Hospital Community Benefits After the ACA: The Emerging Federal Framework

Outlines the federal framework on requirements for hospitals to provide community benefit activities in exchange for tax-exempt status under the 2010 healthcare reform, including community health needs assessments; state policy options; and challenges

Food environments and gut microbiome health: availability of healthy foods, alcohol, and tobacco in a rural Oklahoma tribal community

Background Prior research suggests that dysbiotic gut microbiomes may contribute to elevated health risks among American Indians. Diet plays a key role in maintaining a healthy gut microbiome, yet suboptimal food environments within American Indian communities make obtaining nutritious food difficult.Objective This project characterizes the retail food environment within a rural tribal community, focused on the availability of foods that enhance the health and diversity of the gut microbiome, as well as products that reduce microbiome health (alcohol and tobacco).Design Audits were conducted of all retail stores that sell food within nine communities within the Cheyenne & Arapaho Tribal Jurisdictional Area in western Oklahoma.Main measures Freedman Grocery Store Survey.Key results Alcohol and tobacco were generally far more available in stores than foods that support a healthy gut microbiome, including fruits, vegetables, lean meats, and whole grain bread. Out of the four store types identified in the study area, only supermarkets and small grocers offered a wide variety of healthy foods needed to support microbiota diversity. Supermarkets sold the greatest variety of healthy foods but could only be found in the larger communities. Convenience stores and dollar stores made up 75% of outlets in the study area and offered few options for maintaining microbiome health. Convenience stores provided the only food source in one-third of the communities. With the exception of small grocers, alcohol and tobacco products were widely stocked across all store types.Conclusions The retail food environment in the Cheyenne & Arapaho Tribal Jurisdictional Area offered limited opportunities for maintaining a healthy and diverse microbiome, particularly within smaller rural communities. Additional research is needed to explore the relationship between food environment, dietary intake, and microbiome composition. Interventions are called for to increase the availability of “microbe-friendly” foods (e.g., fresh produce, plant protein, fermented and high fiber foods) in stores.Ye

EMSL and Institute for Integrated Catalysis (IIC) Catalysis Workshop

Within the context of significantly accelerating scientific progress in research areas that address important societal problems, a workshop was held in November 2010 at EMSL to identify specific and topically important areas of research and capability needs in catalysis-related science

The genetic architecture of the human cerebral cortex

The cerebral cortex underlies our complex cognitive capabilities, yet little is known about the specific genetic loci that influence human cortical structure. To identify genetic variants that affect cortical structure, we conducted a genome-wide association meta-analysis of brain magnetic resonance imaging data from 51,665 individuals. We analyzed the surface area and average thickness of the whole cortex and 34 regions with known functional specializations. We identified 199 significant loci and found significant enrichment for loci influencing total surface area within regulatory elements that are active during prenatal cortical development, supporting the radial unit hypothesis. Loci that affect regional surface area cluster near genes in Wnt signaling pathways, which influence progenitor expansion and areal identity. Variation in cortical structure is genetically correlated with cognitive function, Parkinson's disease, insomnia, depression, neuroticism, and attention deficit hyperactivity disorder

Phylogenetic ctDNA analysis depicts early-stage lung cancer evolution.

The early detection of relapse following primary surgery for non-small-cell lung cancer and the characterization of emerging subclones, which seed metastatic sites, might offer new therapeutic approaches for limiting tumour recurrence. The ability to track the evolutionary dynamics of early-stage lung cancer non-invasively in circulating tumour DNA (ctDNA) has not yet been demonstrated. Here we use a tumour-specific phylogenetic approach to profile the ctDNA of the first 100 TRACERx (Tracking Non-Small-Cell Lung Cancer Evolution Through Therapy (Rx)) study participants, including one patient who was also recruited to the PEACE (Posthumous Evaluation of Advanced Cancer Environment) post-mortem study. We identify independent predictors of ctDNA release and analyse the tumour-volume detection limit. Through blinded profiling of postoperative plasma, we observe evidence of adjuvant chemotherapy resistance and identify patients who are very likely to experience recurrence of their lung cancer. Finally, we show that phylogenetic ctDNA profiling tracks the subclonal nature of lung cancer relapse and metastasis, providing a new approach for ctDNA-driven therapeutic studies

The impact of PICALM genetic variations on reserve capacity of posterior cingulate in AD continuum

Phosphatidylinositolbinding clathrin assembly protein (PICALM) gene is one novel genetic player associated with late-onset Alzheimer’s disease (LOAD), based on recent genome wide association studies (GWAS). However, how it affects AD occurrence is still unknown. Brain reserve hypothesis highlights the tolerant capacities of brain as a passive means to fight against neurodegenerations. Here, we took the baseline volume and/or thickness of LOAD-associated brain regions as proxies of brain reserve capacities and investigated whether PICALM genetic variations can influence the baseline reserve capacities and the longitudinal atrophy rate of these specific regions using data from Alzheimer’s Disease Neuroimaging Initiative (ADNI) dataset. In mixed population, we found that brain region significantly affected by PICALM genetic variations was majorly restricted to posterior cingulate. In sub-population analysis, we found that one PICALM variation (C allele of rs642949) was associated with larger baseline thickness of posterior cingulate in health. We found seven variations in health and two variations (rs543293 and rs592297) in individuals with mild cognitive impairment were associated with slower atrophy rate of posterior cingulate. Our study provided preliminary evidences supporting that PICALM variations render protections by facilitating reserve capacities of posterior cingulate in non-demented elderly

Early role of vascular dysregulation on late-onset Alzheimer's disease based on multifactorial data-driven analysis

Multifactorial mechanisms underlying late-onset Alzheimer's disease (LOAD) are poorly characterized from an integrative perspective. Here spatiotemporal alterations in brain amyloid-β deposition, metabolism, vascular, functional activity at rest, structural properties, cognitive integrity and peripheral proteins levels are characterized in relation to LOAD progression. We analyse over 7,700 brain images and tens of plasma and cerebrospinal fluid biomarkers from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Through a multifactorial data-driven analysis, we obtain dynamic LOAD–abnormality indices for all biomarkers, and a tentative temporal ordering of disease progression. Imaging results suggest that intra-brain vascular dysregulation is an early pathological event during disease development. Cognitive decline is noticeable from initial LOAD stages, suggesting early memory deficit associated with the primary disease factors. High abnormality levels are also observed for specific proteins associated with the vascular system's integrity. Although still subjected to the sensitivity of the algorithms and biomarkers employed, our results might contribute to the development of preventive therapeutic interventions