Application of the PEN-3 Model in a Diabetes Prevention Intervention

More effective strategies for addressing health issues in African American communities are needed. As part of a three year NIH funded Project Export grant, this community campus partnership used community-based participatory research principles and thePEN-3 Cultural Framework to develop a culturally specific, locally relevant intervention to prevent Diabetes among African-Americans. A comprehensive needs assessment which included 13 elicitation interviews, 3 focus groups, and 217 surveys resulted in identifying major themes including overall lack of knowledge regarding Diabetes,issues of denial and stigma, sense of inevitability, influence of family on perceptionsand behaviors, communication issues with health care providers, and lack of culturally sensitive materials. Community partners provided input into the assessment strategies,materials and intervention development, as well as recruitment and information dissemination strategies which in conjunction with the Pen-3 framework, allowed us to develop a culturally relevant strategy for reducing Diabetes related health disparities in our community

Nitrogen uptake strategies of edaphically specialized Bornean tree species

The association of tree species with particular soil types contributes to high b diversity in forests, but the mechanisms producing such distributions are still debated. Soil nitrogen (N) often limits growth and occurs in differentially available chemical forms. In a Bornean forest where tree species composition changes dramatically along a soil gradient varying in supplies of different N-forms, we investigated whether tree species’ N-uptake and soil specialization strategies covaried. We analyzed foliar 15N natural abundance for a total of 216 tree species on clay or sandy loam (the soils at the gradient’s extremes) and conducted a 15N-tracer experiment with nine specialist and generalist species to test whether species displayed flexible or differential uptake of ammonium and nitrate. Despite variation in ammonium and nitrate supplies and nearly 4 % difference in foliar δ15N between most soil specialists and populations of generalists on these soils, our 15N tracer experiment showed little support for the hypothesis that soil specialists vary in N-form use or the ratios in which they use these forms. Instead, our results indicate that these species possess flexible capacities to take up different inorganic N forms. Variation between soil specialists in uptake of different N forms is thus unlikely to cause the soil associations of tree species and high b diversity characteristic of this Bornean rain forest. Flexible uptake strategies would facilitate N-acquisition when supply rates of N-forms exhibit spatiotemporal variation and suggest that these species may be functionally redundant in their responses to N gradients and influences on ecosystem N-cycles

Probing Star Formation at Low Metallicity: The Radio Emission of Super Star Clusters in SBS0335-052

We present high-resolution radio continuum observations of the nascent starburst in the metal-poor galaxy SBS 0335-052. These radio data were taken with the Very Large Array and include observations at 0.7cm, 1.3cm, 2cm, 3.6cm, and 6cm. These observations enable us to probe the thermal radio nebulae associated with the extremely young star-forming regions in this galaxy. Two discrete and luminous star-forming regions are detected in the south of the galaxy that appear to be associated with massive star clusters previously identified at optical wavelengths. However, the remaining optically-identified massive star clusters are not clearly associated with radio emission (either thermal or non-thermal) down to the sensitivity limits of these radio data. The spectral energy distributions of the two radio-detected clusters are consistent with being purely thermal, and the entire region has an inferred ionizing flux of ~1.2 x 10^ 53 s^-1, which is equivalent to ~12,000 "typical" O-type stars (type O7.5 V). The observations presented here have resolved out a significant contribution from diffuse non-thermal emission detected previously, implying a previous episode of significant star formation. The current star formation rate (SFR) for this southern region alone is ~1.3 M_sun yr^-1, or ~ 23M_sun yr^-1 kpc^-2. This SFR derived from thermal radio emission also suggests that previous optical recombination line studies are not detecting a significant fraction of the current star formation in SBS 0335-052. From model fits to the radio spectral energy distribution, we infer a global mean density in the two youngest clusters of n_e > 10^3-10^4 cm^-3. In addition, a comparison between the compact and diffuse radio emission indicates that up to ~50% of the ionizing flux could be leaking out of the compact HII regions.Comment: accepted AJ, 14 pages, 5 figure

The Histone Deacetylase Inhibitor Romidepsin Spares Normal Tissues While Acting as an Effective Radiosensitizer in Bladder Tumors in Vivo

Funding Information: This work was funded by Cancer Research UK (CRUK; C5255/A23755). J.L.R. was funded by CRUK (project grant C15140/A19817). C.K.T. was funded by a CRUK DPhil Research Training and Support Grant, the Balliol College Alfred Douglas Stone Scholarship, and the University of Oxford Clarendon Fund. S.K. was funded by a CRUK/MRC Oxford Institute of Radiation Oncology CRUK studentship.Peer reviewedPublisher PD

Acute Skeletal Muscle Wasting and Dysfunction Predict Physical Disability at Hospital Discharge in Patients with Critical Illness

BACKGROUND: Patients surviving critical illness develop muscle weakness and impairments in physical function; however, the relationship between early skeletal muscle alterations and physical function at hospital discharge remains unclear. The primary purpose of this study was to determine whether changes in muscle size, strength and power assessed in the intensive care unit (ICU) predict physical function at hospital discharge. METHODS: Study design is a single-center, prospective, observational study in patients admitted to the medicine or cardiothoracic ICU with diagnosis of sepsis or acute respiratory failure. Rectus femoris (RF) and tibialis anterior (TA) muscle ultrasound images were obtained day one of ICU admission, repeated serially and assessed for muscle cross-sectional area (CSA), layer thickness (mT) and echointensity (EI). Muscle strength, as measured by Medical Research Council-sum score, and muscle power (lower-extremity leg press) were assessed prior to ICU discharge. Physical function was assessed with performance on 5-times sit-to-stand (5STS) at hospital discharge. RESULTS: Forty-one patients with median age of 61 years (IQR 55-68), 56% male and sequential organ failure assessment score of 8.1 ± 4.8 were enrolled. RF muscle CSA decreased significantly a median percent change of 18.5% from day 1 to 7 (F = 26.6, p = 0.0253). RF EI increased at a mean percent change of 10.5 ± 21% in the first 7 days (F = 3.28, p = 0.081). At hospital discharge 25.7% of patients (9/35) met criteria for ICU-acquired weakness. Change in RF EI in first 7 days of ICU admission and muscle power measured prior to ICU were strong predictors of ICU-AW at hospital discharge (AUC = 0.912). Muscle power at ICU discharge, age and ICU length of stay were predictive of performance on 5STS at hospital discharge. CONCLUSION: ICU-assessed muscle alterations, specifically RF EI and muscle power, are predictors of diagnosis of ICU-AW and physical function assessed by 5x-STS at hospital discharge in patients surviving critical illness

Asfotase alfa therapy for children with hypophosphatasia

Background. Hypophosphatasia (HPP) is caused by loss-of-function mutation(s) of the gene that encodes the tissue-nonspecific isoenzyme of alkaline phosphatase (TNSALP). Consequently, cell-surface deficiency of TNSALP phosphohydrolase activity leads to extracellular accumulation of inorganic pyrophosphate, a natural substrate of TNSALP and inhibitor of mineralization. Children with HPP can manifest rickets, skeletal pain, deformity, fracture, muscle weakness, and premature deciduous tooth loss. Asfotase alfa is a recombinant, bone-targeted, human TNSALP injected s.c. to treat HPP. In 2012, we detailed the 1-year efficacy of asfotase alfa therapy for the life-threatening perinatal and infantile forms of HPP. Methods. Here, we evaluated the efficacy and safety of asfotase alfa treatment administered to children 6–12 years of age at baseline who were substantially impaired by HPP. Two radiographic scales quantitated HPP skeletal disease, including comparisons to serial radiographs from similarly affected historical control patients. Results. Twelve children receiving treatment were studied for 5 years. The 6-month primary endpoint was met, showing significant radiographic improvement. Additional significant improvements included patient growth, strength, motor function, agility, and quality of life, which for most patients meant achieving normal values for age- and sex-matched peers that were sustained at 5 years of treatment. For most, pain and disability resolved. Mild to moderate injection-site reactions were common and were sometimes associated with lipohypertrophy. Low anti–asfotase alfa antibody titers were noted in all patients. No evidence emerged for clinically important ectopic calcification or treatment resistance. Conclusions. Asfotase alfa enzyme replacement therapy has substantial and sustained efficacy with a good safety profile for children suffering from HPP. Trial Registration. ClinicalTrials.gov NCT00952484 (https://clinicaltrials.gov/ct2/show/NCT00952484) and NCT01203826 (https://clinicaltrials.gov/ct2/show/NCT01203826). Funding. Alexion Pharmaceuticals Inc. and Shriners Hospitals for Children

The interplay between learner beliefs and foreign language anxiety: insights from the Turkish EFL context

Foreign language learning in classroom settings has long been found to be associated with anxiety (Horwitz, 1986). Though it is known that sources of foreign language anxiety are varied (Young, 1991), whether anxiety is related to learners’ inherent beliefs about language learning is understudied. To this end, the present study examines the possible relationship between learner beliefs and language anxiety in the under-researched Turkish EFL context. A population of university-level Turkish EFL learners (n=153) completed the Beliefs about Language Learning Inventory (BALLI) and the Foreign Language Classroom Anxiety scale (FLCAS). The underlying constructs in both instruments were explored using an Exploratory Factor Analysis (EFA). A series of Pearson Product-Moment Correlation Coefficient (PPMCC) tests were performed on the factor scores from both instruments. The findings revealed that fear of ambiguity was positively linked to classroom performance anxiety and negative feelings towards English. In addition, the more confident learners feel themselves using English, the more desire they seem to have to interact with native speakers. Overall, positive beliefs about language learning may be helpful in reducing anxiety and boosting confidence in language learning. These findings not only enhance our understanding of the complex psychology of language learning but also have important implications for instructed EFL/ESL settings

Accuracy of Components of SCAT to Identify Children With Concussion

BACKGROUND: The Sport Concussion Assessment Tool version 3 (SCAT3) and its child version (ChildSCAT3) are composite physical and neuropsychological scoring systems used to assess athletes after sport-related concussion. Based on limited validation data, we aimed to evaluate the ability of SCAT3 and ChildSCAT3 to differentiate children aged 5 to 16 years with concussion from controls. METHODS: Prospective observational study of children in the emergency department with concussion (CONC group) and 2 control groups ([1] upper-limb injury [ULI] and [2] Well children) with equal-sized subgroups in 3 age bands of 5 to 8, 9 to 12, and 13 to 16 years. ChildSCAT3 was used for participants aged 5 to 12 years, and SCAT3 was used for participants aged 13 to 16 years. Differences between study groups were analyzed by using analysis of variance models, adjusting for age and sex. RESULTS: We enrolled 264 children (90 CONC, 90 ULI, and 84 Well) in equal-sized age bands. The number and severity of child- and parent-reported symptom scores were significantly higher in the CONC group than either control group (P &amp;lt; .001). Mean double (ChildSCAT3 P &amp;lt; .001) and tandem stance errors (both P ≤ .01) were also significantly higher, and immediate memory was significantly lower for the CONC group (P &amp;lt; .01). No statistically significant group differences were found for orientation and digit backward tasks. There were no significant differences between ULI and Well control groups. CONCLUSIONS: Overall, SCAT3 and ChildSCAT3 can differentiate concussed from nonconcussed patients, particularly in symptom number and severity. </jats:sec