Child Obesity in Context: Ecology of Family and Community

Minority and low socioeconomic status groups have the highest rates of overweight and obesity. Children from these families face a greater risk for weight-related health problems such as diabetes, heart disease and cancer as compared to their non-minority and more affluent peers. Factors from the larger physical, social, and cultural environments, and within families, influence weight status among children. Many of these factors are yet to be identified and relationships among known factors are complex and not well understood. The National Institutes of Health and U.S. Department of Agriculture have proposed a research agenda for social and behavioral scientists to “examine how social contexts influence health and elucidate the mechanisms through with those mechanisms operate”, and to “develop ways to intervene on those factors for preventing obesity.” This editorial presents a social ecological view of child obesity and proposes several steps necessary to identify how community and family domain factors affect the weight-regulating behaviors of children. An empirically-based, theoretically-driven approach will lead to efficacious interventions which can be translated and widely disseminated into community-based programs, thus increasing the probability of success of population-based obesity prevention and control interventions

Considerations for Using a Geographic Information System to Assess Environmental Supports for Physical Activity

The use of a geographic information system (GIS) to study environmental supports for physical activity raises several issues, including acquisition and development, quality, and analysis. We recommend to public health professionals interested in using GIS that they investigate available data, plan for data development where none exists, ensure the availability of trained personnel and sufficient time, and consider issues such as data quality, analyses, and confidentiality. This article shares information about data-related issues that we encountered when using GIS to validate responses to a questionnaire about environmental supports for physical activity

Short-Term Removal of Exercise Impairs Glycemic Control in Older Adults: A Randomized Trial

Postprandial glycemia (PPG) predicts cardiovascular disease, and short-term physical inactivity increases PPG in young, active adults. Whether this occurs in older, active adults who may be more prone to bouts of inactivity is unknown. This study determined if postprandial interstitial glucose (PPIG) was impaired in active older adults following the removal of exercise for 3 days (NOEX) compared to active young adults. In this randomized, crossover study, 11 older (69.1 ± 1.9 years) and 9 young (32.8 ± 1.8 years) habitually active (≥90 min/week of exercise) adults completed 3-days of NOEX and 3-days of normal habitual exercise (EX), separated by ≥1 week. Diet was standardized across phases. Glycemic control (3-day average) was assessed via continuous glucose monitoring during both phases. Significant main effects of age and phase were detected (p \u3c 0.05), but no interaction was found for steps/day (p \u3e 0.05) (old EX: 6283 ± 607, old NOEX: 2380 ± 382 and young EX: 8798 ± 623, young NOEX: 4075 ± 516 steps/day). Significant main effects of age (p = 0.002) and time (p \u3c 0.001) existed for 1-h PPIG, but no effect of phase or interactions was found (p \u3e 0.05). Significant main effects (p \u3c 0.05) of age (old: 114 ± 1 mg/dl, young: 106 ± 1 mg/dl), phase (NOEX: 112 ± 1 mg/dl, EX: 108 ± 1 mg/dl), and time (0 min: 100 ± 2, 30 min: 118 ± 2, 60 min: 116 ± 2, 90 min: 111 ± 2, 120 min: 108 ± 2 mg/dl) in 2-h PPIG were detected, but no interaction was found (p \u3e 0.05). However, only significant main effects of phase (NOEX: 14 ± 1 and EX:12 ± 1, p \u3e 0.05) were found for 24-h blood glucose standard deviation. Older adults appear to have impaired glycemic control compared to young adults and exercise removal impairs glycemic control in both populations. Yet, the impairment in glycemic control with exercise removal is not different between old and young adults

Developmental Changes and Injury Induced Disruption of the Radial Organization of the Cortex in the Immature Rat Brain Revealed by In Vivo Diffusion Tensor MRI

During brain development, morphological changes modify the cortex from its immature radial organization to its mature laminar appearance. Applying in vivo diffusion tensor imaging (DTI), the microstructural organization of the cortex in the immature rat was analyzed and correlated to neurohistopathology. Significant differences in apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were detected between the external (I-III) and deep (IV-VI) cortical layers in postnatal day 3 (P3) and P6 pups. With cortical maturation, ADC was reduced in both cortical regions, whereas a decrease in FA was only seen in the deep layers. A distinct radial organization of the external cortical layers with the eigenvectors perpendicular to the pial surface was observed at both ages. Histology revealed maturational differences in the cortical architecture with increased neurodendritic density and reduction in the radial glia scaffolding. Early DTI after hypoxia-ischemia at P3 shows reduced ADC and FA in the ipsilateral cortex that persisted at P6. Cortical DTI eigenvector maps reveal microstructural disruption of the radial organization corresponding to regions of neuronal death, radial glial disruption, and astrocytosis. Thus, the combined use of in vivo DTI and histopathology can assist in delineating normal developmental changes and postinjury modifications in the immature rodent brai

Unlocking biomarker discovery: Large scale application of aptamer proteomic technology for early detection of lung cancer

Lung cancer is the leading cause of cancer deaths, because ~84% of cases are diagnosed at an advanced stage. Worldwide in 2008, ~1.5 million people were diagnosed and ~1.3 million died – a survival rate unchanged since 1960. However, patients diagnosed at an early stage and have surgery experience an 86% overall 5-year survival. New diagnostics are therefore needed to identify lung cancer at this stage. Here we present the first large scale clinical use of aptamers to discover blood protein biomarkers in disease with our breakthrough proteomic technology. This multi-center case-control study was conducted in archived samples from 1,326 subjects from four independent studies of non-small cell lung cancer (NSCLC) in long-term tobacco-exposed populations. We measured >800 proteins in 15uL of serum, identified 44 candidate biomarkers, and developed a 12-protein panel that distinguished NSCLC from controls with 91% sensitivity and 84% specificity in a training set and 89% sensitivity and 83% specificity in a blinded, independent verification set. Performance was similar for early and late stage NSCLC. This is a significant advance in proteomics in an area of high clinical need

Using negative-latency gravitational wave alerts to detect prompt radio bursts from binary neutron star mergers with the Murchison Widefield Array

We examine how fast radio burst (FRB)-like signals predicted to be generated during the merger of a binary neutron star (BNS) may be detected in low-frequency radio observations triggered by the aLIGO/Virgo gravitational wave detectors. The rapidity, directional accuracy, and sensitivity of follow-up observations with the Murchison Widefield Array (MWA) are considered. We show that with current methodology, the rapidity criteria fails for triggered MWA observations above 136 MHz for BNS mergers within the aLIGO/Virgo horizon, for which little dispersive delay is expected. A calculation of the expected reduction in response time by triggering on `negative latency' alerts from aLIGO/Virgo observations of gravitational waves generated by the BNS inspiral is presented. This allows for observations up to 300 MHz where the radio signal is expected to be stronger. To compensate for the poor positional accuracy expected from these alerts, we propose a new MWA observational mode that is capable of viewing one quarter of the sky. We show the sensitivity of this mode is sufficient to detect an FRB-like burst from an event similar to GW170817 if it occurred during the ongoing aLIGO/Virgo third science run (O3).Comment: Published in MNRAS Letters. 8 pages (5 main + 3 supplemental), 4 figures. Link to article: https://academic.oup.com/mnrasl/advance-article-abstract/doi/10.1093/mnrasl/slz129/555266

Use of Coronary Computed Tomographic Angiography to guide management of patients with coronary disease

Background In a prospective, multicenter, randomized controlled trial, 4,146 patients were randomized to receive standard care or standard care plus coronary computed tomography angiography (CCTA). Objectives The purpose of this study was to explore the consequences of CCTA-assisted diagnosis on invasive coronary angiography, preventive treatments, and clinical outcomes. Methods In post hoc analyses, we assessed changes in invasive coronary angiography, preventive treatments, and clinical outcomes using national electronic health records. Results Despite similar overall rates (409 vs. 401; p = 0.451), invasive angiography was less likely to demonstrate normal coronary arteries (20 vs. 56; hazard ratios [HRs]: 0.39 [95% confidence interval (CI): 0.23 to 0.68]; p < 0.001) but more likely to show obstructive coronary artery disease (283 vs. 230; HR: 1.29 [95% CI: 1.08 to 1.55]; p = 0.005) in those allocated to CCTA. More preventive therapies (283 vs. 74; HR: 4.03 [95% CI: 3.12 to 5.20]; p < 0.001) were initiated after CCTA, with each drug commencing at a median of 48 to 52 days after clinic attendance. From the median time for preventive therapy initiation (50 days), fatal and nonfatal myocardial infarction was halved in patients allocated to CCTA compared with those assigned to standard care (17 vs. 34; HR: 0.50 [95% CI: 0.28 to 0.88]; p = 0.020). Cumulative 6-month costs were slightly higher with CCTA: difference $462 (95$303 to $621). Conclusions In patients with suspected angina due to coronary heart disease, CCTA leads to more appropriate use of invasive angiography and alterations in preventive therapies that were associated with a halving of fatal and non-fatal myocardial infarction. (Scottish COmputed Tomography of the HEART Trial [SCOT-HEART]; NCT01149590