Chemoreceptor responsiveness at sea level does not predict the pulmonary pressure response to high altitude

The hypoxic ventilatory response (HVR) at sea level (SL) is moderately predictive of the change in pulmonary artery systolic pressure (PASP) to acute normobaric hypoxia. However, because of progressive changes in the chemoreflex control of breathing and acid-base balance at high altitude (HA), HVR at SL may not predict PASP at HA. We hypothesized that resting peripheral oxyhemoglobin saturation (SpO2) at HA would correlate better than HVR at SL to PASP at HA. In 20 participants at SL, we measured normobaric, isocapnic HVR (L/min·-%SpO2 -1) and resting PASP using echocardiography. Both resting SpO2 and PASP measures were repeated on day 2 (n=10), days 4-8 (n=12), and 2-3 weeks (n=8) after arrival at 5050m. These data were also collected at 5050m on life-long HA residents (Sherpa; n=21). Compared to SL, SpO2 decreased from 98.6 to 80.5% (P<0.001), while PASP increased from 21.7 to 34.0mmHg (P<0.001) after 2-3 weeks at 5050m. Isocapnic HVR at SL was not related to SpO2 or PASP at any time point at 5050m (all P>0.05). Sherpa had lower PASP (P<0.01) than lowlanders on days 4-8 despite similar SpO2. Upon correction for hematocrit, Sherpa PASP was not different from lowlanders at SL, but lower than lowlanders at all HA time points. At 5050m, whilst SpO2 was not related to PASP in lowlanders at any point (all R2=0.50), there was a weak relationship in the Sherpa (R2=0.16; P=0.07). We conclude that neither HVR at SL nor resting SpO2 at HA correlates with elevations in PASP at HA

The "Goldilocks Effect" in Cystic Fibrosis: identification of a lung phenotype in the cftr knockout and heterozygous mouse

BACKGROUND: Cystic Fibrosis is a pleiotropic disease in humans with primary morbidity and mortality associated with a lung disease phenotype. However, knockout in the mouse of cftr, the gene whose mutant alleles are responsible for cystic fibrosis, has previously failed to produce a readily, quantifiable lung phenotype. RESULTS: Using measurements of pulmonary mechanics, a definitive lung phenotype was demonstrated in the cftr-/- mouse. Lungs showed decreased compliance and increased airway resistance in young animals as compared to cftr+/+ littermates. These changes were noted in animals less than 60 days old, prior to any long term inflammatory effects that might occur, and are consistent with structural differences in the cftr-/- lungs. Surprisingly, the cftr+/- animals exhibited a lung phenotype distinct from either the homozygous normal or knockout genotypes. The heterozygous mice showed increased lung compliance and decreased airway resistance when compared to either homozygous phenotype, suggesting a heterozygous advantage that might explain the high frequency of this mutation in certain populations. CONCLUSIONS: In the mouse the gene dosage of cftr results in distinct differences in pulmonary mechanics of the adult. Distinct phenotypes were demonstrated in each genotype, cftr-/-, cftr +/-, and cftr+/+. These results are consistent with a developmental role for CFTR in the lung

Practicing Collaborative Skills through an Interprofessional Interview with Individuals Diagnosed with Parkinson’s Disease

OBJECTIVE To enhance student appreciation for collaboration/team-based care through participation in an interprofessional (IP) history-taking opportunity with individuals diagnosed with Parkinson’s disease (PD). METHODS Eighty-eight self-selected students from Louisiana State University Health-New Orleans and Xavier University College of Pharmacy participated in an IP elective course which included conducting an IP interview with a PD patient. To assess student perspectives regarding the IP interview, the students completed a thirteen item survey and reflection assignment. RESULTS Eighty-six students completed the survey and twenty-four completed the reflection assignment. 95% of students agreed the team-based interview and the development of an IP plan of care increased their awareness of the multiple perspectives to consider in designing a care plan. The Kruskal-Wallis test indicated a statistically significant difference among programs for survey question numbers two and four. All four IP education competencies (value and ethics, roles/responsibilities, interprofessional communication, teams and teamwork) were highlighted in the reflection assignment. CONCLUSION The IP interview allowed students to gain knowledge of PD, better understand the role of other disciplines, and create a holistic plan of care

Integrating Interprofessional Education into an Academic Enrichment Program

INTRODUCTION: Interprofessional education (IPE) is widely accepted as an important aspect of health professional programs. However, there is limited IPE research focused in the pre-health professional student population. The aim of this study was to measure pre-health student perceptions of IPE and their knowledge of other health professions during a summer academic enrichment program. METHODS: Students who had completed their first or second year of college studies participated in the six week Summer Health Professions Education Program (SHPEP) funded by the Robert Wood Johnson Foundation. Students engaged in IPE through an online module, as well as small group activities. RESULTS: Fifty-three students who participated in the 2017 SHPEP demonstrated statistically significant positive changes in IPE perceptions using the SPICE-R2 assessment tool. In addition, student perceived knowledge of the scope of practice of dental providers, physician providers and public health professionals also improved. DISCUSSION: Our results suggest introducing pre-health students to IPE opportunities broadens their understanding of different healthcare professions’ roles and responsibilities, as well as team leadership that is influenced by context rather than traditional hierarchies. CONCLUSION: Additional research engaging pre-health students in IPE is needed. However, initial findings suggest a positive impact in engaging early learners in IPE

EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA); Scientific Opinion on the Tolerable Upper Intake Level of calcium

&lt;p&gt;Following a request from the European Commission, the Panel on Dietetic Products, Nutrition and Allergies was asked to re-evaluate the safety in use of calcium. The Panel was requested to consider if the Tolerable Upper Intake Level (UL) for calcium established by the SCF in 2003 (2,500 mg/day for adults, including pregnant and lactating women), which was based on different intervention studies of long duration in which total daily calcium intakes of 2,500 mg from both diet and supplements were tolerated without adverse effects, needed to be changed on the basis of new available evidence. A number of placebo controlled human intervention studies in adults published since then also showed that total daily calcium intakes of 2,500 mg from both diet and supplements are tolerated without adverse effects. The Panel considers that no relationship has been established between long-term calcium intakes from diet and supplements and increased risk of nephrolithiasis, cardiovascular disease or prostate cancer. No new data have become available which would require a revision of the UL for calcium for adults, including pregnant and lactating women, of 2,500 mg. No new data have become available which would allow the setting of a UL for infants, children or adolescents. Data from European populations indicate that intakes of calcium in high consumers among adult males can be close to the UL. Although available data do not allow the setting of a UL for infants, children or adolescents, no risk has been identified with highest current levels of calcium intake in these age groups.&lt;/p&gt

Occupational exposure to inhaled nanoparticles: Are young workers being left in the dust?

Occupational exposure to inhaled nanoparticles (NPs) represents a significant concern for worker health. Adolescent workers may face unique risks for exposure and resulting health effects when compared with adult workers. This manuscript discusses key differences in risks for occupational exposures to inhaled NPs and resulting health effects between young workers and adult workers via an examination of both physiological and occupational setting factors. Previous studies document how adolescents often face distinct and unique exposure scenarios to occupational hazards when compared to adults. Moreover, they also face different and unpredictable health effects because biological functions such as detoxification pathways and neurological mechanisms are still developing well into late adolescence. Early exposure also increases the chances of developing long-latency disease earlier in life. Taken together, adolescents' rapid growth and development encompasses highly dynamic and complex processes. An aggravating factor is that these processes do not necessarily fall in line with legal classifications of adulthood, nor with occupational exposure limits created for adult workers. The differences in exposures and health consequences from NPs on young workers are insufficiently understood. Research is needed to better understand what adolescent-specific mitigation strategies may be most suitable to address these risk factors

Epidemiology of Type 2 Diabetes and Cardiovascular Disease: Translation From Population to Prevention: The Kelly West Award Lecture 2009

In the book Epidemiology of Diabetes and Its Vascular Lesions (1978), Kelly West summarized extant knowledge of the distribution and causes of diabetes. The 30 years of epidemiological research that followed have seen remarkable advances in the understanding of obesity as a risk factor for type 2 diabetes, and diabetes and pre-diabetes as risk factors for cardiovascular disease. Increasingly detailed understanding of these relationships has, unfortunately, been accompanied by an alarming increase in the prevalence of obesity, diabetes, and cardiovascular disease. West recognized that pre-diabetes is recognizable as what we now call metabolic syndrome. He predicted that novel insight into diabetes pathogenesis would come from biochemical and genetic epidemiology studies. He predicted that type 2 diabetes could be prevented by healthy lifestyle change. The challenge now is for us to translate these insights into effective strategies for the prevention of the modern epidemic of diabetes and vascular disease

Real-time reverse transcription polymerase chain reaction development for rapid detection of Tomato brown rugose fruit virus and comparison with other techniques

[EN] Background: Tomato brown rugose fruit virus (ToBRFV) is a highly infectious tobamovirus that causes severe disease in tomato (Solanum lycopersicum L.) crops. In Italy, the first ToBRFV outbreak occurred in 2018 in several provinces of the Sicily region. ToBRFV outbreak represents a serious threat for tomato crops in Italy and the Mediterranean Basin. Methods: Molecular and biological characterisation of the Sicilian ToBRFV ToB-SIC01/19 isolate was performed, and a sensitive and specific Real-time RT-PCR TaqMan minor groove binder probe method was developed to detect ToBRFV in infected plants and seeds. Moreover, four different sample preparation procedures (immunocapture, total RNA extraction, direct crude extract and leaf-disk crude extract) were evaluated. Results: The Sicilian isolate ToB-SIC01/19 (6,391 nt) showed a strong sequence identity with the isolates TBRFV-P12-3H and TBRFV-P12-3G from Germany, Tom 1-Jo from Jordan and TBRFV-IL from Israel. The ToB-SIC01/19 isolate was successfully transmitted by mechanical inoculations in S. lycopersicum L. and Capsicum annuum L., but no transmission occurred in S. melongena L. The developed real-time RT-PCR, based on the use of a primer set designed on conserved sequences in the open reading frames3, enabled a reliable quantitative detection. This method allowed clear discrimination of ToBRFV from other viruses belonging to the genus Tobamovirus, minimising false-negative results. Using immunocapture and total RNA extraction procedures, the real-time RT-PCR and end-point RT-PCR gave the same comparable results. Using direct crude extracts and leaf-disk crude extracts, the end-point RT-PCR was unable to provide a reliable result. This developed highly specific and sensitive real-time RT-PCR assay will be a particularly valuable tool for early ToBRFV diagnosis, optimising procedures in terms of costs and time.Panno, S.; Ruiz-Ruiz, S.; Giovani Carusso, A.; Alfaro Fernández, AO.; Font San Ambrosio, MI.; Davino, S. (2019). Real-time reverse transcription polymerase chain reaction development for rapid detection of Tomato brown rugose fruit virus and comparison with other techniques. PeerJ. 7:1-20. https://doi.org/10.7717/peerj.7928S1207Alkowni, R., Alabdallah, O., & Fadda, Z. (2019). Molecular identification of tomato brown rugose fruit virus in tomato in Palestine. Journal of Plant Pathology, 101(3), 719-723. doi:10.1007/s42161-019-00240-7Cambrón-Crisantos, J. M., Rodríguez-Mendoza, J., Valencia-Luna, J. B., Alcasio-Rangel, S., García-Ávila, C. D. J., López-Buenfil, J. A., & Ochoa-Martínez, D. L. (2018). Primer reporte de Tomato brown rugose fruit virus (ToBRFV) en Michoacán, México. Revista Mexicana de Fitopatología, Mexican Journal of Phytopathology, 37(1). doi:10.18781/r.mex.fit.1810-5Davino, S., Miozzi, L., Panno, S., Rubio, L., Davino, M., & Accotto, G. P. (2012). Recombination profiles between Tomato yellow leaf curl virus and Tomato yellow leaf curl Sardinia virus in laboratory and field conditions: evolutionary and taxonomic implications. Journal of General Virology, 93(12), 2712-2717. doi:10.1099/vir.0.045773-0Davino, S., Napoli, C., Dellacroce, C., Miozzi, L., Noris, E., Davino, M., & Accotto, G. P. (2009). Two new natural begomovirus recombinants associated with the tomato yellow leaf curl disease co-exist with parental viruses in tomato epidemics in Italy. Virus Research, 143(1), 15-23. doi:10.1016/j.virusres.2009.03.001Davino, S., Panno, S., Iacono, G., Sabatino, L., D’Anna, F., Iapichino, G., … Davino, M. (2016). Genetic variation and evolutionary analysis ofPepino mosaic virusin Sicily: insights into the dispersion and epidemiology. Plant Pathology, 66(3), 368-375. doi:10.1111/ppa.12582Ferriol, I., Rangel, E. A., Panno, S., Davino, S., Han, C. G., Olmos, A., & Rubio, L. (2015). Rapid detection and discrimination of fabaviruses by flow-through hybridisation with genus- and species-specific riboprobes. Annals of Applied Biology, 167(1), 26-35. doi:10.1111/aab.12204Fidan, H., Sarikaya, P., & Calis, O. (2019). First report of Tomato brown rugose fruit virus on tomato in Turkey. New Disease Reports, 39(1), 18-18. doi:10.5197/j.2044-0588.2019.039.018Hanssen, I. M., Lapidot, M., & Thomma, B. P. H. J. (2010). Emerging Viral Diseases of Tomato Crops. Molecular Plant-Microbe Interactions®, 23(5), 539-548. doi:10.1094/mpmi-23-5-0539Jacobi, V., Bachand, G. ., Hamelin, R. ., & Castello, J. . (1998). Development of a multiplex immunocapture RT-PCR assay for detection and differentiation of tomato and tobacco mosaic tobamoviruses. Journal of Virological Methods, 74(2), 167-178. doi:10.1016/s0166-0934(98)00086-xLarkin, M. A., Blackshields, G., Brown, N. P., Chenna, R., McGettigan, P. A., McWilliam, H., … Higgins, D. G. (2007). Clustal W and Clustal X version 2.0. Bioinformatics, 23(21), 2947-2948. doi:10.1093/bioinformatics/btm404Levitzky, N., Smith, E., Lachman, O., Luria, N., Mizrahi, Y., Bakelman, H., … Dombrovsky, A. (2019). The bumblebee Bombus terrestris carries a primary inoculum of Tomato brown rugose fruit virus contributing to disease spread in tomatoes. PLOS ONE, 14(1), e0210871. doi:10.1371/journal.pone.0210871Ling, K.-S., Tian, T., Gurung, S., Salati, R., & Gilliard, A. (2019). First Report of Tomato Brown Rugose Fruit Virus Infecting Greenhouse Tomato in the United States. Plant Disease, 103(6), 1439. doi:10.1094/pdis-11-18-1959-pdnLuria, N., Smith, E., Reingold, V., Bekelman, I., Lapidot, M., Levin, I., … Dombrovsky, A. (2017). A New Israeli Tobamovirus Isolate Infects Tomato Plants Harboring Tm-22 Resistance Genes. PLOS ONE, 12(1), e0170429. doi:10.1371/journal.pone.0170429Menzel, W., Knierim, D., Winter, S., Hamacher, J., & Heupel, M. (2019). First report of Tomato brown rugose fruit virus infecting tomato in Germany. New Disease Reports, 39(1), 1-1. doi:10.5197/j.2044-0588.2019.039.001Panno, S., Caruso, A. G., & Davino, S. (2017). The nucleotide sequence of a recombinant tomato yellow leaf curl virus strain frequently detected in Sicily isolated from tomato plants carrying the Ty-1 resistance gene. Archives of Virology, 163(3), 795-797. doi:10.1007/s00705-017-3674-9Panno, S., Caruso, A. G., & Davino, S. (2019). First Report of Tomato Brown Rugose Fruit Virus on Tomato Crops in Italy. Plant Disease, 103(6), 1443-1443. doi:10.1094/pdis-12-18-2254-pdnPanno, S., Caruso, A. G., Troiano, E., Luigi, M., Manglli, A., Vatrano, T., … Davino, S. (2019). Emergence of tomato leaf curl New Delhi virus in Italy: estimation of incidence and genetic diversity. Plant Pathology, 68(3), 601-608. doi:10.1111/ppa.12978Panno, S., Davino, S., Rubio, L., Rangel, E., Davino, M., García-Hernández, J., & Olmos, A. (2012). Simultaneous detection of the seven main tomato-infecting RNA viruses by two multiplex reverse transcription polymerase chain reactions. Journal of Virological Methods, 186(1-2), 152-156. doi:10.1016/j.jviromet.2012.08.003Panno, S., Ferriol, I., Rangel, E. A., Olmos, A., Han, C.-G., Martinelli, F., … Davino, S. (2014). Detection and identification of Fabavirus species by one-step RT-PCR and multiplex RT-PCR. Journal of Virological Methods, 197, 77-82. doi:10.1016/j.jviromet.2013.12.002Pelham, J. (1966). Resistance in tomato to tobacco mosaic virus. Euphytica, 15(2), 258-267. doi:10.1007/bf00022331Puchades, A. V., Carpino, C., Alfaro-Fernandez, A., Font-San-Ambrosio, M. I., Davino, S., Guerri, J., … Galipienso, L. (2017). Detection of Southern tomato virus by molecular hybridisation. Annals of Applied Biology, 171(2), 172-178. doi:10.1111/aab.12367Salem, N., Mansour, A., Ciuffo, M., Falk, B. W., & Turina, M. (2015). A new tobamovirus infecting tomato crops in Jordan. Archives of Virology, 161(2), 503-506. doi:10.1007/s00705-015-2677-

Associations of Cardiorespiratory Fitness and Obesity With Risks of Impaired Fasting Glucose and Type 2 Diabetes in Men

OBJECTIVE—The purpose of this study was to examine the associations of cardiorespiratory fitness (hereafter fitness) and various obesity measures with risks of incident impaired fasting glucose (IFG) and type 2 diabetes