metabolism is significantly altered by infant formula‐based diets matched for digestible energy intake in a neonatal piglet model, likely due to the disparate protein and lipid composition of the three diets. Future work will be to assess and integrate the metabolomic profile in liver, ileum, and urine to provide a comprehensive overview of metabolic changes associated with infant formula feeding.

Support or Funding Information

USDA‐ARS Project 6026‐5100‐010‐05S
Iron Status Predicts EEG Measures of Brain Function During a Memory Task in 4–6 Month Old Infants and May Reveal Associations Between Early Iron Status and Memory Behavior
Authors: Nevins Julie E.H. , Robertson Steven S. , Canfield Richard L. , Haas Jere D.
Published: June 2021

Background

Iron deficiency (ID) during late gestation and infancy—the period of peak brain development—is associated with longterm cognitive deficits. Infants of weaning age (4–6 mo) have an elevated risk of low iron stores, yet no clinical definition of ID exists for infants <12 mo. Previous studies are limited by non‐specific measures of cognition.

Objective

We hypothesized that decreased neural responses mediate the relationship between low iron status and memory performance.

Methods

In a cross‐sectional study of infants (4–6 mo, n = 23), we assessed iron status with hemoglobin (Hb) and serum ferritin (sFt), as well as brain activity with electroencephalography (EEG) during a memory task and novelty preference (%Nov) during a second memory task. Both tasks measured infant response to novel versus familiar visual stimuli. We used mixed regression models to determine whether the between‐stimulus difference in amplitude of the EEG “slow wave” (ΔLSW), a known correlate of memory, mediates the association between iron status and novelty preference. Relevant covariates were also included.

Results

As expected, the LSW was more negative for novel vs control stimuli (p = 0.04). For every 1 μV change in ΔLSW, %Nov increased 0.52 ± 0.26 (SE)% (p=0.05). The ΔLSW parameter estimate increased to 0.56 ± 0.24 (p=0.02) when anemia (Hb <110 g/L; β= −4.97 ± 1.64, p<0.01) and age (β= 0.65 ± 0.26, p=0.01) were added to the model. Having low iron stores (sFt <45.0 μg/L) produced a similar result as anemia, except that ΔLSW was no longer significantly associated with %Nov after adding ferritin status to the model.

Conclusions

The infants had a greater neural response to novel versus familiar stimuli, and anemia status predicted the magnitude of ΔLSW. Preliminary analyses suggest that ΔLSW was not a mediator because the relationship between anemia and %Nov was strengthened, not diminished, when ΔLSW was added to the model. ΔLSW could be a negative confounder. The biological theory and data from animal studies provide a strong case for the presence of a mediating relationship between iron status, brain function, and memory performance in early infancy. Our methods should be repeated in a longitudinal follow‐up and ideally a randomized controlled trial, as it may be that the hypothesized mediation is only related to the change in Fe status.

Support or Funding Information

Funded by USDA/CUAES (#NYC‐399413) & Cornell Human Ecology Alumni Association; JN supported by NSF GRFP
Hydroxytyrosol is more a more potent antioxidant than tyrosol
Authors: Rodríguez‐Morató Jose , de la Torre Rafael , Blumberg Jeffrey , Chen C‐Y. Oliver
Published: June 2021

Tyrosol (Tyr), a phenolic present in olive oil and wine, is converted to hydroxytyrosol (Hty) via hepatic phase I enzymes in vitro and in vivo. Tyr and Hty possess an array of potential bioactions, including antioxidant, cardioprotectant, antitumor, antimicrobial, antidiabetic and neuroprotection. However, the relative efficacy of these 2 compounds has not been characterized. Thus, we compared the capacity of Tyr vs. Hty in vitro for antioxidant actions in HepG2 cells. Using the FRAP and ORAC assays, we noted total antioxidant capacity of Hty was 25‐ and 3.5‐fold higher than Tyr, respectively. At physiological concentrations of 1–25 μmol/L, neither Tyr nor Hty altered HepG2 cell viability determined after 24‐h incubation with the MTT assay. Hty at 5 μmol/L displayed 40% greater cellular protection against 250 μmol/L H2O2‐induced apoptosis than Tyr. Similarly, at 5 μmol/L, Hty was 4‐ and 3.5‐fold more effective than Tyr in reducing 50 μmol/L AAPH‐ and 500 μmol/L H2O2‐induced production of reactive oxygen species, respectively, determined using the CM‐H2DCFDA assay. Using LC‐MS/MS, sulfated and methylated metabolites of Hty and Tyr were detected in the HepG2 cell lysates, but neither glucuronidated nor hydroxylated forms were detected. In conclusion, Hty (and potentially its phase II metabolites) displayed more potent antioxidant activity than Tyr, possibly due to an additional hydroxyl group in its phenol ring.

Support or Funding Information

FIS‐ISCIII‐FEDER, CIBEROBN, FI‐DGR2012 Predoctoral Fellowship, and USDA
Online and In‐Person Nutrition Education Reduces Sodium Intake: A Randomized Trial to Assess Knowledge, Self‐Efficacy and Behaviors in WIC Participants
Authors: Au Lauren , Whaley Shannon , Rosen Nila J , Meza Martha , Ritchie Lorrene D
Published: June 2021

High blood pressure is one of the leading causes of preventable morbidity and mortality in the U.S., and low‐income populations are at increased risk. The purpose of this randomized controlled trial was to examine the impacts of online and in‐person group nutrition education on changes in knowledge, self‐efficacy, and behaviors related to sodium reduction in a diverse sample of low‐income women enrolled in Women, Infants, and Children (WIC) between November 2014‐May 2015. The content of the lesson focused on ways to reduce sodium intake and promoted healthy low‐salt cooking options. 580 WIC participants from 3 Los Angeles, CA WIC clinics were randomly assigned to receive in‐person group education (n=294) or online education (n=286). Questionnaires assessing knowledge, self‐efficacy, and behaviors related to sodium reduction were administered before and after education, and 2 to 4 months later. T‐tests and x 2 tests were used to compare changes within and between in‐person and online groups. ANCOVA and GEE were used to assess differences in change between groups. Positive changes in knowledge and self‐efficacy improved between pre‐ and post‐questionnaire and were retained 2–4 months later for both groups (P<0.05). Both groups reported significant improvements in behaviors related to using less salt in cooking, and eating less salt, processed foods, fast‐food, and restaurant foods (all P<0.001). Overall, this study demonstrates that both online and in‐person group education can result in improvements in knowledge, self‐efficacy, and behaviors related to reducing sodium intake in a low‐income population. Findings support the use of innovative and effective nutrition education to low‐income populations to improve long‐term dietary behaviors.

Support or Funding Information

This project has been funded with Federal funds from the U.S. Department of Agriculture, Food and Nutrition Service through grant WIC NEI‐12‐TX to Baylor College of Medicine to the Nutrition Policy Institute at the University of California's Division of Agriculture and Natural Resources (formally the Center for Weight and Health at the University of California, Berkeley). The contents of this publication do not necessarily reflect the view or policies of the U.S. Department of Agriculture, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.
Social Media Usage Pattern among Supplemental Nutrition Assistance Program Education (SNAP‐Ed) eligible Individuals in Georgia
Authors: White Alice , Hagues Rachel , Childers Austin , Lee Jung Sun , Olubajo Babatunde , Phua Joe
Published: June 2021

Social media has a potential to deliver nutrition education messages effectively and efficiently to large, underserved populations, but little is known about the current social media usage pattern among SNAP‐Ed eligible population. The purpose of this study was to understand the current social media practices in a sample of SNAP‐Ed eligible Georgians who participated in a series of focus group interviews to examine the feasibility of developing a statewide social marketing intervention as part of the SNAP‐Ed programming in Georgia. A total of 68 participants representing a range of rural and urban counties in Georgia completed a social media use survey prior to the focus group (n=68, mean age 40.3±14.4, 94.1% female, 75.0% minority). About 63% of the study sample reported they use social media on a day‐to‐day basis, and 82.4% have a membership to at least 1 social media platform. Most of the study sample reported to have a Facebook membership (76.5%), and access social media through smartphones (73.5%). Through social media, participants preferred to receive health and nutrition information on a daily to weekly basis (92.6%) especially recipes and food tips. Those who are regularly using social media were more likely to be female, have at least 1 membership to a social media platform, and more likely to read health and nutrition information on social media. The findings from this study identified and suggest approaches that social media can be used as an effective means of engaging SNAP‐Ed eligible individuals as part of the statewide SNAP‐Ed Social Marketing intervention in Georgia.

Support or Funding Information

This study was funded by USDA SNAP‐Ed.
The Impact of Limonin on Gut Microbiota
Authors: Gu Min , Sun Jin , Qi Ce , Cai Kun Xiao , Goulette Tim , Song Yue Ming , You Meng xiao , Sela David , Xiao Hang
Published: June 2021

The gut microbiota play critical roles in human health, and diet can modulate the compositions of the gut microbiota, which in turn may contribute to altered health outcomes such as changes in the risks of chronic diseases. Limonin is one of the major bioactive compounds found in citrus fruits and have been reported to possess various beneficial health effects. This study was aimed to determine the effects of dietary limonin on the gut microbiota. Mice were fed limonin in the diet (0.05% w/w) for 5 weeks, and the microbiota were isolated for composition analysis. Terminal restriction fragment length polymorphism (T‐RFLP) patterns and Misequencing analysis were used to profile gut microbiota in the cecum, colon and feces of the mice. The results showed that compared to the control mice, treatment of limonin did not cause significant change on the diversity of the cecal microbiota, while significant changes were observed in the diversity of colonic microbiota after limonin treatment. In the colon, abundance of colonic Enterobacteriaceae was decreased by 10‐fold, while the abundance of Bifidobacteria and Lactobacillus was increased significantly in the mice treated with limonin (p<0.001). Moreover, the abundance of colonic Clostridiales was reduced to one third of that of the control mice by the administration of limonin. Overall, our study provide the first line of evidence that dietary limonin could alter gut microbiota, which warrants further investigation to determine its implication in human health.

Support or Funding Information

This study was partially supported by fund form USDA.
Impact of Body Mass Index and Metabolic Health Status on All‐Cause Mortality Risk among Older Adults
Authors: Cheng Feon W. , Gao Xiang , Mitchell Diane C. , Wood Craig , Still Christopher , Jensen Gordon L.
Published: June 2021

Introduction

Reduced all‐cause mortality has been reported for older persons with overweight or class I obesity (body mass index, BMI 25.0–29.9 or 30.0–34.9 kg/m2, respectively) compared to those of desirable BMI (18.5–24.9 kg/m2). The explanation for this observation remains unclear. Our objective was to investigate the joint effects of BMI and metabolic health status on all‐cause mortality in a well characterized cohort of advanced age.

Methods

Among 4,551 older adults with a mean age of 74 ± 4.7 years at baseline, we categorized individuals into eight groups according to BMI categories (18.5–24.9, 25.0–29.9, 30.0–34.9, and ≥35.0 kg/m2) and the presence or absence of a metabolically healthy phenotype, defined as having 0 or 1 of the metabolic risk factors based on a modified Adult Treatment Panel III guideline proposed by the National Cholesterol Education Program. Metabolically unhealthy was 2 or more risk factors. A Cox proportional hazards model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for age, sex, smoking, alcohol, laboratory values, and comorbidity status.

Results

There were 2,294 mortality cases over a mean 10.9 years of follow up. Compared to metabolically healthy persons of desirable BMI 18.5–24.9 kg/m2, metabolically unhealthy participants of all BMI groups had increased risk of all‐cause mortality (Figure 1). Compared with metabolically healthy BMI 18.5–24.9 kg/m2 individuals, their metabolically healthy overweight and obesity class I counterparts were not at greater all‐cause mortality risk (HR, 0.89; 95 CI%, 0.74–1.06 and HR, 0.75; 95 CI%, 0.59–0.94, respectively) (P‐Interaction: 0.03, Figure 1).

Conclusions

Among older adults, metabolically healthy overweight or mild obesity (class I) is not associated with a higher mortality risk and unhealthy metabolic status may be a risk factor for all‐cause mortality regardless of BMI group. It appears that metabolically healthy overweight and mildly obese persons of advanced age account for the “obesity paradox”.

Support or Funding Information

Supported by United States Department of Agriculture, Agricultural Research Service, 8050‐51530‐012‐01A.
Toward closing the dietary fiber gap: candidate genes associated with dietary fiber content in common bean
Authors: Brick Mark A , Thompson Henry J
Published: June 2021

Common bean (Phaseolus vulgaris) is known as an important source of protein, mineral nutrients and dietary fiber in the human diet. These compounds have dietary health implications, including lowering blood pressure, reducing the risk of advanced colorectal cancer, obesity, diabetes and cardiovascular disease. Common bean also contain oligosaccharides such as raffinose, stachyose, and verbascose that have been reported to enhance human health. This research was conducted to better understand the genetic control of components of dietary fiber including oligosaccharides in common bean. Genome wide association studies (GWAS) were conducted on 280 lines from Middle American common bean germplasm to map the genomic regions responsible for soluble and insoluble dietary fiber, and oligosaccharides. GWAS coupled with common bean whole genome sequence data could lead to higher resolution mapping and facilitate candidate gene discovery. We used 15,127 SNPs with minor allele frequency of 5% and greater in a population of 263 genotypes from the BeanCAP project to map fiber and oligosaccharide traits. We identified strong candidate genes for soluble and insoluble dietary fiber content, and oligosaccharides.

Support or Funding Information

Supported by the USDA/NIFA Common Bean Coordinated Agricultural Project (BeanCAP), the Colorado State University Agricultural Experiment Station, and PHS grant R01‐CA172375 from the National Cancer Institute.
Dietary Flavonoid Intake Is Negatively Associated with Anthropometric Risk Factors for Chronic Disease in Some Population Subgroups But Not Others: Results from What We Eat in America, NHANES 2007–2010
Authors: Sebastian Rhonda S , Enns Cecilia Wilkinson , Goldman Joseph D , Steinfeldt Lois C , Moshfegh Alanna J
Published: June 2021

Flavonoids, bioactive compounds found in plants, are considered beneficial for human health. Whereas favorable associations between flavonoid intakes and anthropometric measures that are risk factors for chronic disease have been found in various studies, little research has examined whether similar associations exist in the U.S. population overall or in specific racial/ethnic groups. The purpose of this study was to investigate whether flavonoid intake is related to body mass index (BMI) and waist circumference (WC) in a large, nationally representative sample of U.S. adults. Data from one 24‐hour recall for 5,378 males and 5,480 non‐pregnant, non‐lactating females age 20 years and over participating in What We Eat in America (WWEIA), NHANES 2007–2010 were analyzed. Intakes of total flavonoids and six flavonoid classes (anthocyanidins, flavan‐3‐ols, flavanones, flavones, flavonols, and isoflavones) were determined by applying the recently released, comprehensive database Flavonoid Values for USDA Survey Foods and Beverages 2007–2008. The few plant‐based foods/beverages that were new in the 2009–2010 survey were assigned the flavonoid profile of the most similar 2007–2008 item. For total flavonoids and for each class, individuals were divided into four categories of intake, and trends in BMI and WC were determined using orthogonal polynomial contrasts with adjustment for confounding variables. For all adults age 20 years and over, negative trends in both BMI and WC were found with increasing category of intake of total flavonoids, anthocyanidins, flavan‐3‐ols, and flavanones (p<0.001). Identical trends were seen among men, but only anthocyanidins and flavanones were inversely associated with BMI and WC among women. No significant associations were found between anthropometric measures and intakes of flavones, flavonols, or isoflavones. Among non‐Hispanic (NH) whites (both genders together), inverse associations were found between WC and total flavonoid intake and between both BMI and WC and intakes of anthocyanidins, flavan‐3‐ols, and flavanones. Among Hispanics, inverse associations were found between both BMI and WC and anthocyanidin intake. Among NH blacks, no relationships were identified between anthropometric measures and flavonoid intakes. Negative associations between flavonoid intake and BMI and WC are not uniform across flavonoid classes, gender, or race/ethnicity. The finding of significant negative associations between flavonoid intakes and BMI and WC in some populations but not others suggests that further examination by race/ethnicity of intake of flavonoids and flavonoid‐containing foods/beverages might contribute to understanding of disparities in chronic disease occurrence.

Support or Funding Information

ARS, USDA
Overweight and Obesity, Weight Perception, and Weight Management Practices among Supplemental Nutrition Assistance Program Education (SNAP‐Ed) Participants in Georgia
Authors: Bailey Claudette , Lee Jung Sun , Olubajo Babatunde
Published: June 2021

Under the Healthy, Hunger‐Free Kids Act of 2010, the SNAP‐Ed program has been reestablished as the nutrition education and obesity prevention program; however, little is known about weight perception and weight‐related practices among SNAP‐Ed eligible individuals, who are disproportionately affected by obesity. This study examined overweight and obesity, weight perception, and weight management strategies in a sample of SNAP‐Ed participants in Georgia (southeastern United States) (n=261, mean age 54.9±20.8, 76.6% female, 70.9% non‐Hispanic black). Body weight, height, and weight‐related practices were assessed based on data from self‐administered paper surveys collected by trained paraprofessionals at program entry. Almost three‐quarters of the sample was overweight (31.4%) or obese (42.2%), and 54.8% reported at least one diagnosis of selected diet‐related chronic conditions including high blood pressure, high cholesterol, diabetes, and heart disease. Among those who reported overweight and obese body weight status, only 60.1% perceived themselves as being overweight. Overweight and obese participants who accurately perceived their weight were more likely to desire weight loss and to have attempted to lose weight than those who did not perceive themselves as overweight. In particular, overweight/obese participants reporting at least one of the selected diagnoses were more likely to desire weight loss than those who reported none (OR 3.5; CI 1.9, 6.6; p<0.0001). About 43% of the study sample reported having attempted weight loss within the previous 12 months, and the most common weight loss strategies were eating less food (61.2%), eating less junk food (59.5%), exercising (59.5%), drinking a lot of water (57.7%), and eating more fruits, vegetables, and salads (54.6%). The findings from this study show a much higher burden of obesity among SNAP‐Ed participants in Georgia than in the general population and highlight the importance and urgency of developing a culturally tailored obesity prevention program to meet their unique needs as part of SNAP‐Ed programming.

Support or Funding Information

This study was funded by USDA SNAP‐Ed.
Calcium Absorption Among Racially Diverse Pregnant Women
Authors: Lesser Mary N. R. , Nguyen Leyna , King Janet C. , O'Brien Kimberly O. , Fung Ellen B.
Published: June 2021

Longitudinal studies of calcium metabolism during pregnancy (PG) have shown that maternal calcium (Ca) absorption increases progressively from the first to the third trimester to meet the needs of the developing fetus. This increase in calcium absorption is directly related to maternal Ca intake. However, even with this increase in absorption, maternal and fetal needs may not be met in women with chronically low Ca intakes (<500 mg/day). Low Ca intakes are not uncommon among women in the USA and may result in maternal bone mobilization. Studies of Ca intake and absorption among racially diverse pregnant women are limited. Thus, this cross‐sectional study was done to determine the effect of racial differences on Ca absorption during the third trimester of pregnancy. Forty women, 10 each from four racial groups (African‐American (AA), Asian, Caucasian, Latina) were recruited between 30–36 weeks gestation. The following outcomes were measured: Ca intake from validated FFQ, Ca absorption, 24 hour urinary Ca excretion, 25OH vitamin D, and bone resorption as assessed by C‐terminal telopeptide (CTx). Ca absorption was measured from a standardized breakfast meal providing 330 mg Ca using the dual stable isotope technique (44Ca oral & 42Ca IV). To date, 34 women have completed the study (6 AA, 8 Asian, 10 Caucasian, 10 Latina) and are presented herein. Preliminary results show that of the 4 groups, only Latina and AA women met the pregnancy Ca RDA. Fasting serum Ca averaged 10.4 ± 0.6 mg/dL in the group as a whole, and it was not associated with CTx or race (r=0.0019, p=NS). Ca absorption ranged from 28.6–80.6% in the whole group of 34 women, and it was not associated with the habitual Ca intake. However, there is an interaction between race, Ca intake and Ca absorption, suggesting that women of different race absorb Ca differently based on Ca intake. 25OH vitamin D was significantly higher (p=0.053) in Caucasian women (29.9 ± 6.5 ng/mL) compared to Asian women (21.3 ± 6.0 ng/mL), and it was inversely related to Ca absorption (p=0.044). 24 hour urinary Ca excretion averaged 163.6 ± 85.5 ug/mL in the whole group; it did not differ by racial group, but it was positively related to Ca absorption (p=0.016). Our preliminary results suggest that in this group of racially diverse women, Ca metabolism is highly variable (intake, absorption, and excretion), which has a larger influence on Ca metabolism parameters than any potential effect due to race.

Support or Funding Information

Supported by USDA #2009‐02925
Multi‐omics of the Soil Microbiome
Authors: Jansson Janet K
Published: June 2021

TheArctic is characterized by vast amounts of carbon stored in permafrost and isan important focal point for the study of climate change as increasing temperature may accelerate microbially‐mediated release of carbon stored inpermafrost into the atmosphere as CO2 and CH4. Yet surprisingly, very little is known about the vulnerability of permafrost andresponse of microorganisms in the permafrost to their changing environment. To address these knowledge gaps we used omics technologiesto explore permafrost microbial communities, to reveal hitherto unknown soilmicrobial populations and to link them to specific soil biogeochemical processes. For these projects we employed an omics pipeline that includes metagenomics, metatranscriptomics and metaproteomics to determine the phylogenetic and functional gene compositions and their expression in complex, non‐sterile soil samples collected from the field at several locations in Alaska. These studies have presented several challenges due to the unprecedented large size of the datasets and the insufficiency of available bioinformatic tools & databases to analyze, correlate and integrate thedata. To address these challenges we developed a novel functional gene databaseand used different assembly and analysis algorithms to determine key featuresin the datasets. The data reveal the microbial diversity, composition andfunctional potential in permafrost and how the microbial communities respond toclimate change impacts.

Support or Funding Information

Microbiomes in Transition, LDRD, Pacific Northwest National Laboratories, Richland, Washington
Role of Hippocampal Neurogenesis in Drug Addiction
Authors: Silva Roberto Javier Morales , Galinato Melissa H , Mandyam Chitra
Published: June 2021

Methamphetamine, a psychostimulant and neurotoxic drug, has been shown to inhibit neurogenesis in the hippocampal region of the brain. The hippocampus is responsible for functions such as short‐term and long‐term memory, spatial orientation, and connecting emotions and senses. Also the hippocampus is involved in forming context‐specific memories associated with reinstatement of drug‐seeking. Neurogenesis is the process of stem‐like precursor cells that proliferate into preneuronal progenitor cells that then differentiate into immature neurons that become granule cell neurons in the dentate gyrus. This process is impaired by methamphetamine and other drugs of abuse. The objective of this study is to determine the role of spontaneous neurogenesis in the dentate gyrus in drug addiction. To address this, we took a genetic approach using GFAP‐TK transgenic animals to conditionally inhibit the process of neurogenesis. GFAP‐TK+ and TK− (wild‐type controls) were submitted to intravenous surgery to implant a catheter to the jugular vein for intravenous drug self‐administration. The self‐administration behavior was divided in 5 phases: drug acquisition, forced abstinence from drug (withdrawal), extinction, and context‐ and cue‐ induced reinstatement. During withdrawal GFAP‐TK+ animals received valganciclovir diet (valcyte) to inhibit the proliferation and differentiation of neural precursor cells in the dentate gyrus. Controls received vehicle diet. One hour following reinstatement session, TK+ and TK− animals were sacrificed and the brain was processed for immunohistochemistry. Valcyte treatment in TK+ rats reduced the number of Ki‐67 and NeuroD cells in the hippocampus compared to vehicle TK− controls. In parallel, TK+ rats showed impaired lever discrimination during extinction sessions and context‐induced reinstatement, but not cue‐induced reinstatement, indicating enhanced motivation to seek methamphetamine in the absence of the drug. These results indicate that hippocampal neurogenesis plays a role in extinguishing drug seeking behavior and suppresses motivation during context induced reinstatement.

Support or Funding Information

The study was supported by funds from the National Institute on Drug Abuse (DA022473 and DA034140 to CDM) and National Science Foundation (DGE‐1144086) to MG
The Importance of Formalized, Lifelong Physician Career Development: Making the Case for a Paradigm Shift
Authors: Collins R. Thomas , Sanford Rania
Published: June 2021

The value of structured development processes has been recognized and implemented in formal physician training programs such as residencies and fellowships. Physicians are seemingly viewed as a “finished product” upon completing formal training. In recent years, a number of academic medical centers have implemented formalized early-career development programs for physicians, largely those who have a major research focus. However, beyond the early stage of physicians’ careers, formalized and intentional physician career development programs are rare. The lack of a philosophy of intentional, career-long individual development at academic medical centers reflects a narrow understanding of the implicit contract between employers and employees. The resulting gap leads the vast majority of physicians to fall short of their potential, further leading to long-term loss for the academic medical centers, their physicians, and society as a whole. Based on the framework of analyze-design-develop-implement-evaluate, the authors propose a robust, iterative model for physician career development that goes beyond skills and knowledge maintenance toward leveraging a broad range of individual capabilities, needs, and contexts along the career lifespan. The model provides a means for harnessing physicians’ strengths and passions in concert with the needs of their organization to create greater physician fulfillment and success, which in turn would benefit the patients they care for and the academic medical centers in which they work.
Radiation Reduction Strategies in Pediatric Orthopaedics
Authors: Sawyer Jeffrey R.
Published: June 2021

Introduction:

Pediatric orthopaedic patients have the potential for significant radiation exposure from the use of imaging studies, such as computed tomography and bone scintigraphy. With the potential for long-term treatment, such as is required for scoliosis or osteogenesis imperfecta, patients are at even greater risk of radiation-induced carcinogenesis.

Discussion:

Although an association between radiation and cancer risk is evident, causation is difficult to prove because comorbidities or genetic predispositions may play a role in the higher baseline rates of malignancy later in life. Efforts have been made over the years to reduce exposure using more modern imaging techniques and simple radiation reduction strategies. Educational efforts and clinical practice guidelines are decreasing the rate of computed tomography scan use in pediatrics. Although considerable work is being done on the development of radiation-free imaging modalities, imaging that uses ionizing radiation will, in the near term, be necessary in specific circumstances to provide optimal care to pediatric orthopaedic patients.

Conclusion:

Knowledge of the ionizing radiation exposure associated with commonly used tests as well as radiation-reduction strategies is essential for the optimal and safe care of pediatric orthopaedic patients.
“Shared Decision Making Assistant”
Authors: Wang Sitong , Ye Zhixia , Pan Zeya , Yang Ning , Li Yu , Li Yunyun , Li Li
Published: June 2021

The development of medical technology provides medical specialists with a variety of choices for their primary liver cancer patients, including partial liver resection, transcatheter arterial chemoembolization, liver transplantation, and so on. However, in this context, because patients with primary liver cancer frequently do not receive adequate information to help make complicated medical decisions, those patients, who are usually otherwise ignorant about their disease, are facing multiple difficult choices. The problem might be alleviated with a process called “shared decision making.” Accordingly, researchers developed a smartphone application named “Shared Decision Making Assistant” for primary liver cancer patients in China, and in this article, we report the process of its development. First, individual interviews were conducted to identify the specific needs and status of primary liver cancer patients participating in shared decision making. Next, expert group discussions were held among primary liver cancer medical experts, nurses, and software engineers, using a decision-making process called the Delphi method, which was used to arrive at a group opinion or decision by surveying a panel of experts, to draft the framework and decide on the contents of the mobile health–based decision aids program. Feedbacks and suggestions were collected to optimize the workflow of “Shared Decision Making Assistant.” The resulting application consisted of seven modules: personal information, primary liver cancer treatment knowledge center, decision aids path, continuing care, interactive platform, health education, and backstage management.
Diagnosis and Treatment for Acute Focal Bacterial Nephritis With Renal Abscess Based on Magnetic Resonance Imaging Evaluation
Authors: Fujita Yuji , Kuwashima Shigeko , Nomura Kohei , Kano Yuji , Yoshihara Shigemi
Published: June 2021

A 5-year-old boy was diagnosed with left acute focal bacterial nephritis (AFBN) complicated with renal abscess (RA) on magnetic resonance imaging (MRI). MRI is useful for diagnosing AFBN and RA complications. He was administered antibiotics for 3 weeks on evaluation of MRI findings. Evaluation of apparent diffusion coefficient values over time may be useful as an index of treatment of RA.
Hip and Pelvic Floor Muscle Strength in Women With and Without Urgency and Frequency-Predominant Lower Urinary Tract Symptoms
Authors: Foster Stefanie N. , Spitznagle Theresa M. , Tuttle Lori J. , Sutcliffe Siobhan , Steger-May Karen , Lowder Jerry L. , Meister Melanie R. , Ghetti Chiara , Wang Jinli , Mueller Michael J. , Harris-Hayes Marcie
Published: June 2021

Background:

Urgency and frequency are common lower urinary tract symptoms (UF-LUTS) in women. There is limited evidence to guide physical therapist-led treatment.

Objectives:

To compare hip and pelvic floor muscle strength between women with and without UF-LUTS. We hypothesized women with UF-LUTS would demonstrate (1) diminished hip external rotator and abductor strength and (2) equivalent pelvic floor strength and diminished endurance compared with controls.

Study Design:

A matched case-control study.

Methods:

Women with UF-LUTS (cases) and controls were matched on age, body mass index, and vaginal parity. An examiner measured participants' (1) hip external rotator and abductor strength via dynamometry (maximum voluntary effort against fixed resistance) and (2) pelvic floor muscle strength (peak squeeze pressure) and endurance (squeeze pressure over a 10-second hold) via vaginal manometry. Values were compared between cases and controls with paired-sample t tests (hip) or Wilcoxon signed rank tests (pelvic floor).

Results:

In 21 pairs (42 women), hip external rotation (67.0 ± 19.0 N vs 83.6 ± 21.5 N; P = .005) and hip abduction strength (163.1 ± 48.1 N vs 190.1 ± 53.1 N; P = .04) were significantly lower in cases than in controls. There was no significant difference in pelvic floor strength (36.8 ± 19.9 cmH2O vs 41.8 ± 21.0 cmH2O; P = .40) or endurance (234.0 ± 149.6 cmH2O × seconds vs 273.4 ± 149.1 cmH2O × seconds; P = .24).

Conclusion:

Women with UF-LUTS had weaker hip external rotator and abductor muscles, but similar pelvic floor strength and endurance compared with controls. Hip strength may be important to assess in patients with UF-LUTS; further research is needed.
Association between aspartate aminotransferase-to-alanine aminotransferase ratio and insulin resistance among US adults
Authors: Visaria Aayush , Pai Suraj , Cheung Maggie , Ahlawat Sushil
Published: June 2021

Objective

To determine whether a low aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AST/ALT ratio) is associated with insulin resistance among those without liver dysfunction.

Methods

In this cross-sectional study of the National Health and Nutrition Examination Survey (NHANES) 2011–2016, we included 2747 (1434 male and 1313 nonpregnant female) adults ≥20 years without evidence of liver dysfunction (ALT<30 in male and <19 in female, negative viral serologies, no excess alcohol consumption, no elevated transferrin saturation, AST/ALT <2). Serum AST/ALT ratio was categorized into sex-specific quartiles (female: <1.12, 1.12–1.29, 1.29–1.47, ≥1.47 and male: <0.93, 0.93–1.09, 1.09–1.26, ≥1.26). The primary outcome was insulin resistance, as determined by Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) index score ≥3. Covariate-adjusted odds ratios (ORs) were estimated. Study analysis completed from 13 March 2020 to 21 April 2021.

Results

Among the 2747 individuals, 33% had insulin resistance. Those in the lowest quartile (Q1) of AST/ALT had 75% higher adjusted odds of insulin resistance compared to the highest quartile (Q4) [aOR (95% confidence interval (CI), 1.75 (1.20–2.57)]. This association was more pronounced in those with elevated BMI [Q1 vs. Q4; BMI ≥ 25: 2.29 (1.58–3.33), BMI < 25: 0.66 (0.26–1.69); NAFLD per Fatty Liver Index ≥ 60: 2.04 (1.21–3.44), No NAFLD: 1.68 (0.94–3.01)].

Conclusion

Lower AST/ALT ratio is associated with increased insulin resistance among those with healthy-range ALT, especially in those with BMI greater than or equal to 25 kg/m2.
Neutrophil–lymphocyte ratio and the risk of hepatocellular carcinoma in patients with hepatitis B-caused cirrhosis
Authors: Shi Ke , Li Ping , Xue Dongying , Liu Yao , Zhang Qun , Ping Ranchong , Wang Xianbo
Published: June 2021

Aim

The neutrophil-to-lymphocyte ratio (NLR) has been reported as a prognostic marker of hepatocellular carcinoma (HCC); however, the relationship between NLR and risk of HCC occurrence has yet to be systematically elucidated. We aimed to investigate the association between NLR and HCC risk in patients with hepatitis B-caused cirrhosis (HBC) undergoing antiviral therapy.

Methods

A total of 1599 patients with HBC receiving entecavir or tenofovir at three tertiary hospitals between June 2014 and November 2017 were included. Cox proportional hazards regression was used to identify the association between NLR and risk of HCC occurrence by adjusting for potential risk factors. The cumulative incidence of HCC was evaluated using Kaplan–Meier analysis.

Results

At study enrollment, the median NLR was 2.0 (interquartile range, 1.4–3.0). The 3-year cumulative probabilities of HCC were 4.8, 8.4, 13.2, and 18.0% across the NLR quartiles, respectively (P < 0.001). Compared with the lowest quartile, higher NLR correlated with an increased HCC occurrence [NLR 1.4–2.0: adjusted hazard ratio (aHR), 1.18 (95% confidence interval (CI), 1.11–1.25); NLR 2.0–3.0: aHR, 2.09 (95% CI, 1.19–3.66); NLR > 3.0: aHR, 2.80 (95% CI, 1.59–4.95); P for trend = 0.001] in the fully adjusted models. In the subgroup analysis, elevated NLR was associated with increased HCC risk, regardless of stratification criteria.

Conclusion

Elevated NLR is an independent risk factor for HCC occurrence in patients with HBC undergoing antiviral therapy.
Quality and Cost in Community Health Centers
Authors: Carey Kathleen , Luo Qian , Dor Avi
Published: June 2021

Background:

Quantifying health care quality has long presented a challenge to identifying the relationship between provider level quality and cost. However, growing focus on quality improvement has led to greater interest in organizational performance, prompting payers to collect various indicators of quality that can be combined at the provider level.

Objective:

To explore the relationship between quality and average cost of medical visits provided in US Community Health Centers (CHCs) using composite measures of quality.

Research Design:

Using the Uniform Data System collected by the Bureau of Primary Care, we constructed composite measures by combining 9 process and 2 outcome indicators of primary care quality provided in 1331 US CHCs during 2015–2018. We explored different weighting schemes and different combinations of individual quality indicators constructed at the intermediate domain levels of chronic condition control, screening, and medication management. We used generalized linear modeling to regress average cost of a medical visit on composite quality measures, controlling for patient and health center factors. We examined the sensitivity of results to different weighting schemes and to combining individual quality indicators at the overall level compared with the intermediate domain level.

Results:

Both overall and domain level composites performed well in the estimations. Average cost of a medical visit was negatively associated with quality, although the magnitude of the effect varied across weighting schemes.

Conclusion:

Efforts toward improvement of primary health care quality delivered in CHCs need not involve greater cost.
Common pediatric infestations: update on diagnosis and treatment of scabies, head lice, and bed bugs
Authors: Ogbuefi Nonye , Kenner-Bell Brandi
Published: June 2021

Purpose of the review

This review will update pediatric providers on the recent data regarding the epidemiology, diagnosis, and treatment of common skin infestations affecting children and adolescents.

Recent findings

Standard superficial skin biopsy for scabies and the vacuum method for head lice can increase diagnostic accuracy and efficiency. There is growing resistance to some of the traditional treatments for scabies and head lice, and progress has been made in finding newer and potentially more effective treatments, such as oral moxidectin for scabies and abametapir for head lice. Recent studies have established the safety of traditional treatments, such as permethrin and oral ivermectin in infants and small children.

Permethrin and ivermectin are both considered safe and effective for children and adolescents with scabies. Permethrin is generally considered safe in infants less than two months of age. Proper application of permethrin is critical, and providers should emphasize proper application technique. Treatment of head lice should only be initiated with active infestations. Resistance to permethrin continues to increase and other options are now available, including an over-the-counter topical ivermectin formulation. Identification and eradication of bed bug infestations are crucial in preventing bedbug bites.