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The gastrointestinal microbial consortium in dairy cattle is critical to determining the energetic status of the dairy cow from birth through her final lactation. The ruminant's microbial community can degrade a wide variety of feedstuffs, which can affect growth, as well as production rate and efficiency on the farm, but can also affect food safety, animal health, and environmental impacts of dairy production. Gut microbial diversity and density are powerful tools that can be harnessed to benefit both producers and consumers. The incentives in the United States to develop Alternatives to Antibiotics for use in food-animal production have been largely driven by the Veterinary Feed Directive and have led to an increased use of probiotic approaches to alter the gastrointestinal microbial community composition, resulting in improved heifer growth, milk production and efficiency, and animal health. However, the efficacy of direct-fed microbials or probiotics in dairy cattle has been highly variable due to specific microbial ecological factors within the host gut and its native microflora. Interactions (both synergistic and antagonistic) between the microbial ecosystem and the host animal physiology (including epithelial cells, immune system, hormones, enzyme activities, and epigenetics) are critical to understanding why some probiotics work but others do not. Increasing availability of next-generation sequencing approaches provides novel insights into how probiotic approaches change the microbial community composition in the gut that can potentially affect animal health (e.g., diarrhea or scours, gut integrity, foodborne pathogens), as well as animal performance (e.g., growth, reproduction, productivity) and fermentation parameters (e.g., pH, short-chain fatty acids, methane production, and microbial profiles) of cattle. However, it remains clear that all direct-fed microbials are not created equal and their efficacy remains highly variable and dependent on stage of production and farm environment. Collectively, data have demonstrated that probiotic effects are not limited to the simple mechanisms that have been traditionally hypothesized, but instead are part of a complex cascade of microbial ecological and host animal physiological effects that ultimately impact dairy production and profitability. [ABSTRACT FROM AUTHOR]

This study examined complex terrain march performance and cardiorespiratory responses when carrying different Soldier loads. Nine active duty military personnel (age, 21 ± 3 yr; height, 1.72 ± 0.07 m; body mass (BM), 83.4 ± 12.9 kg) attended two test visits during which they completed consecutive laps around a 2.5-km mixed terrain course with either a fighting load (30% BM) or an approach load (45% BM). Respiratory rate and heart rate data were collected using physiological status monitors. Training impulse (TRIMP) scores were calculated using Banister's formula to provide an integrated measure of both time and cardiorespiratory demands. Completion times were not significantly different between the fighting and approach loads for either Lap 1 (p = 0.38) or Lap 2 (p = 0.09). Respiration rate was not significantly higher with the approach load than the fighting load during Lap 1 (p = 0.17) but was significantly higher for Lap 2 (p = 0.04). However, heart rate was significantly higher with the approach load versus the fighting load during both Lap 1 (p = 0.03) and Lap 2 (p = 0.04). Furthermore, TRIMP was significantly greater with the approach load versus the fighting load during both Lap 1 (p = 0.02) and Lap 2 (p = 0.02). Trained military personnel can maintain similar pacing while carrying either fighting or approach loads during short mixed terrain marches. However, cardiorespiratory demands are greatly elevated with the approach load and will likely continue to rise during longer distance marches. [ABSTRACT FROM AUTHOR]

Highlights • Stress and attachment paradigms suggest sexual minorities may experience physiological stress response dysregulation. • Sympathetic nervous system (SNS) dysregulation can result from social stressors like those experienced by sexual minorities. • It is not known if there might be sexual orientation disparities in SNS biomarker diurnal salivary alpha-amylase (sAA). • In a cohort of 1663 young adults, sexual minority women but not men showed sAA dysregulation compared to heterosexuals. • Stress and attachment paradigms may help to explain sex differences in sexual orientation-related SNS dysregulation. Abstract Sexual minorities in the United States are at elevated risk of prejudice, discrimination, and violence victimization due to stigma associated with their sexual orientation. These stressors may contribute to physiological stress responses and changes in the regulation of the sympathetic nervous system (SNS). To date, no studies have examined the associations among minority sexual orientation, recent stressful events, and diurnal salivary alpha-amylase (sAA) patterns. The present study included 1663 young adults ages 18–32 years (31% men, 69% women) from the Growing Up Today Study, a prospective cohort of U.S. youth. Participants provided five saliva samples over the course of one day to estimate diurnal sAA patterns. Sexual orientation groups included completely heterosexual with no same-sex partners (CH; referent), mostly heterosexual/completely heterosexual with same-sex partners, and gay/lesbian/bisexual (LB or GB). Sex-stratified multilevel models were fit to evaluate the association of sexual orientation with diurnal patterns of log sAA. The association of recent stressful events was also evaluated. Among women, sexual minorities scored significantly higher than CH on perceived stress and number of stressful events in the past month (p < 0.05). Among men, sexual minorities scored higher than CH on perceived stress but not recent stressful events. In multivariable models, recent stressful events were not associated with sAA patterns, but significant sexual orientation group differences in sAA diurnal rhythm were observed among women though not among men. Compared to CH women, LB showed a blunted awakening response and elevated sAA levels across the day, both indicators consistent with SNS dysregulation. Findings suggest dysregulation of stress physiology in LB women, but not other sexual minority women or men, relative to same-sex heterosexuals. Observed dysregulation may relate to exposure among LB women to chronic stressors associated with sexual orientation stigma, although these relations and differences by sex warrant further study. [ABSTRACT FROM AUTHOR]

A growing body of research shows affluent White neighborhoods have more acres of parks and more park facilities than low-income ethnic minority communities in many Global North cities. Most of these investigations focused on neighborhood-level differences and did not analyze broader inequities across cities. This is a particularly significant limitation in the U.S., where changes in the political economy of parks due to a reduced local tax base have led cities to compete against each other to secure park funding from national nonprofits and public agencies. To address this gap, we examined whether the quality of urban park systems – measured through The Trust for Public Land’s ParkScore – varies depending on a city’s median income and ethnic composition. Based on multivariate regressions in which we control for features of the urban fabric, we found U.S. cities with higher median incomes and lower percentages of Latino and Non-Hispanic Black residents have higher ParkScores than other cities. Some inequities also emerged for park coverage, park spending per person, and park facilities, with majority-Latino cities being particularly disadvantaged. These findings echo the results of neighborhood-level studies in Global North contexts, suggesting neighborhood-level inequities in park provision might scale up to inequities across cities. This study contributes to environmental justice theory and advocacy by demonstrating the importance of scaling up analyses of park provision to cross-city comparisons. Implications for landscape planning, public policy, and grant-making are discussed. [ABSTRACT FROM AUTHOR]

Low salinity negatively affects growth and survival in the eastern oyster, which decreases productivity of aquaculture operations along the mid-Atlantic and Gulf Coasts of the United States. With heavy rainfall events predicted to become more frequent, coastal aquaculture operations face increased risk of prolonged exposure to extreme low salinity conditions. While recent experimental work has determined that survival in extreme low salinity (< 3) is a moderately heritable trait in the eastern oyster, further experimental challenges were conducted to investigate the importance of challenge duration and temperature on the survival phenotype and estimation of its genetic parameters to hone the experimental challenge for potential incorporation into a breeding program. Growth (shell height) and algal removal were also assessed to investigate physiological phenotypes associated with differential survival in extreme low salinity. A subset of individuals from 51 half-sibling families were exposed to one of two experimental challenges: a short-term low salinity (2.5) challenge at constant temperature (27 °C) for 2 months, or a long-term low salinity (2.5) challenge where temperature was adjusted daily to match local ambient conditions for 6-months. Differential mortality was observed across families for both the short-term and long-term low salinity challenges, and narrow-sense heritability estimates were similar for both challenges (short-term h2 = 0.35, long-term h2 = 0.4). Strong phenotypic (r S = 0.89) and genetic (r G = 0.81) correlations for family mortality were found between challenges. Algal clearance metrics over a 24-h clearance experiment differed among families (p < 0.001), but were only weakly associated with family survival in the long-term low salinity exposure (range p = 0.08–0.23, R2 = 5–10%). Growth was negligible during the long-term challenge. However, after being returned to ambient salinities (13), there was no difference in growth rate, wet weight gain, or mortality between oysters from families with low or high survival in the long-term exposure (p > 0.05), indicating that low salinity tolerant oysters can recover following low salinity events. This work shows that a short-term (2 month) low salinity (2.5) challenge at a constant temperature captures the same patterns of family mortality as a 6-month, temperature fluctuating challenge. Additionally, measuring individual oyster clearance rate and the parameters derived from the algal removal curves provide additional insight into the physiological status of oysters under extreme low salinity stress. • Oyster aquaculture farmers experience Extreme low salinity results in reduced growth and increased mortality, posing a threat to the oyster aquaculture industry. • A short low salinity laboratory challenge produces similar mortality and heritability as a more realistic challenge. • Algae removal (clearance) varies among families at low salinity. • Oysters recover normal growth and survival when reintroduced to ambient salinity after 6 months of low salinity exposure. [ABSTRACT FROM AUTHOR]

Objective To examine associations of proximity to major roadways, sustained exposure to fine particulate matter (PM 2.5 ), and acute exposure to ambient air pollutants with adipokines and measures of glucose homeostasis among participants living in the northeastern United States. Methods We included 5958 participants from the Framingham Offspring cohort examination cycle 7 (1998–2001) and 8 (2005–2008) and Third Generation cohort examination cycle 1 (2002–2005) and 2 (2008–2011), who did not have type 2 diabetes at the time of examination visit. We calculated 2003 annual average PM 2.5 at participants' home address, residential distance to the nearest major roadway, and daily PM 2.5 , black carbon (BC), sulfate, nitrogen oxides (NO x ), and ozone concentrations. We used linear mixed effects models for fasting glucose, insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) which were measured up to twice, and used linear regression models for adiponectin, resistin, leptin, and hemoglobin A1c (HbA1c) which were measured only once, adjusting for demographics, socioeconomic position, lifestyle, time, and seasonality. Results The mean age was 51 years and 55% were women. Participants who lived 64 m (25th percentile) from a major roadway had 0.28% (95% CI: 0.05%, 0.51%) higher fasting plasma glucose than participants who lived 413 m (75th percentile) away, and the association appeared to be driven by participants who lived within 50 m from a major roadway. Higher exposures to 3- to 7-day moving averages of BC and NO x were associated with higher glucose whereas the associations for ozone were negative. The associations otherwise were generally null and did not differ by median age, sex, educational attainment, obesity status, or prediabetes status. Conclusions Living closer to a major roadway or acute exposure to traffic-related air pollutants were associated with dysregulated glucose homeostasis but not with adipokines among participants from the Framingham Offspring and Third Generation cohorts. [ABSTRACT FROM AUTHOR]

Background: The past decade has seen over a four-fold increase in deaths from opioid overdose in the United States. To address this growing epidemic, many localities initiated policies to expand access to naloxone (a drug that reverses the effects of opioids); however, little is known how naloxone access affects opioid use behaviours.Methods: The present qualitative study used semi-structured, in-depth interviews with inpatients at a substance use treatment centre. All patients who met study inclusion criteria (in treatment for opioid use, between the ages of 18 and 40, able to speak and understand English, and had not previously completed an interview with the research team) were invited to participate. Interviews were conducted until thematic saturation was reached (N=20) and covered the participant's naloxone knowledge, access, and attitudes, as well as experience(s) with opioid use and opioid overdose, and their naloxone use in the context of opioid overdose. Thematic content analysis was used to analyze interview transcripts.Results: Five main themes were uncovered during analysis; first, awareness about naloxone, including, content knowledge and source information for naloxone. Naloxone awareness was very common among opioid users; however, depth of knowledge varied; some participants did not make any efforts to have naloxone available, and others felt that it was "just as important as a clean needle." The second theme explored how naloxone access intersects with drug selling. The third theme explored naloxone availability while using, including attitudes about naloxone, occasions with no naloxone availability, when naloxone is "good to have," and when naloxone is a priority for users. The fourth theme examined changes in opioid use behaviours associated with naloxone access. Primarily, participants discussed changing how much heroin they used in a given situation to achieve a bigger high. The final theme explored naloxone behaviours that alter overdose mortality risk, such as how users distinguish when to use naloxone, dis-incentives to naloxone use, and solo opioid use.Conclusion: Results indicate that though naloxone awareness was high, there was great variation in the associated attitudes and practices. Participants generally described naloxone as an important resource, but not all were inclined to carry or use it appropriately. Future research needs to examine why different groups of opioid users access naloxone differently, particularly to identify those at risk for experimental opioid use while carrying naloxone. [ABSTRACT FROM AUTHOR]

In this paper, we analyze the commuting behavior of workers in the United States, with a focus on the differences between employees and the self-employed. Using the American Time Use Survey for the years 2003–2014, our empirical results show that employees spend 7.22 more minutes per day commuting than their self-employed counterparts, which represents a difference of 17% of the average commuting time of employed workers. This is especially prevalent in non-metropolitan areas, and it also appears to depend on the size of the population of the area of residence. Our results suggest that there is a complex relationship between urban form and the commuting behavior of workers. [ABSTRACT FROM AUTHOR]

Carefully designed interventions consistently help K-12 teachers learn how to implement a more autonomy-supportive classroom motivating style. In the present study, we investigated what resources teachers acquired during these interventions that explained why they are so able to successfully upgrade the quality of their motivating style. We randomly assigned 91 full-time teachers to participate or not in a year-long autonomy-supportive intervention program (ASIP), and we longitudinally assessed autonomy support and three hypothesized mediating resources—gains in need satisfaction during teaching, gains in teaching efficacy, and a greater adoption of intrinsic instructional goals. The ASIP did increase teachers’ autonomy support, as expected, and the two resources that explained this professional developmental achievement were intervention-enabled gains in teaching efficacy and intrinsic instructional goals. [ABSTRACT FROM AUTHOR]

The NIH Office of Dietary Supplements convened a public workshop on iron screening and supplementation in iron-replete pregnant women and young children in 2016 in Bethesda, Maryland. The starting point for the workshop was the recent reports from the US Preventive Services Task Force concluding that there was insufficient evidence to evaluate the benefits and harms associated with iron screening and routine supplementation among asymptomatic pregnant women and young children (6-24 mo old) in the United States. The goal of the workshop was to explore and refine understanding about the existing knowledge gaps and research needs associated with these preventive services for these groups. Given the focus on the United States, planning for the workshop took into account the higher iron status in the United States compared with developing countries and, in turn, included a focus on iron-replete individuals consistent with the U-shaped risk curve for nutrient-health relations. Topic areas included adaptations in iron homeostasis associated with pregnancy and young childhood, the impact of inflammation, measurement of iron status, current estimates of iron status for pregnant women and young children in the United States and in Europe, and emerging evidence suggesting adverse effects associated with iron supplementation of ironreplete individuals. A crosscutting dialogue conducted at the close of the workshop formed the basis for a workshop summary that specified evidence gaps and research needs in a range of areas centered on the relation of these adaptations of iron homeostasis with the response to and risk from iron supplementation as well as the need for indicators informative of the full continuum of iron status and based on health outcomes, not just erythropoiesis. [ABSTRACT FROM AUTHOR]

Background: Total-body iron stores (TBI), which are calculated from serum ferritin and soluble transferrin receptor concentrations, can be used to assess the iron status of populations in the United States. Objective: This analysis, developed to support workshop discussions, describes the distribution of TBI and the prevalence of iron deficiency (ID) and ID anemia (IDA) among toddlers, nonpregnant females, and pregnant females. Design: We analyzed data from NHANES; toddlers aged 12-23 mo (NHANES 2003-2010), nonpregnant females aged 15-49 y (NHANES 2007-2010), and pregnant females aged 12-49 y (NHANES 1999-2010). We used SAS survey procedures to plot distributions of TBI and produce prevalence estimates of ID and IDA for each target population. All analyses were weighted to account for the complex survey design. Results: According to these data, ID prevalences (6 SEs) were 15.1%±1.7%, 10.4%±0.5%, and 16.3%±1.3% in toddlers, nonpregnant females, and pregnant females, respectively. ID prevalence in pregnant females increased significantly with each trimester (5.3%±1.5%, 12.7%±2.3%, and 27.5%±3.5% in the first, second, and third trimesters, respectively). Racial disparities in the prevalence of ID among both nonpregnant and pregnant females exist, with Mexican American and non-Hispanic black females at greater risk of ID than non-Hispanic white females. IDA prevalence was 5.0%±0.4% and 2.6%±0.7% in nonpregnant and pregnant females, respectively. Conclusions: Available nationally representative data suggest that ID and IDA remain a concern in the United States. Estimates of ironreplete status cannot be made at this time in the absence of established cutoffs for iron repletion based on TBI. The study was registered at clinicaltrials.gov as NCT03274726. [ABSTRACT FROM AUTHOR]

The quality of indoor environment has received considerable attention owing to the declining outdoor human activities and the associated public health issues. The prolonged exposure of children in childcare facilities or the occupational exposure of adults to indoor environmental triggers can be a culprit of the pathophysiology of several commonly observed idiopathic syndromes. In this study, concentrations of potentially toxic plasticizers (phthalates as well as non-phthalates) were investigated in 28 dust samples collected from three different indoor environments across the USA. The mean concentrations of non-phthalate plasticizers [acetyl tri- n -butyl citrate (ATBC), di-(2-ethylhexyl) adipate (DEHA), and di-isobutyl adipate (DIBA)] were found at 0.51–880 μg/g for the first time in indoor dust samples from childcare facilities, homes, and salons across the USA. The observed concentrations of these replacement non-phthalate plasticizer were as high as di-(2-ethylhexyl) phthalate, the most frequently detected phthalate plasticizer at highest concentration worldwide, in most of indoor dust samples. The estimated daily intakes of total phthalates (n = 7) by children and toddlers through indoor dust in childcare facilities were 1.6 times higher than the non-phthalate plasticizers (n = 3), whereas estimated daily intake of total non-phthalates for all age groups at homes were 1.9 times higher than the phthalate plasticizers. This study reveals, for the first time, a more elevated (∼3 folds) occupational intake of phthalate and non-phthalate plasticizers through the indoor dust at salons (214 and 285 ng/kg-bw/day, respectively) than at homes in the USA. [ABSTRACT FROM AUTHOR]

Fat, oil and grease (FOG) blockages in sewer systems are a substantial problem in the United States. It has been estimated that over 50% of sewer overflows are a result of FOG blockages. In this work, a thorough laboratory study was undertaken to examine key variables that contribute to FOG deposit formation under controlled conditions. Physical and chemical properties and their interactions were evaluated and conditions that generated deposits that mimicked field FOG deposits were identified. It was found that 96 of the of 128 reaction conditions tested in the laboratory formed FOG deposits with similar physical and chemical characteristics as field FOG deposits. It was also found that FOG deposits can be created through fatty acid crystallization and not just saponification. Furthermore FOG deposits were found to be more complex than previously documented and contain free fatty acids, fatty acid metal salts, triacylglycerol's, diacylglycerol's and, monoacylglycerol's. Lastly it was found that FOG deposits that only contained saturated fatty acids were on average 2.1 times higher yield strength than deposits that contained unsaturated fatty acids. [ABSTRACT FROM AUTHOR]

Objectives: To characterize gender differences in the prevalence of mental and physical health conditions and evaluate the moderating effect of assaultive trauma on risk for these conditions in a nationally representative sample of male and female U.S. veterans.Methods: Cross-sectional data were analyzed from 3157 U.S. veterans from the National Health and Resilience in Veterans Study. Multivariable logistic regression analyses assessed gender differences in health outcomes and evaluated physical and sexual trauma as possible moderators of these outcomes.Results: Compared to male veterans, female veterans had higher prevalence estimates of lifetime posttraumatic stress (OR=3.33) and lifetime and current major depressive (ORs=2.10 and 2.76, respectively) disorders, and lifetime histories of arthritis, migraine headaches, and osteoporosis (ORs ranging 2.14-9.74), but lower prevalence estimates of lifetime nicotine dependence (OR=0.46), lifetime and current alcohol use (ORs=0.19 and 0.36, respectively) and lifetime drug use (OR=0.39) disorders, and lifetime histories of diabetes, heart attack, and high blood pressure (ORs ranging 0.05-0.49). The elevation in risk associated with physical and sexual assault was greater for males than females for numerous health conditions (but greater for females for posttraumatic stress disorder).Conclusions: Results provide a comprehensive assessment and characterization of gender differences in mental and physical health conditions and risk conferred by assaultive trauma for certain conditions in U.S. veterans. [ABSTRACT FROM AUTHOR]

Background: Childhood maltreatment is a known risk factor for cannabis initiation and problem use, but the extent to which this association is attributable to shared familial influences is unknown. We estimate the magnitude of associations between childhood maltreatment, timing of cannabis initiation, and cannabis-related problems, in European-American (EA) and African-American (AA) women, and parse the relative influence of additive genetic (A), shared environmental (C), and individual-specific environmental (E) factors on these constructs and their covariation.Methods: Data were from diagnostic telephone interviews conducted with 3786 participants (14.6% AA) in a population-based study of female twins. Logistic regression analyses and twin modeling were used to test for associations, and estimate the relative contributions of genetic and environmental influences to childhood maltreatment and cannabis outcomes and their covariation.Results: Maltreatment was significantly associated with increased likelihood of cannabis initiation before age 15 among EAs (OR=6.33) and AAs (OR=3.93), but with increased likelihood of later initiation among EAs only (OR=1.68). Maltreatment was associated with cannabis problems among both groups (EA OR=2.32; AA OR=2.03). Among EA women, the covariation between maltreatment and cannabis outcomes was primarily attributable to familial environment (rC=0.67-0.70); among AAs, only individual-specific environment contributed (rE=0.37-0.40).Conclusion: Childhood maltreatment is a major contributor to early initiation of cannabis as well as progression to cannabis problems in both AA and EA women. Distinctions by race/ethnicity are not in the relative contribution of genetic factors, but rather in the type of environmental influences that contribute to stages of cannabis involvement. [ABSTRACT FROM AUTHOR]

Background: Despite success of public health-oriented tobacco control programs in lowering the smoking prevalence over the past several decades, it is unclear whether similar reductions in smoking have been experienced among pregnant women, especially in vulnerable groups such as those with major depression and/or lower socioeconomic status.Objectives: The purpose of this study is to examine the relationship between major depressive episode (MDE) and smoking among pregnant women overall, and by demographics and to estimate changes in the prevalence of cigarette smoking among pregnant women with and without MDE from 2005 to 2014.Study Design: Cigarette use among pregnant women with and without MDE was examined using logistic regression models in the National Survey on Drug Use and Health.Results: Prenatal smoking is more common among pregnant women with, compared to without, MDE (32.5% vs. 13.0%; (adjusted OR=2.50 (1.85, 3.40)), and greater disparities were revealed when also considering income, education and race. Over time, smoking during pregnancy increased significantly among women with MDE (35.9% to 38.4%; p=0.02)) and showed a decreasing trend among women without MDE (12.5% to 9.1%; p=0.07) from 2005 to 2014.Conclusions: Over the past decade, smoking during pregnancy has increased among women experiencing a major depressive episode and is over four times more common among pregnant women with, than without, MDE. Disparities in smoking during pregnancy by MDE status and socioeconomic subgroups appear substantial. Given the multitude of risks associated with both MDE and smoking during the prenatal period, more work targeting this vulnerable and high-risk group is needed. [ABSTRACT FROM AUTHOR]

Background: Highly caffeinated energy drinks (EDs) are popular with adolescents and young adults, but longitudinal consumption patterns are poorly understood especially in relation to other substance use.Methods: ED and other substance use were assessed annually (modal ages 21-25) among a sample (n=1099) who were originally recruited as first-year college students (modal age 18). Trajectory groups were derived based on probability of past-year use during ages 21-24, and compared for possible differences in substance use outcomes at age 25, holding constant demographics, sensation-seeking, other caffeine consumption, and age 21 substance use.Results: From age 21-25, ED consumption declined in both annual prevalence [62.5%wt to 49.1%wt (wt=weighted)] and frequency of use among consumers (35.2-26.3 days/year). Yet individuals exhibiting a Persistent trajectory (51.4%) of consumption outnumbered those with Non-Use (20.6%), Intermediate (17.4%), or Desisting (10.6%) trajectories. Age 25 cocaine use, nonmedical use of prescription stimulants (NPS), and alcohol use disorder (AUD) risk were significantly associated with trajectory group membership, with Persistent and Intermediate groups exhibiting the highest risk for such outcomes, even accounting for prior substance use and other risk factors. Neither marijuana nor tobacco use were associated with group membership.Conclusions: The typical pattern of ED consumption among this sample was sustained use throughout young adulthood. Such individuals appear to be at high risk for adverse substance use outcomes, and results suggest possible specificity regarding cocaine use and NPS, and AUD risk. More research is needed to understand the mechanisms underlying the connection between ED and substance use. [ABSTRACT FROM AUTHOR]

Brettanomyces may add complexity to wine at low concentrations but at high concentrations, can result in objectionable wines. The objective of this study was to determine the concentrations at which consumers from two different locations were able to detect Brettanomyces volatile compounds present in a red wine. A red wine blend, used in both countries, was spiked to create five treatments containing different concentrations of 4-ethylphenol (4-EP), 4-ethylguiacol (4-EG), and 4-ethylcatechol (4-EC) in a 5:1:1 ratio, respectively. These treatments were evaluated by consumers in the United States and Portugal (n = 121) using a difference from control test. Consumers were also classified as having low, medium, or high wine knowledge. Among the spiked samples, the greatest degree of difference was found between the second and third treatments, corresponding to reported detection and recognition threshold ranges of 4-EP and 4-EG. For some treatments, consumers from Portugal classified in the medium or high knowledge level reported significantly higher mean differences from the control than those in the low knowledge group (p < 0.05). Results demonstrated consumers' ability to detect differences in red wines due to Brettanomyces volatile compounds. Results provide useful context on how wine knowledge and cultural variants may affect the detection of Brettanomyces . [ABSTRACT FROM AUTHOR]

Introduction: This study assessed the relationship between secondhand smoke exposure (SHSe) as measured by serum cotinine and healthcare utilization among children.Methods: In 2016, the 2009-2012 National Health and Nutrition Examination Survey data were analyzed including 4,985 children aged 3-19 years. Associations between SHSe and having a routine place for healthcare, type of place, and hospital utilization were examined using logistic regression models. Poisson regression analyses assessed the relationship between SHSe and number of hospital admissions. Relationships between SHSe and acute care visits and hospital utilization were examined among asthmatic children.Results: SHSe level did not differ by having a routine place for healthcare, although children with high SHSe indicative of active smoking (cotinine ≥3 ng/mL) were 3.49 times (95% CI=1.77, 6.89) more likely to use an emergency department. Children with high SHSe were 2.85 times (95% CI=1.87, 4.34) more likely to have had an overnight hospital stay. Children with high SHSe had 2.05 times (95% CI=1.46, 2.87) the risk of having a higher number of hospital admissions for overnight stays versus children with no SHSe (cotinine <0.05 ng/mL). Among asthmatic children, those with high SHSe and low SHSe (cotinine 0.05-2.99 ng/mL) were more likely to have an acute care visit, overnight hospital stay, and higher number of hospital admissions than asthmatic children with no SHSe.Conclusions: High SHSe is associated with increased healthcare utilization. The emergency department and inpatient settings are important venues in which to routinely offer cessation and SHSe reduction interventions. [ABSTRACT FROM AUTHOR]

Aquaculture of the Pacific white shrimp Litopenaeus vannamei in low-salinity water is a viable industry and production strategy in the southeastern United States. A major challenge facing this industry is a phenomenon called late-term mortality which is thought to be driven by thermal stress at the end of the growing season when water temperatures can reach or exceed 36 °C in shrimp production ponds. To investigate the physiological mechanisms behind upper lethal limits in shrimp, we evaluated linkages between empirically measured thermal limits and absolute aerobic scope (AAS), or ability to provide energy above that needed for basic maintenance. In this study, we tested whether thermal tolerance decreases with increasing shrimp age/size and whether AAS is a useful concept for understanding the physiological basis of thermal tolerance in shrimp. We exposed two size classes (small: 2.07 ± 0.86 and large: 24.64 ± 2.55 g) of shrimp to increasing temperature at a rate of 1 °C/h from 28 to 42 °C. At each temperature, we used intermittent respirometry to estimate resting metabolic rate and we directly measured lethal thermal tolerance by evaluating critical thermal maximum (CT max). Additionally, we used the electron transport system assay to estimate maximum metabolic rate (RMR) at temperatures from 9 to 45 °C. Small shrimp had a higher CT max than large shrimp, with upper lethal limits of 40.6 and 39.0 °C, respectively. For both size-classes, AAS reached its minimum (AAS min) at temperatures near the peak RMR (RMR peak) and within 2 °C of CT max. Large shrimp exhibited a lower temperature at AAS min than that of the smaller shrimp. Reductions in AAS appear to be one of the underlying physiological drivers of thermal tolerance in L. vannamei and an indicator of increasing thermal stress. Changes in the temperature at which AAS reaches its minimum may be a useful predictor of shifts in thermal tolerance among shrimp size-classes. • Pacific white shrimp were exposed to increasing temperature to measure physiological response to acute thermal stress • Upper thermal limits (CT max) decreased with increased shrimp size • Absolute aerobic scope declined to minimum values at temperatures near the RMRpeak and within 2 °C of CT max • Reductions in absolute aerobic scope appear to be one of the underlying physiological drivers of shrimp thermal tolerance [ABSTRACT FROM AUTHOR]

Posttraumatic stress disorder (PTSD) is associated with increased risk for Type 2 diabetes and cardiovascular disease (cardiometabolic disease), warranting research into targeted prevention strategies. In the present case–control study of 160 young (mean age 32.7 years) male military veterans, we aimed to assess whether PTSD status predicted increased markers of cardiometabolic risk in otherwise healthy individuals, and further, to explore biological pathways between PTSD and these increased markers of cardiometabolic risk. Toward these aims, we compared measures of cardiometabolic risk, namely insulin resistance (IR) (HOMA-IR), metabolic syndrome (MetS) and prediabetes, between 80 PTSD cases and 80 controls without PTSD. We then determined whether PTSD-associated increases in HOMA-IR were correlated with select biological variables from pathways previously hypothesized to link PTSD with cardiometabolic risk, including systemic inflammation (increased C-reactive protein, interleukin-6, and tumor necrosis factor α), sympathetic over-activity (increased resting heart rate), and neuroendocrine dysregulation (increased plasma cortisol or serum brain-derived neurotrophic factor (BDNF)). We found PTSD diagnosis was associated with substantially higher HOMA-IR (cases 4.3 ± 4.3 vs controls 2.4 ± 2.0; p < 0.001), and a higher frequency of MetS (cases 21.3% vs controls 2.5%; p < 0.001), but not prediabetes (cases 20.0% vs controls 18.8%; p > 0.05). Cases also had increased pro-inflammatory cytokines ( p < 0.01), heart rate ( p < 0.001), and BDNF ( p < 0.001), which together predicted increased HOMA-IR (adjusted R 2 = 0.68, p < 0.001). Results show PTSD diagnosis in young male military veterans without cardiometabolic disease is associated with increased IR, predicted by biological alterations previously hypothesized to link PTSD to increased cardiometabolic risk. Findings support further research into early, targeted prevention of cardiometabolic disease in individuals with PTSD. [ABSTRACT FROM AUTHOR]

In the 1980s, a case–control epidemiologic study was conducted in Iowa (USA) to analyze the association between exposure to disinfection by-products (DBPs) and bladder cancer risk. Trihalomethanes (THMs), the most commonly measured and dominant class of DBPs in drinking water, served as a primary metric and surrogate for the full DBP mixture. Average THM exposure was calculated, based on rough estimates of past levels in Iowa. To reduce misclassification, a follow-up study was undertaken to improve estimates of past THM levels and to re-evaluate their association with cancer risk. In addition, the risk associated with haloacetic acids, another class of DBPs, was examined. In the original analysis, surface water treatment plants were assigned one of two possible THM levels depending on the point of chlorination. The re-assessment considered each utility treating surface or groundwater on a case-by-case basis. Multiple treatment/disinfection scenarios and water quality parameters were considered with actual DBP measurements to develop estimates of past levels. The highest annual average THM level in the re-analysis was 156 μg/L compared to 74 μg/L for the original analysis. This allowed the analysis of subjects exposed at higher levels (> 96 μg/L). The re-analysis established a new approach, based on case studies and an understanding of the water quality and operational parameters that impact DBP formation, for determining historical exposure. [ABSTRACT FROM AUTHOR]

Background Magnesium and calcium are antagonistic in many physiologic processes. However, few studies have investigated the associations of supplemental calcium with lung cancer risk taking this antagonism into account. We evaluated the effect of calcium and vitamin D supplementation on lung cancer incidence and explored whether the ratio of baseline calcium to magnesium (Ca:Mg) intake modifies the association in the Women’s Health Initiative (WHI) calcium plus vitamin D supplementation (CaD) trial. Methods The intervention phase of the WHI CaD was a double-blinded, randomized, placebo-controlled trial in 36,382 postmenopausal women aged 50–79 years, recruited at 40 U.S. centers. Post-intervention follow-up continued among 29,862 (86%) of the surviving participants. Risk of lung cancer in association with CaD supplementation was evaluated using proportional hazard regression models. Results After 11 years’ cumulative follow-up, there were 207 lung cancers (incidence 0.11% per year) in the supplement arm and 241 (0.12%) in the placebo arm (hazard ratio (HR) for the intervention, 0.91; 95% confidence interval (CI), 0.71–1.17). Subgroup analyses suggested that the HR for lung cancer varied by baseline Ca:Mg intake ratio among women who were current smokers at enrollment ( p = 0.04 for interaction). Conclusions Over the entire follow-up period, calcium and vitamin D supplementation did not reduce lung cancer incidence among postmenopausal women. In exploratory analyses, an interaction was found for the baseline Ca:Mg intake ratio on lung cancer among current smokers at the trial entry. This findings need to be further studied for the role of calcium with magnesium in lung carcinogenesis in current smokers. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the role of vitamin D intake and serum levels on conception of clinical pregnancy and live birth.Design: Prospective cohort study.Setting: Academic medical centers.Patient(s): Healthy, nulliparous women, age 18-39 years, and their male partners.Intervention(s): None.Main Outcome Measure(s): Clinical pregnancy and live birth were compared between those who did or did not meet the vitamin D estimated average requirement (EAR) intake (10 μg/d) and with serum 25-hydroxyvitamin D (25(OH)D) considered at risk for inadequacy or deficiency (<50 nmol/L) or sufficient (≥50 nmol/L).Result(s): Among 132 women, 37.1% did not meet the vitamin D EAR and 13.9% had serum levels at risk for inadequacy or deficiency. Clinical pregnancies were significantly higher among women who met the vitamin D EAR (67.5% vs. 49.0%) and with sufficient serum 25(OH)D (64.3% vs. 38.9%) compared with those who did not. Live births were higher among those who met the vitamin D EAR (59.0% vs. 40.0%). The adjusted odds ratio (AOR) of conceiving a clinical pregnancy was significantly higher among those who met the EAR (AOR = 2.26; 95% confidence interval [CI], 1.05-4.86) and had sufficient serum 25(OH)D (AOR = 3.37; 95% CI, 1.06-10.70). The associations were not significant after controlling for selected nutrients and dietary quality.Conclusion(s): Women with vitamin D intake below EAR and serum 25(OH)D levels at risk for inadequacy or deficiency may be less likely to conceive and might benefit from increased vitamin D intake to achieve adequacy.Clinical Trial Registration Number: NCT00642590. [ABSTRACT FROM AUTHOR]

Salmonella Enteritidis (SE) prevalence in eggs is a major concern to the egg industry. Some research has shown that egg sweating can increase Salmonella penetration into egg contents when refrigerated eggs are moved to a warmer temperature. This occurs when eggs are tempered before wash, to minimize thermal cracks. The effect of egg sweating on SE penetration into shell eggs over a 6 week storage period at 4°C was assessed. A 2 × 2 factorial of SE inoculation and egg sweating was utilized. Treatments included (SES) nalidixic acid (NA)-resistant SE inoculated and sweated, (SENS) NA-resistant SE inoculated and not sweated, (NSES) buffered peptone water (BPW) inoculated and sweated, and (NSENS) BPW inoculated and not sweated. Eggs were inoculated with 108 SE. Eggs formed condensation for approximately 17 min in a 32°C incubator. Shell rinse, shell emulsion, and egg contents were sampled then enumerated and assessed for prevalence of SE over a 6 wk storage period at 4°C. After wk 1, the SENS shell rinse had higher SE counts (0.32 log10 CFU/mL) than the other 3 treatments, where no SE was enumerated. A significant week by treatment interaction was found for the shell rinse SE detection (P < 0.05). In subsequent weeks, no SE counts were obtained from the egg shell rinse, shell emulsion, or egg contents. The SENS shell rinses had significantly higher SE prevalence than the SES rinses in weeks 1 (100% vs. 34.3%), 2 (57.6% vs. 22.2%), and 3 (38.2% vs. 11.1%) (P < 0.05). In samples from weeks 4, 5, and 6, there was no difference in SE prevalence between SES and SENS. Egg sweating did not increase SE penetration into the shell emulsion across treatment or week (P < 0.05). The decreasing trend of SE prevalence obtained over the study period indicate that refrigeration is effective at inhibiting SE growth. These results indicate that egg sweating occurring under common US egg handling practices is not harmful to egg safety. [ABSTRACT FROM AUTHOR]

Background: Multicenter longitudinal objective data for survival into adulthood of patients who have undergone Fontan procedures are lacking.Objectives: This study sought to describe transplant-free survival and explore relationships between laboratory measures of ventricular performance and functional status over time.Methods: Exercise testing, echocardiography, B-type natriuretic peptide, functional health assessment, and medical history abstraction were repeated 9.4 ± 0.4 years after the Fontan Cross-Sectional Study (Fontan 1) and compared with previous values. Cox regression analysis explored risk factors for interim death or cardiac transplantation.Results: From the original cohort of 546 subjects, 466 were contacted again, and 373 (80%) were enrolled at 21.2 ± 3.5 years of age. Among subjects with paired testing, the percent predicted maximum oxygen uptake decreased (69 ± 14% vs. 61 ± 16%; p < 0.001; n = 95), ejection fraction decreased (58 ± 11% vs. 55 ± 10%; p < 0.001; n = 259), and B-type natriuretic peptide increased (median [interquartile range] 13 [7 to 25] pg/mol vs. 18 [9 to 36] pg/mol; p < 0.001; n = 340). At latest follow-up, a lower Pediatric Quality of Life Inventory physical summary score was associated with poorer exercise performance (R2 adjusted = 0.20; p < 0.001; n = 274). Cumulative complications since the Fontan procedure included additional cardiac surgery (32%), catheter intervention (62%), arrhythmia treatment (32%), thrombosis (12%), and protein-losing enteropathy (8%). Since Fontan 1, 54 subjects (10%) have received a heart transplant (n = 23) or died without transplantation (n = 31). The interval risk of death or/cardiac transplantation was associated with poorer ventricular performance and functional health status assessed at Fontan 1, but it was not associated with ventricular morphology, the subject's age, or the type of Fontan connection.Conclusions: Interim transplant-free survival over 12 years in this Fontan cohort was 90% and was independent of ventricular morphology. Exercise performance decreased and was associated with worse functional health status. Future interventions might focus on preserving exercise capacity. (Relationship Between Functional Health Status and Ventricular Performance After Fontan-Pediatric Heart Network; NCT00132782). [ABSTRACT FROM AUTHOR]

Background: The consumption of trans fatty acids (TFAs) is associated with an increased risk of cardiovascular disease, and reducing their consumption is a major public health objective. Food intake studies have provided estimates for TFA concentrations in the US population; however, there is a need for data on TFA blood concentrations in the population. Objective: The objective of this study was to determine plasma TFA concentrations in a nationally representative group of fasted adults in the US population in NHANES samples from 1999-2000 and 2009-2010. Design: Four major TFAs [palmitelaidic acid (C16:1n-7t), trans vaccenic acid (C18:1n-7t), elaidic acid (C18:1n-9t), and linoelaidic acid (C18:2n-6t,9t)] were measured in plasma in 1613 subjects from NHANES 1999-2000 and 2462 subjects from NHANES 2009-2010 by gas chromatography-mass spectrometry. Geometric means and distribution percentiles were calculated for each TFA and their sum by age, sex, and race/ethnicity (non-Hispanic white, non-Hispanic black, Mexican American), and covariate-adjusted geometric means were computed by using a model that included these demographic and other dietary factors, as well as survey year and any significant interaction terms. Results: These nationally representative data for the adult US population show that TFA concentrations were 54% lower in NHANES 2009-2010 than in NHANES 1999-2000. Covariate-adjusted geometric means for the sum of the 4 TFAs were 81.4 μmol/L (95% CI: 77.3, 85.6 μmol/L) and 37.8 μmol/L (95% CI: 36.4, 39.4 μmol/L) in NHANES 1999-2000 and 2009-2010, respectively. Even with the large decline in TFA concentrations, differences between demographic subgroups were comparable in the 2 surveys. Conclusion: The results indicate an overall reduction in TFA concentrations in the US population and provide a valuable baseline to evaluate the impact of the recent regulation categorizing TFAs as food additives. [ABSTRACT FROM AUTHOR]

Background: Vitamin D deficiency has been linked to all-cause mortality and cancer. However, the biological plausibility of these associations is not well established. Leukocyte telomere length (LTL) shortening is associated with aging and is a hallmark of genomic instability and carcinogenesis.Objective: We aimed to investigate the association between serum 25-hydroxyvitamin D [25(OH)D] concentrations and LTL in the general US population.Methods: We analyzed data from the US NHANES 2001-2002. The study population comprised 1542 younger adults (aged 20-39 y), 1336 middle-aged adults (aged 40-59 y), and 1382 older adults (aged ≥60 y). LTL was measured by using quantitative polymerase chain reaction. Serum 25(OH)D concentrations ≥50 nmol/L were considered optimal. Linear regression, adjusted for age, sex, race/ethnicity, body mass index (BMI), total energy and sugar intakes, calcium intake, socioeconomic status, milk and dietary supplement consumption, and physical activity, was applied to investigate the association between serum 25(OH)D and LTL.Results: In the total population, age, sex, BMI, and non-Hispanic black race/ethnicity were significant predictors of LTL. In the participants aged 40-59 y, an increment in serum 25(OH)D of 10 nmol/L was associated with a 0.03- ± 0.01-kbp longer LTL, adjusted for age, sex, race/ethnicity, and other factors (P = 0.001). In the same age group, 25(OH)D concentrations ≥50 nmol/L were associated with a 0.13- ± 0.04-kbp longer LTL than those for 25(OH)D concentrations <50 nmol/L (P = 0.01). The association was independent of age, sex, race/ethnicity, BMI, and other factors.Conclusions: In a nationally representative population of adults, serum 25(OH)D was positively associated with LTL in middle-aged participants (aged 40-59 y), independently of other factors. These findings suggest that decreased 25(OH)D concentrations are associated with genomic instability, although the clinical impact of this observation remains unclear. [ABSTRACT FROM AUTHOR]

Objectives: Explore how adults from diverse racial and socioeconomic backgrounds perceive the use of weight loss drugs (prescription, over-the counter, herbals and supplements) and lifestyle modification.Methods: Individual, face-to-face, semi-structured interviews were conducted with persons presenting to an academic hospital-affiliated outpatient pharmacy serving ethnic minorities and low income individuals.Results: Fifty persons were interviewed, including 21 African Americans, 11 Hispanics and 17 low-income individuals (annual income <$20,000), of whom 33 self-reported as overweight or obese. Ever-users (14/50) and nonusers (36/50) of weight loss drugs expressed a belief in the importance of diet and exercise, but were not necessarily doing so themselves. Fear of side effects and skepticism towards efficacy of drugs deterred use. Some expressed concern over herbal product safety; others perceived herbals as natural and safe. Drugs were often viewed as a short-cut and not a long-term weight management solution.Conclusion: A range of concerns related to the safety and efficacy of weight loss drugs were expressed by this lower income, ethnically diverse population of underweight to obese adults.Practice Implications: There is need and opportunity for healthcare providers to provide weight loss advice and accurate information regarding the safety and efficacy of various types of weight loss approaches. [ABSTRACT FROM AUTHOR]

Background: Many individuals with intellectual and developmental disabilities (IDD) have sedentary lifestyles.Aims: (a) compare adults with IDD with the general adult population on adherence to U.S. physical activity (PA) guidelines, and (b) determine what factors predict adherence to PA guidelines by adults with IDD.Methods: We compared adults with IDD from the 2011-2012 National Core Indicators Adult Consumer Survey (NCI-ACS) with the general U.S. population on meeting PA guidelines. We examined the association of demographic, diagnostic, mobility, health and community participation variables with meeting PA guidelines by adults with IDD.Results: The rate for adults with IDD meeting PA guidelines (13.5%) was less than half that of the general population (30.8%). Among adults with IDD, at-risk groups included those with more severe disability, Down syndrome, mobility impairments, obesity, poor health, mental illness, no independent access to community exercise, and less frequent participation in community exercise. Going out for exercise was the only form of community participation associated with meeting PA guidelines. People who accessed the community for exercise independently (i.e., alone) were more likely to meet PA guidelines.Conclusions: Interventions aimed at increasing PA for people with IDD should consider these factors in their design. [ABSTRACT FROM AUTHOR]

Background: Healthful dietary patterns have been associated with lower risks of type 2 diabetes and coronary artery disease, but their relations with intermediate markers of cardiometabolic and endocrine health are less established. Objective: We evaluated the Dietary Approaches to Stop Hypertension (DASH), the alternate Mediterranean diet (aMED), and the Alternate Healthy Eating Index (aHEI) diet-quality scores with cardiometabolic and endocrine plasma biomarkers in US women. Design: The trial was a cross-sectional analysis of 775 healthy women in the Women's Lifestyle Validation Study that was conducted within the NHS (Nurses' Health Study) and NHS II longitudinal cohorts. Multiple linear regression models adjusted for potential confounders were used to estimate associations between quartiles of dietary pattern-adherence scores that were derived from a food-frequency questionnaire and plasma biomarker concentrations that were collected simultaneously. Results: In multivariable models in which highest and lowest quartiles of dietary pattern scores were compared, 1) DASH was significantly associated with higher concentrations of high-density lipoprotein (9%) and sex-hormone binding globulin (SHBG) (21%), and lower concentrations of leptin (28%), triglycerides (19%), and C-peptide (4%) (all P-trend ≤ 0.04); 2) the aMED was associated with 19% higher SHBG and 16% lower triglycerides (P-trend = 0.02 and 0.003, respectively); and 3) the aHEI was associated with significantly higher concentrations of insulin (16%) and SHBG (19%) and lower concentrations of leptin (18%) (all P-trend ≤ 0.02). Further adjustment for body mass index (BMI) attenuated these associations but remained significant for 1) DASH with leptin and triglycerides and 2) the aMED with triglycerides (all P-trend ≤ 0.03). Conclusions: Adherence to healthful dietary patterns is associated with favorable concentrations of many cardiometabolic and endocrine biomarkers. [ABSTRACT FROM AUTHOR]

Background: Large-herd dairy parlor workers experience a high prevalence of musculoskeletal symptoms in the upper extremity. The purpose of this study was to evaluate the effect of milking unit design on upper extremity muscle activity during milking unit attachment.Methods: Upper extremity muscle activity was recorded among U.S. large-herd parlor workers (n=11) using surface electromyography. Participants performed several milking unit attachment cycles with each of six milking unit designs. Muscle activity levels were then compared between unit designs.Results: Mean muscle activity levels (in %MVE) across milking units ranged from 6.8 to 8.2 for the upper trapezius, 8.2 to 10.3 for the anterior deltoid, 13.8 to 17.2 for the forearm flexors, and 9.9 to 12.4 for the forearm extensors. Pairwise comparisons between milking units did not reveal statistically significant differences in muscle activity levels across milking unit designs. However, a general pattern of higher muscle activity was observed with specific milking units. Milking unit weight, milk tube spread, and teat cup shape may explain differences in muscle activity levels.Conclusions: Milking unit design may influence muscle activity levels among parlor workers. Small reductions in muscle activity associated with milking unit design have the potential to delay the onset of fatigue or development of musculoskeletal health outcomes among parlor workers. [ABSTRACT FROM AUTHOR]

Objective: Despite substantial evidence on the prevalence and correlates of overweight and obesity (OW/OB) in adults with bipolar disorder (BD), little is known about this topic in adolescents with BD.Method: The method consisted of the National Comorbidity Survey-Adolescent Supplement, a face-to-face survey of mental disorders from 2001 through 2004, using a modified version of the fully structured World Health Organization Composite International Diagnostic Interview. Participants were adolescents 13 to 17 years of age, with bipolar disorder I or II (n = 295), major depressive disorder (n = 1,112), or controls with neither mood disorder (n = 8,716). Analyses examined for group differences in the prevalence of OW/OB and for correlates of OW/OB in the group with BD.Results: There were no significant differences in weight categories across groups. OW and OB in adolescents with BD were associated with significantly higher lifetime rates of suicide attempt (odds ratio 3.02, 95% CI 1.11-8.24), physical or sexual abuse (2.82, 1.20-6.60), binge eating or bulimia (2.66, 1.13-6.26), and conduct disorder (2.60, 1.10-6.13) in covariate-adjusted analyses. OW and OB also were significantly associated with seeing a professional for depression, being hospitalized overnight for depression, and receiving general medical treatment.Conclusion: The similar prevalence of OW/OB in adolescents with and without BD suggests that this potent association in adults likely comprises a consequence of BD or its correlates. In contrast, the strong association of OW/OB with proxies for depression severity, including suicide attempts and hospitalization, is already evident even in this young, nonclinical sample. Studies are warranted to determine whether early intervention of OW/OB in BD might optimize physical and mental health. [ABSTRACT FROM AUTHOR]

Background: Adequate water intake is critical to physiologic and cognitive functioning. Although water requirements increase with body size, it remains unclear whether weight status modifies the relation between water intake and hydration status. Objective: We examined how the association between water intake and urine osmolality, which is a hydration biomarker, varied by weight status. Design: NHANES cross-sectional data (2009-2012) were analyzed in 9601 nonpregnant adults aged ≥20 y who did not have kidney failure. Weight status was categorized with the use of body mass index on the basis of measured height and weight (underweight or normal weight, overweight, and obesity). Urine osmolality was determined with the use of freezing-point depression osmometry. Hypohydration was classified according to the following age-dependent formula: ≥831 mOsm/kg - [3.4 x (age - 20 y)]. Total water intake was determined with the use of a 24-h dietary recall and was dichotomized as adequate or low on the basis of the Institute of Medicine's adequate intake recommendations for men and women (men: ≥3.7 or <3.7 L; nonlactating women: ≥2.7 or <2.7 L; lactating women: ≥3.8 or <3.8 L for adequate or low intakes, respectively). We tested interactions and conducted linear and log-binomial regressions. Results: Total water intake (P = 0.002), urine osmolality (P < 0.001), and hypohydration prevalence (P < 0.001) all increased with higher weight status. Interactions between weight status and water intake status were significant in linear (P = 0.005) and log-binomial (P = 0.015) models, which were then stratified. The prevalence ratio of hypohydration between subjects with adequate water intake and those with low water intake was 0.56 (95% CI: 0.43, 0.73) in adults who were underweight or normal weight, 0.67 (95% CI: 0.57, 0.79) in adults who were overweight, and 0.78 (95% CI: 0.70, 0.88) in adults who were obese. Conclusion: On a population level, obesity modifies the association between water intake and hydration status. [ABSTRACT FROM AUTHOR]

Objective: To evaluate exposure to tobacco, marijuana, and indoor heating/cooking sources in relation to antimüllerian hormone (AMH) levels.Design: Cross-sectional analysis in a sample of premenopausal women (n = 913) enrolled in the Sister Study cohort (n = 50,884).Setting: Not applicable.Patient(s): Women, ages 35-54 years at time of enrollment, with an archived serum sample and at least one intact ovary and classified as premenopausal.Intervention(s): Not applicable.Main Outcome Measure(s): Serum AMH (ng/mL) levels ascertained by ultrasensitive ELISA assay.Result(s): Lower AMH levels were associated with sources of indoor heating, including burning wood (-36.0%; 95% confidence interval [CI], -55.7%, -7.8%) or artificial fire logs (-45.8%; 95% CI, -67.2%, -10.4%) at least 10 times/year in a residential indoor stove/fireplace. Lower AMH levels were also observed in women who were current smokers of ≥20 cigarettes/day relative to nonsmokers (-56.2%; 95% CI, -80.3%, -2.8%) and in women with 10+ years of adult environmental tobacco smoke (ETS) exposure (-31.3%; 95% CI, -51.3%, -3.1%), but no associations were observed for marijuana use.Conclusion(s): We confirmed previously reported findings of lower AMH levels in current heavy smokers and also found associations for long-term ETS exposure and indoor burning of wood or artificial fire logs. These findings suggest that combustion by-products from common exposures can have toxic effects on the human ovary. [ABSTRACT FROM AUTHOR]

The Society for Assisted Reproductive Technology (SART) was established within a few years of assisted reproductive technology (ART) in the United States, and has not only reported on the evolution of infertility care, but also guided it toward improved success and safety. Moving beyond its initial role as a registry, SART has expanded its role to include quality assurance, data validation, practice and advertising guidelines, research, patient education and advocacy, and membership support. The success of ART in this country has greatly benefited from SART's role, as highlighted by a series of graphs. SART continues to set the standard and lead the way. [ABSTRACT FROM AUTHOR]

Background: Patients with repaired tetralogy of Fallot (rTOF) suffer from progressive ventricular dysfunction decades after their surgical repair. We hypothesized that measures of ventricular strain and dyssynchrony would predict deterioration of ventricular function in patients with rTOF. Methods: A database search identified all patients at a single institution with rTOF who underwent cardiovascular magnetic resonance (CMR) at least twice, >6 months apart, without intervening surgical or catheter procedures. Seven primary predictors were derived from the first CMR using a custom feature tracking algorithm: left (LV), right (RV) and inter-ventricular dyssynchrony, LV and RV peak global circumferential strains, and LV and RV peak global longitudinal strains. Three outcomes were defined, whose changes were assessed over time: RV end-diastolic volume, and RV and LV ejection fraction. Multivariate linear mixed models were fit to investigate relationships of outcomes to predictors and ten potential baseline confounders. Results: One hundred fifty-three patients with rTOF (23 ± 14 years, 50 % male) were included. The mean follow-up duration between the first and last CMR was 2.9 ± 1.3 years. After adjustment for confounders, none of the 7 primary predictors were significantly associated with change over time in the 3 outcome variables. Only 1-17 % of the variability in the change over time in the outcome variables was explained by the baseline predictors and potential confounders. Conclusions: In patients with repaired tetralogy of Fallot, ventricular dyssynchrony and global strain derived from cine CMR were not significantly related to changes in ventricular size and function over time. The ability to predict deterioration in ventricular function in patients with rTOF using current methods is limited. [ABSTRACT FROM AUTHOR]

Background: Acute pulmonary embolism (PE) has an annual incidence of 100,000 cases in the United States and is divided into three categories: nonmassive, submassive, and massive. Several studies have evaluated the use of thrombolytics in submassive and massive PE.Objective: Our aim was to provide emergency physicians with an updated review of the controversy about the use of thrombolytics in submassive and massive PE.Discussion: Nonmassive PE is defined as PE in the setting of no signs of right ventricular strain (echocardiogram or biomarker) and hemodynamic stability. Submassive PE is defined as evidence of right ventricular strain with lack of hemodynamic instability. Massive PE occurs with occlusive thromboembolism that causes hemodynamic instability. Thrombolysis is warranted in patients with massive PE. Thrombolytic use in submassive PE with signs of right ventricular strain or damage presents a quandary for physicians. Several recent studies have evaluated the use of thrombolytics in patients with submassive PE. These studies have inconsistent definitions of submassive PE, evaluate differing primary outcomes, and use different treatment protocols with thrombolytics and anticoagulation agents. Although significant study heterogeneity exists, thrombolytics can improve long-term outcomes, with decreased bleeding risk with half-dose thrombolytics and catheter-directed treatments. Major bleeding significantly increases in patients over age 65 years. The risks and benefits of thrombolytic treatment-primarily improved long-term outcomes-should be considered on a case-by-case basis. Shared decision-making with the patient discussing the risks and benefits of treatment is advised.Conclusions: Thrombolytic use in massive PE is warranted, but patients with submassive PE require case-by-case analysis with shared decision making. The risks, including major hemorrhage, and benefits, primarily improved long-term outcomes, should be considered. Half-dose thrombolytics and catheter-directed treatment demonstrate advantages with decreased risk of bleeding and improved long-term functional outcomes. Further studies that assess risk stratification, functional outcomes, and treatment protocols are needed. [ABSTRACT FROM AUTHOR]

Introduction: Little is known about trends in national rates of injection-related skin and soft tissue infections (SSTI) and their relationship to the structural risk environment for heroin users. Use of Mexican-sourced "Black Tar" heroin, predominant in western US states, may have greater risk for SSTI compared with eastern US powder heroin (Colombian-sourced) due to its association with non-intravenous injection or from possible contamination.Methods: Using nationally representative hospital admissions data from the Nationwide Inpatient Sample and heroin price and purity data from the Drug Enforcement Administration, we looked at rates of hospital admissions for opiate-related SSTI (O-SSTI) between 1993 and 2010. Regression analyses examined associations between O-SSTI and heroin source, form and price.Results: Hospitalization rates of O-SSTI doubled from 4 to 9 per 100,000 nationally between 1993 and 2010; the increase concentrated among individuals aged 20-40. Heroin market features were strongly associated with changes in the rate of SSTI. Each $100 increase in yearly heroin price-per-gram-pure was associated with a 3% decrease in the rate of heroin-related SSTI admissions. Mexican-sourced-heroin-dominant cities had twice the rate of O-SSTI compared to Colombian-sourced-heroin-dominant cities.Discussion: Heroin-related SSTI are increasing and structural factors, including heroin price and source-form, are associated with higher rates of SSTI hospital admissions. Clinical and harm reduction efforts should educate heroin users on local risk factors, e.g., heroin type, promote vein health strategies and provide culturally sensitive treatment services for persons suffering with SSTI. [ABSTRACT FROM AUTHOR]

Introduction: Smoking is more prevalent among persons living with HIV (PLWH) than the general population. Little is known about the prevalence of non-cigarette tobacco and poly-tobacco use (PTU; using multiple tobacco products) among this population, which, in the general population is associated with poor health and cessation outcomes. We aimed to characterize the prevalence of cigarette and non-cigarette tobacco use, PTU, and correlates of tobacco use status among a nationally-representative sample of PLWH.Methods: Data came from 472 HIV-positive adults from the 2005-2013 National Survey on Drug Use and Health (NSDUH).Results: The prevalence of PTU overall was 8.7% (95% CI=5.6-13.2), and 16.6% (95% CI=10.2-25.7) among past-year tobacco users. In multinomial logistic regression analyses, participants with a high school education or greater (aRRR=2.03, 95% CI=1.03-4.00) were more likely to be non-tobacco users than single product users. Past year drug users (aRRR=0.35, 95% CI=0.19-0.66) and past month binge drinkers (aRRR=0.24, 95% CI=0.12-0.50) were less likely to be non-tobacco users than single product users. Compared to 18-25 year olds, individuals age 26-34 (aRRR=0.13, 95% CI=0.03-0.65) and 35+ (aRRR=0.24, 95% CI=0.09-0.63), and with lifetime anxiety disorder(s) (aRRR=0.18, 95% CI=0.06-0.57) were less likely to be PTUs as compared to single product users. Individuals who reported liking to test themselves by doing risky things were more likely to be PTUs than single product users (aRRR=2.95, 95% CI=1.27-6.84).Conclusions: PTU was slightly higher than in the general population, and should be taken into account when developing cessation interventions tailored to tobacco users living with HIV. [ABSTRACT FROM AUTHOR]

Background: To improve measures of monthly tobacco cigarette smoking among non-daily smokers, predictive of future non-daily monthly and daily smoking.Methods: Data from United States National Longitudinal Study of Adolescent to Adult Health, tracking adolescents, ages 12-21, over 14 years were analyzed. At baseline, 6501 adolescents were assessed; 5114 individuals provided data at waves 1 and 4. Baseline past 30-day non-daily smokers were classified using quantity-frequency measures: cigarettes smoked/day by number of days smoked in the past 30 days.Results: Three categories of past 30-day non-daily smokers emerged using cigarettes/month (low:1-5, moderate: 6-60, high: 61+) and predicted past 30-day smoking at follow-up (low: 44.5%, moderate: 60.0%, high: 77.0%, versus 74.2% daily smokers; rτ=-0.2319, p<0.001). Two categories of non-smokers plus low, moderate and high categories of non-daily smokers made up a five-category non-daily smoking index (NDSI). High NDSI (61+ cigs/mo.) and daily smokers were equally likely to be smoking 14 years later (High NDSI OR=0.97, 95% CI=0.53-1.80 [daily as reference]). Low (1-5 cigs/mo.) and moderate (6-60 cigs/mo.) NDSI were distinctly different from high NDSI, but similar to one another (OR=0.21, 95% CI=0.15-0.29 and OR=0.22, 95% CI=0.14-0.34, respectively) when estimating future monthly smoking. Among those smoking at both waves, wave 1 non-daily smokers, overall, were less likely than wave 1 daily smokers to be smoking daily 14 years later.Conclusions: Non-daily smokers smoking over three packs/month were as likely as daily smokers to be smoking 14-years later. Lower levels of non-daily smoking (at ages 12-21) predicted lower likelihood of future monthly smoking. In terms of surveillance and cessation interventions, high NDSI smokers might be treated similar to daily smokers. [ABSTRACT FROM AUTHOR]

Honey bee colonies in the United States have suffered from an increased rate of die-off in recent years, stemming from a complex set of interacting stresses that remain poorly described. While we have some understanding of the physiological stress responses in the honey bee, our molecular understanding of honey bee cellular stress responses is incomplete. Thus, we sought to identify and began functional characterization of the components of the UPR in honey bees. The IRE1-dependent splicing of the mRNA for the transcription factor Xbp1 , leading to translation of an isoform with more transactivation potential, represents the most conserved of the UPR pathways. Honey bees and other Apoidea possess unique features in the Xbp1 mRNA splice site, which we reasoned could have functional consequences for the IRE1 pathway. However, we find robust induction of target genes upon UPR stimulation. In addition, the IRE1 pathway activation, as assessed by splicing of Xbp1 mRNA upon UPR, is conserved. By providing foundational knowledge about the UPR in the honey bee and the relative sensitivity of this species to divergent stresses, this work stands to improve our understanding of the mechanistic underpinnings of honey bee health and disease. [ABSTRACT FROM AUTHOR]

Introduction: Racial disparities in obesity exist at the individual and community levels. Retail food environment has been hypothesized to be associated with racial disparities in obesity prevalence. This study aimed to quantify how much food environment measures explain racial disparities in obesity at the county level.Methods: Data from 2009 to 2010 on 3,135 U.S. counties were extracted from the U.S. Department of Agriculture Food Environment Atlas and the Behavioral Risk Factor Surveillance System and analyzed in 2013. Oaxaca-Blinder decomposition was used to quantify the portion of the gap in adult obesity prevalence observed between counties with a high and low proportion of African-American residents is explained by food environment measures (e.g., proximity to grocery stores, per capita fast-food restaurants). Counties were considered to have a high African-American population if the percentage of African-American residents was >13.1%, which represents the 2010 U.S. Census national estimate of percentage African-American citizens.Results: There were 665 counties (21%) classified as a high African-American county. The total gap in mean adult obesity prevalence between high and low African-American counties was found to be 3.35 percentage points (32.98% vs 29.63%). Retail food environment measures explained 13.81% of the gap in mean age-adjusted adult obesity prevalence.Conclusions: Retail food environment explains a proportion of the gap in adult obesity prevalence observed between counties with a high proportion of African-American residents and counties with a low proportion of African-American residents. [ABSTRACT FROM AUTHOR]

Extensively drug-resistant (XDR) tuberculosis is becoming increasingly prevalent worldwide, but little is known about XDR tuberculosis in young children. In this Grand Round we describe a 2-year-old child from the USA who developed pneumonia after a 3 month visit to India. Symptoms resolved with empirical first-line tuberculosis treatment; however, a XDR strain of Mycobacterium tuberculosis grew in culture. In the absence of clinical or microbiological markers, low-radiation exposure pulmonary CT imaging was used to monitor treatment response, and guide an individualised drug regimen. Management was complicated by delays in diagnosis, uncertainties about drug selection, and a scarcity of child-friendly formulations. Treatment has been successful so far, and the child is in remission. This report of XDR tuberculosis in a young child in the USA highlights the risks of acquiring drug-resistant tuberculosis overseas, and the unique challenges in management of tuberculosis in this susceptible population. [ABSTRACT FROM AUTHOR]

Objective: To characterize changes in indices of urinary function in prostatectomy patients with presurgical voiding symptoms.Methods: A retrospective analysis of our prostate cancer database identified robot-assisted radical prostatectomy patients between April 2007 and December 2011 who completed pre- and postsurgical (24 months) Expanded Prostate Cancer Index Composite-26 surveys. Gleason score, margins, D'Amico risk, prostate-specific antigen, radiotherapy, and nerve-sparing status were tabulated. Survey questions addressed urinary irritation/obstruction, incontinence, and overall bother. Responses were averaged to calculate a urinary sum (US) score. Patients were stratified according to the severity of their baseline urinary bother (UB), and changes in urinary indices determined at 24 months.Results: A total of 737 patients were included. Postsurgical improvement in urinary obstruction, bother, and sum score was related to baseline UB (P <.001). Men with severe baseline bother had the greatest improvement in US (+9.3), whereas those with asymptomatic baseline UB experienced a decline in US (-2.8). All patients experienced a decline in urinary incontinence of 6.3-8.3 that was independent of baseline bother (P = .507). Patients with severe UB experienced positive outcomes, whereas those at asymptomatic baseline experienced negative US outcomes. Negative urinary incontinence outcomes were unrelated to baseline UB. Age, radiotherapy, and nerve-sparing status were not associated with improved UB (P = .029). However, baseline UB was significantly associated with improvement in postsurgical UB (P = .001).Conclusion: Baseline UB is a predictor of postsurgical improvement in urinary function. These data are helpful when counseling a subset of robot-assisted laparoscopic radical prostatectomy patients with severe preoperative urinary symptoms. [ABSTRACT FROM AUTHOR]

The largest reported soybean grain yield is approximately three-fold more than the highest reported U.S. average yield. An understanding of yield determination is needed to identify avenues for increasing yield and for defining the yield potential of soybean. To illustrate physiological traits important for yield determination, we used a framework that models yield as the product of seed number (seed m −2 ) and individual seed mass (mass seed ). Developmentally, seed m −2 is determined first and is proportional to the biomass accumulation rate (BAR, g m −2 d −1 ) and the fraction of assimilate allocated to reproductive structures. Seed m −2 is inversely proportional to the individual seed growth rate (ISGR, mg seed −1 d −1 ) where the ISGR represents the minimum amount of assimilate necessary to prevent a flower or pod from aborting. Hence, seed m −2 can be increased by optimizing conditions for crop growth (e.g., radiation interception, stress-free environment, high soil fertility levels) and having a low ISGR. Determination of mass seed occurs later during ontogeny than seed m −2 and can be expressed as the product of the ISGR and the effective seedfilling period (EFP, d). Variation among genotypes for ISGR is quite large and is generally not affected greatly by the environment. There is also genotypic variation in the EFP, but the EFP is decreased by a variety of biotic and abiotic stresses. Our analysis indicates that reaching the potential yield of soybean depends upon high BAR and extending the EFP, and a key factor affecting both of these variables is ensuring non-limiting crop nutrition, especially nitrogen. Strategies for increasing soybean maximum yield include early planting (which extends the EFP), optimizing crop nutrition, minimizing biotic and abiotic stresses, and developing breeding programs tailored for high yield environments. Characterizing physiological traits important for yield with genetic markers offers tools for combining favorable traits for high-yield environments. [ABSTRACT FROM AUTHOR]

Cardiovascular morbidity and mortality as a result of inhaled tobacco products continues to be a global healthcare crisis, particularly in low- and middle-income nations lacking the infrastructure to develop and implement effective public health policies limiting tobacco use. Following initiation of public awareness campaigns 50 years ago in the United States, considerable success has been achieved in reducing the prevalence of cigarette smoking and exposure to secondhand smoke. However, there has been a slowing of cessation rates in the United States during recent years, possibly caused by high residual addiction or fatigue from cessation messaging. Furthermore, tobacco products have continued to evolve faster than the scientific understanding of their biological effects. This review considers selected updates on the genetics and epigenetics of smoking behavior and associated cardiovascular risk, mechanisms of atherogenesis and thrombosis, clinical effects of smoking and benefits of cessation, and potential impact of electronic cigarettes on cardiovascular health. [ABSTRACT FROM AUTHOR]

Introduction The IOM recommends schools adopt a Whole-of-School (WOS) approach—one that is comprehensive, coordinated, and provides opportunities for students to be active before, during, and after school. This study examined, in a nationally representative sample of secondary students in the conterminous U.S., (1) the degree of implementation of a WOS approach and (2) the association between WOS implementation and student physical activity. Methods A WOS index—based on six school practices—was calculated using self-reported school administrator data gathered in 2010 and 2011 (N=1,031). Student-level data were obtained from nationally representative samples of eighth-, tenth-, and 12th-grade students during the same years (eighth grade, n schools =96, n students =3,689; tenth/12th grades, n schools =178, n students =4,670). Multilevel Poisson models were estimated in 2013–2014 to examine the relationship between the WOS index and self-reported physical activity. Results Few students attended schools with high WOS index scores. Middle school students attending schools with higher WOS index scores were physically active for at least 60 minutes on more days than students attending schools with lower WOS index scores (exp[β]=1.031, 95% CI=1.008, 1.054). The WOS index score was not associated with physical activity among high school students. Conclusions This study finds that many schools are not offering the full array of practices comprising a WOS approach to physical activity, especially at the high school level. Yet, middle school students could have increased physical activity levels if schools were to implement a WOS approach to physical activity. [ABSTRACT FROM AUTHOR]

The article discusses research done on serum unmetabolized folic acid (UMFA). It references the study "Unmetabolized Folic Acid Is Detected in Nearly All Serum Samples From US Children, Adolescents, and Adults" by C. M. Pfeiffer and colleagues published within the issue. Topics discussed include the effects of vitamin use and fasting conditions on folate forms, the effect of vitamin usage on UMFA, and predictors of the presence of UMFA in serum.

Traumatic brain injury (TBI) is one of the largest health problems in the United States and affects both cognitive and motor function. Although weakness is common in TBI patients, few studies have demonstrated a reduction in strength in models of brain injury. We have developed a behavioral method to measure volitional forelimb strength and quantify forelimb weakness following traumatic brain injury. In this paper, we report the ability of the isometric pull task to measure both acute and chronic impairments in forelimb motor function following a controlled cortical impact (CCI) in rodents. Following CCI, volitional forelimb strength is reduced by 36% and remains significantly reduced after 6 weeks of post-lesion training. We also show that CCI results in impairment of multiple additional measures of forelimb function for several weeks post-injury. [ABSTRACT FROM AUTHOR]