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PURPOSE Laminar blood flow is known to play a critical role in maintaining endothelial homeostasis in blood vessels. It exerts a shear stress on the endothelial cells (ECs), which is essential for the regulation of various vascular functions. In this study, the effects of laminar blood flow-induced enhanced endothelial homeostasis on the maintenance of vascular function were investigated. METHODS Human umbilical vein endothelial cells (HUVECs) were employed to study gene expression associated with vessel dilation and angiogenesis in response to varying shear stress levels. To assess angiogenesis, experimental mice participated in voluntary wheel running for 16 weeks. To evaluate the vascular autophagic function, the six weeks old C57BL/6 mice underwent an hour of forced treadmill running for 10 weeks. The resulting gene expression was evaluated through western blotting and quantitative real-time polymerase chain reaction (qRT-PCR). RESULTS Disturbed flow resulting from partial ligation surgery in the mice's carotid artery led to a decrease in angiogenic capacity compared to the laminar flow observed in ex vivo sprouting assays. Cultured HUVECs exhibited a significant increase in VEGF expression when exposed to increased durations of 20 dyne/cm² laminar shear stress (LSS). Following a 10-week treadmill exercise regimen, ECs in the carotid arteries of mice showed a significant increase in the expression of autophagic genes, such as LC3II, Atg3, and Atg7, which was not observed in smooth muscle cells (SMCs). LSS was found to boost the expression of both total and phosphorylated eNOS, genes involved in vascular dilation regulation, specifically in ECs. CONCLUSIONS These findings suggest that laminar blood flow sustains vascular function, such as angiogenic capacity, through the enhancement of endothelial homeostasis.

Abstract Objective: To examine how the associations between meal consumption and BMI over 8 years differ by weight status in a sample of adolescents. Design: Longitudinal, population-based study. Breakfast, lunch and dinner consumption and BMI were self-reported. Linear regressions were used to examine how the associations between meal consumption and BMI differed by weight status. Setting: Adolescents in the Minneapolis/St. Paul metropolitan area. Participants: Adolescents (n 1,471) were surveyed as part of the EAT 2010–2018 in 2009–2010 (Mage = 14·3 years) and 2017–2018 (Mage = 22·0 years). Results: The prevalence of regular breakfast, lunch and dinner consumption (≥ 5 times/week) ranged from 45 to 65 %, 75 to 89 % and 76 to 94 %, respectively, depending on weight status category. Among adolescents with a sex- and age-specific BMI < 15th percentile, regular consumptions of breakfast, lunch and dinner during adolescence were positively associated with BMI in emerging adulthood compared with irregular consumption of breakfast, lunch and dinner ( 0·05). Conclusions: The relationship between meal consumption during adolescence and BMI in emerging adulthood differs by adolescent weight status. Future studies should investigate underlying factors related to meal consumption routines and BMI.

Background Recruitment for clinical studies is challenging. To overcome barriers, investigators have previously established call-to-entry rates to assist in planning. However, rates specific to low-income minority populations are needed to account for additional barriers to enrolment these individuals face.Objective To obtain a call-to-entry rate in a low-income uninsured Hispanic population with chronic disease.Methods We used data from four of our randomised clinical studies to determine the call-to-entry rate for individuals (n=1075) with or at risk for type 2 diabetes: participants needed/potential participants contacted=recruitment rate (yield). Research staff contacted potential participants to enrol in a study that evaluated 6 month diabetes programmes at community clinics from 2015 to 2020. We recorded call-to-entry rates, reasons for declining the study, show rates, and attrition.Results The call-to-entry rate was 14.5%. Forty per cent of potential participants could not be contacted, and 30.6%, 19.1%, and 5.4% responded yes, no, and maybe, respectively. No show percentages were 54% for yes and 91.4% for maybe responders. The majority (61.6%) declined due to inability to attend; reasons to decline included work (43%), eligibility (18%), transportation (10%), out of town (9%), did not think they needed the programme (7%) and other/unknown (14%). Being a physician predicted inability to reach participants (adjusted OR 2.91, 95% CI 1.73 to 4.90). Attrition was 6.8%.Conclusions We described a call-to-entry rate and detailed recruitment data, including reasons to decline the study. This valuable information can assist investigators in study planning and overcoming enrolment barriers in low-income populations. Telehealth-based or strategies that limit transportation needs may increase participant involvement.Trial registration number NCT03394456.

Introduction Community clinics often face pragmatic barriers, hindering program initiation and replication of controlled research trial results. Mentoring is a potential strategy to overcome these barriers. We piloted an in-person and telehealth mentoring strategy to implement the Telehealth-supported, Integrated Community Health Workers (CHWs), Medication-access, group visit Education (TIME) program in a community clinic.Research design and methods Participants (n=55) were low-income Latino(a)s with type 2 diabetes. The study occurred in two, 6-month phases. Phase I provided proof-of-concept and an observational experience for the clinic team; participants (n=37) were randomized to the intervention (TIME) or control (usual care), and the research team conducted TIME while the clinic team observed. Phase II provided mentorship to implement TIME, and the research team mentored the clinic team as they conducted TIME for a new single-arm cohort of participants (n=18) with no previous exposure to the program. Analyses included baseline to 6-month comparisons of diabetes outcomes (primary outcome: hemoglobin A1c (HbA1c)): phase I intervention versus control, phase II (within group), and research-run (phase I intervention) versus clinic-run (phase II) arms. We also evaluated baseline to 6-month CHW knowledge changes.Results Phase I: compared with the control, intervention participants had superior baseline to 6-month improvements for HbA1c (mean change: intervention: −0.73% vs control: 0.08%, p=0.016), weight (p=0.044), target HbA1c (p=0.035), hypoglycemia (p=0.021), medication non-adherence (p=0.0003), and five of six American Diabetes Association (ADA) measures (p

Background: While children have been shown to have increased BMI during the summer compared to the school year, it is not known if this may be due to seasonal variations in height or weight separately.Methods: Trained nurses measured heights (cm) and weights (kg) in a cohort of Kindergarteners (n = 7648) twice per year from the beginning of kindergarten through 5th grade. Variation in height and weight by season (school year vs. summer) was examined using separate mixed-effects models. Season, sex, and BMI trajectory group were tested as fixed effects. Random effects included repeated measurements of time, students nested within a school, intercept, and slope for growth over time. Similar models using BMIz as the outcome examined the interaction of height or weight with season.Results: The rate of height gain was greater during the school year (∼Sept to April) compared to summer (∼April to Sept) (β = -0.05, SE = 0.013, p < 0.0001). The rate of weight gain did not differ seasonally. Height gain was more strongly associated with increased BMIz during summer compared to the school year (β =.02, SE = 0.005, p

Summary Objective To compare depressive symptomatology as assessed by two frequently used measures, the Beck Depression Inventory (BDI‐1A) and Patient Health Questionnaire (PHQ‐9). Methods Investigators conducted a cross‐sectional secondary analysis of data collected as part of the follow‐up observational phase of the Look AHEAD study. Rates of agreement between the BDI‐1A and PHQ‐9 were calculated, and multivariable logistic regression was used to examine the relationship between differing depression category classifications and demographic factors (ie, age, sex, race/ethnicity) or comorbidities (ie, diabetes control, cardiovascular disease). Results A high level of agreement (κ = 0.47, 95% CI (0.43 to 0.50)) was found in the level of depressive symptomatology between the BDI‐1A and PHQ‐9. Differing classifications (minimal, mild, moderate, and severe) occurred in 16.8% of the sample. Higher scores on the somatic subscale of the BDI‐1A were significantly associated with disagreement as were having a history of cardiovascular disease, lower health‐related quality of life, and minority racial/ethnic classification. Conclusions Either the BDI‐1A or PHQ‐9 can be used to assess depressive symptomatology in adults with overweight/obesity and type 2 diabetes. However, further assessment should be considered in those with related somatic symptoms, decreased quality of life, and in racial/ethnic minority populations.

Abstract Background Little is known about patterns in the transition from healthy weight to overweight or obesity during the elementary school years. This study examined whether there were distinct body mass index (BMI) trajectory groups among elementary school children, and predictors of trajectory group membership. Methods This is a secondary analysis of 1651 elementary school children with complete biannual longitudinal data from kindergarten to the beginning of 5th grade. Heights and weights were measured by trained school nurses using standard procedures at the beginning and end of each school year for 11 consecutive assessments. Group-based trajectory clustering and multinomial logit modeling were conducted. Results When using BMIz score, six trajectory groups were identified revealing substantial consistency in BMIz score across time. When using a categorical variable separating overweight/obese children (BMI ≥ 85%ile) from the rest, five developmental trajectories (persistently non-overweight/obese weight: 51.1 %; early-onset overweight/obese: 9.2 %; late-onset overweight/obese: 9.7 %; becoming healthy weight: 8.2 %; and chronically overweight/obese: 21.8 %) were identified. When using a categorical variable separating obese children (BMI ≥ 95%ile) from the rest, three trajectories (persistently non-obese: 74.1 %, becoming obese: 12.8 %; and chronically obese: 13.2 %) were identified. For both cutoffs (≥ BMI percentile 85 % or 95 %), girls were more likely than boys to be classified in the persistently non-overweight and/or obese group (odds ratios (OR) ranged from 0.53 to 0.67); and Hispanic children and non-Hispanic Black children were more likely to be chronically overweight and/or obese than non-Hispanic White children (OR ranged from 1.57 to 2.44). Hispanic children were also more likely to become obese (OR: 1.84) than non-Hispanic White children when ≥ BMI percentile 95 % was used. Conclusions Boys, Hispanic and non-Hispanic Black children were at higher risk of being overweight or obese throughout their elementary school years, supporting the need for obesity treatment. Post kindergarten and post second grade summer months were times when some children transitioned into overweight/obesity. It will be important to identify which behavioral factors (e.g., diet, physical activity, sedentary behaviors, and/or sleep) predisposed children to becoming overweight/obese, and whether these factors differ by time (Kindergarten versus second grade). If behavioral predisposing factors could be identified early, targeted obesity prevention should be offered.

Abstract Background Disordered eating behaviors and body dissatisfaction are highly prevalent among adolescents and linked to negative health outcomes. While Hispanic adolescents appear to be at high risk of disordered eating and body dissatisfaction, validated tools for assessment of these health concerns among this population are lacking. Methods This study used Confirmatory Factor Analysis to establish factorial validity for the Kids Eating Disorder Survey (KEDS) among a community sample of Hispanic adolescents. Internal consistency was measured by the Kuder-Richardson Formula 20 (KR-20). Results Participants (N = 690) were Hispanic (100%) and female (53%), with a mean age of 12 years. After testing the psychometric properties of KEDS and implementing modifications, the resulting two-factor KEDS model (M-KEDS) showed acceptable fit (TLI = 0.98, CFI = 0.99, RMSEA = 0.06) for the Weight Dissatisfaction (renamed to Negative Weight Attitudes) and Purging/Restriction (renamed to Extreme Weight Control Behaviors) sub-scales and good internal consistency (KR-20 = 0.77). Conclusion M-KEDS is a factorial valid instrument for assessing Extreme Weight Control Behaviors and Negative Weight Attitudes among Hispanic adolescents. Hispanics are among the fastest-growing racial/ethnic groups in the United States, warranting further research on negative weight attitudes and extreme weight control behaviors in this population.

The thickness of current sheets is extremely important, especially as it relates to the onset of fast magnetic reconnection. Onset determines how much magnetic free energy can build up in a field before it is explosively released. This has implications for many phenomena on the Sun and throughout the Universe, including the heating of the solar corona. Significant effort has been devoted to the question of whether equilibrium current sheets in realistic geometries have finite or zero thickness. Using a simple force balance analysis, we show why current sheets without a guide field (2D) and with a guide field that is invariant in the guide field direction (2.5D) cannot be in equilibrium if they have both finite thickness and finite length. We then estimate the conditions under which the tension of a curved line-tied guide field can facilitate equilibrium in 3D sheets that are finite in all dimensions. Finally, we argue that some quasi-statically evolving current sheets undergoing slow stressing—e.g., when the coronal magnetic field is subjected to photospheric boundary driving—may reach a critical shear, at which point they lose equilibrium, spontaneously collapse, and reconnect. The critical shear is generally consistent with the heating requirements of solar active regions.

Dietary quality is important for children’s growth and development. Poor dietary quality and maternal depression are prevalent among low-income, Hispanic families. Maternal depression likely influences child feeding before and during the meal. This secondary data analysis of an observational feeding study (2007–2008) examined how maternal depressive symptomology relates to dietary quality of dinner served to and consumed by Head Start preschoolers in Houston, TX (n = 82 mother-child dyads). A digital photography method assessed food served and consumed by the child at three separate dinner meals in families’ homes. Healthy Eating Index-2010 (HEI) was calculated and averaged across the three meals to measure dietary quality (possible range 0–100). Maternal depression was assessed by the Centers for Epidemiologic Depression Scale (CES-D, possible range 0–60). A series of linear regression models were developed, regressing the total CES-D score and all four CES-D subscales onto both the dietary quality of the meal served and consumed. Dinners served had a HEI of 45.70 ± 9.19 and dinners consumed had a HEI of 44.65 ± 7.34. Clinically significant depressive symptomology (CES-D ≥ 16) was reported by 28% of mothers. Maternal depressive symptomology and the dietary quality served were not related. Controlling for dietary quality served, total CES-D and somatic complaints subscale scores were associated with lower dietary quality consumed (respectively, β = −0.16, p

The bioactive natural product perophoramidine has proved a challenging synthetic target. An alternative route to its indolo[2,3-b]quinolone core structure involving a N-chlorosuccinimde-mediated intramolecular cyclization reaction is reported. Attempts to progress towards the natural product are also discussed with an unexpected deep-seated rearrangement of the core structure occurring during an attempted iodoetherification reaction. X-ray crystallographic analysis provides important analytical confirmation of assigned structures.

Background: There are variable recommendations regarding initiating monotherapy or dual therapy in patients with newly diagnosed type 2 diabetes (T2D). Clear initial strategies are of particular importance in underserved settings where access to care and financial burdens are significant barriers. Objectives: To provide descriptive data of metabolic outcomes to therapy regimens for low-income individuals with newly diagnosed T2D placed on oral hypoglycemic agents (OAs). Methods: We conducted a retrospective chart review of low-income individuals with newly diagnosed T2D initiated on OAs. We provided descriptive data and then evaluated the effects of OA regimens (ie, mono-, dual-, transition [from mono to dual or vice versa] therapy) on hemoglobin A1c (A1c) (baseline to 12 months). Results: A total of 309 patients were included in the study. At 12 months, the mean decrease in A1c for the entire sample was −2.36% (9.37% to 7.01%). Patients prescribed dual therapy had a greater change of A1c compared to those taking monotherapy with metformin (−1.11%, P < .01). Patients who transitioned therapies did not differ in change of A1c compared to monotherapy. Conclusion: Initiation of dual therapy was superior to metformin monotherapy or transitioning therapies and may be preferred for low-income individuals with newly diagnosed T2D.