Health Conversion Foundations

The phenomenon of nonprofit to for-profit conversion in the health industry represents the largest redeployment of charitable assets in history. Because the converting nonprofit health organization is presumed to have provided public benefit before the conversion and because the nonprofit assets have been built by and on behalf of the public, state laws typically require that converting organizations preserve their charitable assets in order to maintain the level of public benefit provided before the conversion. Often these assets are used to endow a new foundation. These foundations -- commonly called conversion foundations -- are the subject of this paper. Over the past two decades, billions of dollars in charitable assets have transferred from the health care industry into organized philanthropy, and billions more will no doubt do so.The trend of health conversions is a very recent but quickly accelerating one: The first conversion foundation was created in 1973, and over the next ten years, only four were created; most were established in the mid-1980s or mid- to late 1990s. Most are fewer than ten years old: 59% were formed between 1994 and 1999, and an additional 11% since 1999

Long live FOXO: unraveling the role of FOXO proteins in aging and longevity

Aging constitutes the key risk factor for age-related diseases such as cancer and cardiovascular and neurodegenerative disorders. Human longevity and healthy aging are complex phenotypes influenced by both environmental and genetic factors. The fact that genetic contribution to lifespan strongly increases with greater age provides basis for research on which protective genes are carried by long-lived individuals. Studies have consistently revealed FOXO (Forkhead box O) transcription factors as important determinants in aging and longevity. FOXO proteins represent a subfamily of transcription factors conserved from Caenorhabditis elegans to mammals that act as key regulators of longevity downstream of insulin and insulin-like growth factor signaling. Invertebrate genomes have one FOXO gene, while mammals have four FOXO genes: FOXO1, FOXO3, FOXO4, and FOXO6. In mammals, this subfamily is involved in a wide range of crucial cellular processes regulating stress resistance, metabolism, cell cycle arrest, and apoptosis. Their role in longevity determination is complex and remains to be fully elucidated. Throughout this review, the mechanisms by which FOXO factors contribute to longevity will be discussed in diverse animal models, from Hydra to mammals. Moreover, compelling evidence of FOXOs as contributors for extreme longevity and health span in humans will be addressed

Bacteria and the Aging and Longevity of Caenorhabditis elegans

The molecular genetic analysis of longevity of Caenorhabditis elegans has yielded fundamental insights into evolutionarily conserved pathways and processes governing the physiology of aging. Recent studies suggest that interactions between C. elegans and its microbial environment may influence the aging and longevity of this simple host organism. Experimental evidence supports a role for bacteria in affecting longevity through distinct mechanisms—as a nutrient source, as a potential pathogen that induces double-edged innate immune and stress responses, and as a coevolved sensory stimulus that modulates neuronal signaling pathways regulating longevity. Motivating this review is the anticipation that the molecular genetic dissection of the integrated host immune, stress, and neuroendocrine responses to microbes in C. elegans will uncover basic insights into the cellular and organismal physiology that governs aging and longevity.National Institute of General Medical Sciences (U.S.)Ellison Medical Foundatio

Can drinking more water prevent urinary tract infections?

Review of: Hooton TM, Vecchio M, Iroz A, et al. Effect of increased daily water intake in premenopausal women with recurrent urinary tract infections: a randomized clinical trial. JAMA Intern Med. 2018;178:1509-1515.Can drinking more water prevent urinary tract infections? A high-quality randomized controlled trial says 'Yes'. PRACTICE CHANGER: Advise premenopausal women with recurrent urinary tract infections (UTIs) and low-volume fluid intake to increase their water intake by at least 1.5 liters daily to reduce the frequency of UTIs. STRENGTH OF RECOMMENDATION: A: Based on a single, high-qulaity randomized controlled trial.Benjamin J. McCollum, MD; Thomas Garigan, MD; John Earwood, MD; Family Medicine Residency, Dwight David Eisenhower, Army Medical Center, Fort Gordon, G

Monotherapy for nonvalvular A-fib with stable CAD?

A meta-analysis found oral anticoagulant (OAC) monotherapy provided efficacy comparable to OAC plus single antiplatelet therapy--with lower bleeding risk.Thomas P. Garigan, MD, MA; John S. Earwood, MD; Michal Poplawski, MD (Department of Soldier and Family Medicine, Eisenhower Army Medical Center, Fort Gordon, GA)Includes bibliographical reference

Genetic interaction with temperature is an important determinant of nematode longevity

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140048/1/acel12658_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/140048/2/acel12658.pd

The first long-lived mutants: discovery of the insulin/IGF-1 pathway for ageing

Inhibiting insulin/IGF-1 signalling extends lifespan and delays age-related disease in species throughout the animal kingdom. This life-extension pathway, the first to be defined, was discovered through genetic studies in the small roundworm Caenorhabditis elegans. This discovery is described here

Dramatic age-related changes in nuclear and genome copy number in the nematode Caenorhabditis elegans

The nematode Caenorhabditis elegans has become one of the most widely used model systems for the study of aging, yet very little is known about how C. elegans age. The development of the worm, from egg to young adult has been completely mapped at the cellular level, but such detailed studies have not been extended throughout the adult lifespan. Numerous single gene mutations, drug treatments and environmental manipulations have been found to extend worm lifespan. To interpret the mechanism of action of such aging interventions, studies to characterize normal worm aging, similar to those used to study worm development are necessary. We have used 4′,6′-diamidino-2-phenylindole hydrochloride staining and quantitative polymerase chain reaction to investigate the integrity of nuclei and quantify the nuclear genome copy number of C. elegans with age. We report both systematic loss of nuclei or nuclear DNA, as well as dramatic age-related changes in nuclear genome copy number. These changes are delayed or attenuated in long-lived daf-2 mutants. We propose that these changes are important pathobiological characteristics of aging nematodes

Marathon related death due to brainstem herniation in rehydration-related hyponatraemia: a case report

Introduction: Identifying marathon runners at risk of neurological deterioration at the end of the race (within a large cohort complaining of exhaustion, dehydration, nausea, headache, dizziness, etc.) is challenging. Here we report a case of rehydration-related hyponatraemia with ensuing brain herniation. Case presentation: We report the death of runner in his 30's who collapsed in the recovery area following a marathon. Following rehydration he developed a respiratory arrest in the emergency room. He was found to be hyponatraemic (130 mM). A CT brain scan showed severe hydrocephalus and brain stem herniation. Despite emergency insertion of an extraventricular drain, he was tested for brainstem death the following morning. Funduscopy demonstrated an acute-on-chronic papilledema; CSF spectrophotometry did not reveal any trace of oxyhemoglobin or bilirubin, but ferritin levels were considerably raised (530 ng/mL, upper reference value 12 ng/mL), consistent with a previous bleed. Retrospectively it emerged that the patient had suffered from a thunderclap headache some months earlier. Subsequently he developed morning headaches and nausea. This suggests that he may have suffered from a subarachnoid haemorrhage complicated by secondary hydrocephalus. This would explain why in this case the relatively mild rehydration-related hyponatremia may have caused brain swelling sufficient for herniation. Conclusion: Given the frequency of hyponatraemia in marathon runners (serum Na <135 mM in about 13%), and the non-specific symptoms, we discuss how a simple screening test such as funduscopy may help to identify those who require urgent neuroimaging

Blueberry polyphenols increase lifespan and thermotolerance in Caenorhabditis elegans

The beneficial effects of polyphenol compounds in fruits and vegetables are mainly extrapolated from in vitro studies or short-term dietary supplementation studies. Due to cost and duration, relatively little is known about whether dietary polyphenols are beneficial in whole animals, particularly with respect to aging. To address this question, we examined the effects of blueberry polyphenols on lifespan and aging of the nematode, Caenorhabditis elegans, a useful organism for such a study. We report that a complex mixture of blue-berry polyphenols increased lifespan and slowed aging-related declines in C. elegans. We also found that these benefits did not just reflect antioxidant activity in these compounds. For instance, blueberry treatment increased survival during acute heat stress, but was not protective against acute oxidative stress. The blueberry extract consists of three major fractions that all contain antioxidant activity. However, only one fraction, enriched in proanthocyanidin compounds, increased C. elegans lifespan and thermotolerance. To further determine how polyphenols prolonged C. elegans lifespan, we analyzed the genetic requirements for these effects. Prolonged lifespan from this treatment required the presence of a CaMKII pathway that mediates osmotic stress resistance, though not other pathways that affect stress resistance and longevity. In conclusion, polyphenolic compounds in blueberries had robust and reproducible benefits during aging that were separable from antioxidant effects