Weight Gain Trajectory Over Five Years for Adult Primary Care Patients in Nebraska

INTRODUCTION: The continued rise in the prevalence of adult obesity in the United States is a public health concern. Several studies have identified the increasing rates of obesity, its impacts, and the factors leading to obesity. Some researchers have made obesity prevalence projections at the national and state levels. This study aims to fill the critical gap in real-time weight data trends among primary care adult patients in Nebraska. The main goal of this study is to determine and analyze the weight trajectory of adults in Nebraska over the past five years and determine if the trends vary among age and gender and if the COVID-19 pandemic impacted weight trajectory. Additionally, this study will compare the collected data to the national obesity prevalence and other researchers’ obesity prevalence projections at the national and state level. METHODS: A retrospective cohort study using un-identified data extracted from Nebraska Medicine’s electronic health record sub-database was utilized to examine adult obesity prevalence based on weights and heights recorded during medical encounters. A sample of 16,507 adults had data recorded for 390,789 unique encounters. The study utilized simple descriptive statistics to calculate frequencies/percentages and means/standard deviations to determine the current prevalence of adult obesity in Nebraska to compare to the national prevalence and other researchers’ prevalence predictions. RESULTS: The average BMI of the study sample (n=16,507) was 30.6 (SD=7.1). The current obesity prevalence among our study sample is 47.6% for overall obesity (BMI ³ 30) and 24.0% for severe obesity (BMI ³ 35). The overall obesity prevalence is 47.9% among females and 47.1% among males. The prevalence of severe obesity is 26.8% among females and 19.9% among males. From January 2017 to October 2021, the average BMI among females and males increased among individuals aged 20 to 49, with females experiencing a larger increase in BMI. Weight loss occurred among both females and males aged 50 years and older. Individuals aged 40-49 years had the highest BMI among females and males. CONCLUSION: This study provides real-time weight trend data among the Nebraska adult population, including the current prevalence of overall and severe obesity. The obesity prevalence in Nebraska continues to move further away from the Healthy People 2030 goal of 36.0% and is close to reaching and exceeding 2030 obesity prevalence research projections, highlighting the importance and critical need for public health interventions to reduce obesity among adults in Nebraska

Impact of Feeding Foods Containing Industrial Hemp-Derived Cannabidiol on Canine Health and Well-Being

Anecdotal evidence of beneficial behavioral and health effects of cannabidiol (CBD) use in companion animals has amplified the need to elucidate safety and potential impacts of CBD use. The purpose of this investigation was to determine the impact of industrial hemp-derived CBD administration on canine health and well-being. We hypothesized that CBD would produce beneficial effects on canine behavior without negatively impacting animal health. Dog treats were formulated to include CBD and shown to be palatable across a range of CBD inclusion levels. Dogs were supplemented with CBD treats and subjected to a noise-induced fear response test to assess potential anxiolytic effect of CBD. Behavioral response to the noise-induced fear response test was unaffected by CBD and did not support an anxiolytic effect of CBD when supplemented at 1.4 mg/kg BW/d. Next, triaxial accelerometers were fitted to dogs’ collars to assess the impact of CBD treats on voluntary daily activity. While voluntary daily activity of healthy adult dogs was unaffected by 1.8 and 4.5 mg CBD/kg BW/d, a reduction in daily scratching suggested a potential antipruritic effect of CBD. Potential impacts on canine health were also assessed by evaluating changes in the canine metabolome, hematology, and serum chemistry, and immune response upon exposure to a novel antigen. The canine metabolome, including amine/phenol, carbonyl, carboxyl, and hydroxyl metabolites, was altered with 4.5 mg CBD/kg BW/d and suggested an impact on glucose, amino acid, vitamin, and nucleotide metabolism. Hematological and clinical indices of health and serum immunoglobulins (IgG and IgM) were largely unaffected by 5 mg CBD/kg BW/d; however, elevated liver enzyme alkaline phosphatase may suggest altered liver function. These findings may be used to formulate recommendations for CBD use in a clinical environment, spur investigation into other potential therapeutic effects of CBD, and may serve as a foundation for the development of regulations on CBD use, all of which are essential to supporting the health and well-being of companion animals

Uncertainty in mass-balance trends derived from altimetry: a case study along the EGIG line, central Greenland

This is the author accepted manuscript. The final version is available from The International Glaciological Society via http://dx.doi.org/10.3189/2015JoG14J123AbstractRepeated measurements of density profiles and surface elevation along a 515 km traverse of the Greenland ice sheet are used to determine elevation change rates and the error in determining mass-balance trends from these rates which arises from short-term fluctuations in mass input, compaction and surface density. Mean values of this error, averaged over 100 km sections of the traverse, decrease with time from the start of observations in 2004, with a half-time of ∼4 years. After 7 years the mean error is less than the ice equivalent mass imbalance.This project is a contribution to the calibration and validation of the European Space Agency (ESA) CryoSat satellite altimeter and is supported by ESA and by the UK Natural Environment Research Council (NERC) Consortium grant NER/O/S/2003/00620. We are grateful to the NERC Geo- physical Equipment Facility and the University of Edinburgh for the loan of Leica GPS systems. Logistic support for the traverses was provided by CH2M HILL Polar Services, G. Somers, J. Pailthorpe, H. Chamberlain, M. Hignell and J. Sweeny gave invaluable assistance in the field and T. Benham provided Figure 1. Finally, we thank R. Arthern for useful discussions and our Scientific Editor, H. Fricker, and two anonymous reviewers for helpful comments

Physiotherapy and a Homeopathic Complex for Chronic Low Back Pain Due to Osteoarthritis: A Randomized, Controlled Pilot Study

Abstract:Context: Osteoarthritis (OA) is a common cause of chronic low back pain (CLBP) and can be managed with the use of drug therapy and physiotherapy. Homeopathic remedies may assist in the management of OA; however, research that supports their effectiveness is limited. Objectives: The study aimed to investigate the efficacy of a homeopathic complex in combination with physiotherapy in the treatment of CLBP due to OA. Design: The study was a six-week, randomized, double-blind, placebo-controlled pilot. Setting: The study took place in a private physiotherapy practice in Gauteng, South Africa. Participants: The participants were 30 males and females, aged 45-75 years, who were receiving physiotherapy treatment for OA of the lumbar spine from a therapist in private practice. Interventions: The intervention and control groups both received standard physiotherapy treatment—massage, thermal therapy, and joint mobilization—every 2 weeks. In addition, the treatment group received a homeopathic complex—6cH each of Arnica montana, Bryonia alba, Causticum, Kalmia latifolia, Rhus toxicodendron, and Calcarea fluorica. The control group a received a placebo. Outcome measures: The primary measure was a visual analogue scale (VAS) for pain. Secondary outcome measures included the Oswestry Disability Index (ODI), an evaluation of each patient’s range of motion (ROM) of the lumbar spine, and a determination of each patient’s need for pain medication..

Expression of RUNX1 correlates with poor patient prognosis in triple negative breast cancer

The RUNX1 transcription factor is widely recognised for its tumour suppressor effects in leukaemia. Recently a putative link to breast cancer has started to emerge, however the function of RUNX1 in breast cancer is still unknown. To investigate if RUNX1 expression was important to clinical outcome in primary breast tumours a tissue microarray (TMA) containing biopsies from 483 patients with primary operable invasive ductal breast cancer was stained by immunohistochemistry. RUNX1 was associated with progesterone receptor (PR)-positive tumours (P<0.05), more tumour CD4+(P<0.05) and CD8+(P<0.01) T-lymphocytic infiltrate, increased tumour CD138+plasma cell (P<0.01) and more CD68+macrophage infiltrate (P<0.001). RUNX1 expression did not influence outcome of oestrogen receptor (ER)-positive or HER2-positive disease, however on univariate analysis a high RUNX1 protein was significantly associated with poorer cancer-specific survival in patients with ER-negative (P<0.05) and with triple negative (TN) invasive breast cancer (P<0.05). Furthermore, multivariate Cox regression analysis of cancer-specific survival showed a trend towards significance in ER-negative patients (P<0.1) and was significant in triple negative patients (P<0.05). Of relevance, triple negative breast cancer currently lacks good biomarkers and patients with this subtype do not benefit from the option of targeted therapy unlike patients with ER-positive or HER2-positive disease. Using multivariate analysis RUNX1 was identified as an independent prognostic marker in the triple negative subgroup. Overall, our study identifies RUNX1 as a new prognostic indicator correlating with poor prognosis specifically in the triple negative subtype of human breast cancer

The motor and cognitive features of Parkinson's disease in patients with concurrent Gaucher disease over 2 years: a case series.

We report the cognitive features and progression of Parkinson's disease (PD) in five patients with concurrent Gaucher disease. The patients presented at an earlier age than patients with sporadic PD, as previously noted by others; but in contrast to many previous reports, our patients followed a variable clinical course. While two patients developed early cognitive deficits and dementia, three others remained cognitively intact over the follow-up period. Thus, in this small case series, PD in the context of GD more closely resembles idiopathic PD in terms of its clinical heterogeneity in contrast to PD associated with GBA heterozygote mutations.NIHR BRC and NIHR Senior Investigator, Rosetrees fundin

Alteration of the Canine Metabolome After a 3-Week Supplementation of Cannabidiol (CBD) Containing Treats: An Exploratory Study of Healthy Animals

Despite the increased interest and widespread use of cannabidiol (CBD) in humans and companion animals, much remains to be learned about its effects on health and physiology. Metabolomics is a useful tool to evaluate changes in the health status of animals and to analyze metabolic alterations caused by diet, disease, or other factors. Thus, the purpose of this investigation was to evaluate the impact of CBD supplementation on the canine plasma metabolome. Sixteen dogs (18.2 ± 3.4 kg BW) were utilized in a completely randomized design with treatments consisting of control and 4.5 mg CBD/kg BW/d. After 21 d of treatment, blood was collected ~2 h after treat consumption. Plasma collected from samples was analyzed using CIL/LC-MS-based untargeted metabolomics to analyze amine/phenol- and carbonyl-containing metabolites. Metabolites that differed — fold change (FC) ≥ 1.2 or ≤ 0.83 and false discovery ratio (FDR) ≤ 0.05 — between the two treatments were identified using a volcano plot. Biomarker analysis based on receiver operating characteristic (ROC) curves was performed to identify biomarker candidates (area under ROC ≥ 0.90) of the effects of CBD supplementation. Volcano plot analysis revealed that 32 amine/phenol-containing metabolites and five carbonyl-containing metabolites were differentially altered (FC ≥ 1.2 or ≤ 0.83, FDR ≤ 0.05) by CBD; these metabolites are involved in the metabolism of amino acids, glucose, vitamins, nucleotides, and hydroxycinnamic acid derivatives. Biomarker analysis identified 24 amine/phenol-containing metabolites and 1 carbonyl-containing metabolite as candidate biomarkers of the effects of CBD (area under ROC ≥ 0.90; P \u3c 0.01). Results of this study indicate that 3 weeks of 4.5 mg CBD/kg BW/d supplementation altered the canine metabolome. Additional work is warranted to investigate the physiological relevance of these changes

Engaging Healthcare Users through Gamification in Knowledge Sharing of Continuous Improvement in Healthcare

Knowledge management systems are key for capturing, retaining, and communicating results from projects and presenting information to staff. The purpose of a knowledge management system is to tap into the vast wisdom from projects and experts across an organization. This research focuses on the knowledge management system within the Veterans Health Administration that was developed as a repository of information on continuous improvement tools such as flowcharts, value stream mapping, 5S, and the application of these in healthcare projects. The use of social network analysis and gamification improves website organization, user participation, and dissemination of shared knowledge related to continuous improvement of operations. The purpose of gamification is to engage, teach, entertain, measure, and improve the ease of use of information systems. The goal of this research is to utilize gamification theory within the knowledge management system to drive behaviors in a targeted audience and engage users in aspects such as writing, contributing, getting the feedback, which will create a more robust, cohesive system. A thorough review of the current knowledge management system was conducted, and a gap analysis was performed comparing the goals and objectives for the system to the current results. Next, gamification techniques with the potential to improve performance were identified and strategies to implement these were developed