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Diets rich in fruit and vegetables are associated with a decreased risk of several cancers via numerous possible mechanisms. For example, phytochemicals may decrease oxidative DNA damage and enhance DNA repair. Markers of oxidative DNA damage in human dietary intervention trials used most frequently include oxidized nucleosides such as 7-hydro-8-oxo-2'-deoxyguanosine, which can be analyzed from isolated DNA or urine. Single-cell gel electrophoresis has been widely used to measure baseline or H(2)O(2)-induced DNA strand breaks or sites of modified bases sensitive to repair enzymes recognizing oxidized purines or pyrimidines. Recently, markers of DNA repair also have been used. Few controlled human dietary interventions have investigated the specific effects of fruit or berries. There are indications that kiwifruit can decrease H(2)O(2) sensitivity of lymphocyte DNA ex vivo and enhance DNA repair. Carefully controlled studies with flavonoid-rich fruit or berry juices found only few significant differences; less rigorously controlled studies gave more optimistic results. Data on the effects of fruit and berries on DNA damage in humans are scarce and inconclusive; adequately controlled studies with validated markers are needed. Because levels of DNA damage are usually low in young healthy volunteers, groups with an enhanced risk of DNA damage should be studied. [ABSTRACT FROM AUTHOR]

Berries are a rich source of various polyphenols, including the flavonoid quercetin. In this article, the results of three intervention studies investigating the bioavailability of quercetin from berries are reviewed. In the first study, we investigated the short-term kinetics of quercetin after consumption of black currant juice and showed that quercetin is rapidly absorbed from it. In the second study, we showed that plasma quercetin levels increase up to 50% in subjects consuming 100 g/day of bilberries, black currants, and lingonberries as a part of their normal diets for 2 mo. In the third study, healthy subjects consumed a diet high or low in vegetables, berries, and other fruit for 6 wk. Quercetin concentrations nearly doubled in the high-vegetable, -berry, and -other fruit group and decreased by 30% in subjects consuming less of these foods than normally. The results showed that plasma quercetin is bioavailable from a diet containing berries and indicate that it may be a good biomarker of fruit and vegetable intake in general. [ABSTRACT FROM AUTHOR]

Background Asymmetric dimethylarginine (ADMA) acts as an endogenous inhibitor of NO-synthase. In the last years ADMA has emerged as a cardiovascular risk factor. The aim of this study was to determine a reference value for ADMA. Methods Plasma samples of 500 healthy subjects in the 19–75 year age group were analyzed. Exclusion criteria from this study were smoking, any known significant disease, body-mass-index (BMI) above 30 kg m−2, elevated plasma lipid levels, impaired renal function, hypertension, and intake of any medication. The ADMA levels were determined by ELISA, (DLD Diagnostics, Hamburg, Germany). Results Mean ADMA plasma concentration of the total population was 0·69 µmol L−1 (SD 0·20) and 95% of the measured values were in the range from 0·36 µmol L−1 to 1·17 µmol L−1. Women below 50 years of age had lower ADMA levels than men below 50 years of age [0·62 (0·17) µmol L−1 vs. 0·69 (0·19) µmol L−1; P = 0·001] and woman above 50 years of age had higher ADMA levels than men above 50 years of age [0·80 (0·22) µmol L−1 vs. 0·73 (0·20) µmol L−1; P = 0·036]. A regression analysis of ADMA levels and age was performed for each sex. The regression factor was r = 0·444 for women in a squared regression model ( P < 0·001) and r = 0·212 for men in a linear regression model ( P < 0·001). Conclusion The study was able to define a reference value for ADMA plasma levels with 0·36–1·17 µmol L−1 and found sex dependent correlations between ADMA and age. Women showed a significant increase in ADMA plasma levels with onset of menopause. [ABSTRACT FROM AUTHOR]

A hospitalist system was developed at Park Nicollet Clinic in 1993, was implemented in 1994, and remains in existence today. It was established without knowledge of any other similar program in the United States. Internists and family practitioners were given the choice to continue to care for hospitalized patients or to become totally office based. The new system has met with good patient acceptance along with increased physician satisfaction and retention. This paper describes some key aspects of the institution of the system in a multispecialty group that includes both family practitioners and internists. [ABSTRACT FROM AUTHOR]

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Competing Interests: The authors made the following disclosures: D.R.P. is a consultant for Biogen Inc. and clinical trials’ principal/subinvestigator for Corbus Pharmaceuticals, Elorac, Inc., Eli Lilly and Company, Emerald Health Pharmaceuticals, Kadmon, Inc., Pfizer, Inc., and Soligenix, Inc. The other authors have no conflicts of interest to disclose.

Prison populations are rapidly aging. Persons in prison age quicker and suffer more chronic illness and disability than their nonincarcerated peers, posing challenges to caring for prisoners who are chronically ill and dying. The goal of our study was to describe state prisons' practices and policies addressing persons in prison with advanced chronic and life limiting illness through a national web-based survey of state-level prison health care professionals. In particular, we focused on advanced care planning, use of health care directives, decision-making about goals of care, including life sustaining treatments, The response rate was 22% for a sample size 152 completed surveys. The average age of respondent was 52 years; majority were female and Caucasian, and had worked in corrections more than 8 years. Nearly half were registered nurses. Most reported their prison did not have a dedicated end-of-life care program and only 11% offered a peer-care program. However, two-thirds indicated their facility provided the opportunity to designate a health care agent with physicians most likely responsible for facilitating completion of a health care directive. It is evident the care of persons aging and dying in prison is complex and requires further investigation addressing staff and prison population education, ethics guidelines for care, compassionate release, and advance care planning. This study suggests that hospice and palliative care professionals could collaborate with corrections professionals and national organizations to provide innovative education and support to enhance the humane care of this vulnerable population., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: All authors listed on this manuscript disclose NO actual or potential conflicts of interest that may affect their relationships and activities, directly or indirectly, related to this work.

Competing Interests: The authors made the following disclosures: D.R.P. is a consultant for Biogen, Inc. and Pfizer, Inc., and a clinical trials investigator for Pfizer, Inc., EMD Serono, Priovant, Emerald Health, Kadmon, and Argenx. B.S. is a consultant for Argenx and has served as a clinical trials investigator for Argenx, AstraZeneca, and Elorac. The other authors have no conflicts of interest to disclose.

Introduction: Whilst glucagon-like peptide-1 receptor agonists (GLP1-RAs) are effective for treating adolescent obesity, weight loss maintenance (WLM; preventing weight regain) remains a challenge. Our goal was to investigate appetite/satiety hormones and eating behaviours that may predict WLM with exenatide (a GLP1-RA) versus placebo in adolescents with severe obesity., Methods: Adolescents who had ≥5% body mass index (BMI) reduction with meal replacement therapy were randomized to 52 weeks of once-weekly exenatide extended release or placebo. In this secondary analysis, eating behaviours and appetite/satiety regulation hormones post-meal replacement therapy (pre-randomization to exenatide or placebo) were evaluated as possible predictors of WLM. Percent change in BMI from randomization to 52 weeks served as the primary measure of WLM., Results: The analysis included 66 adolescents (mean age 16.0 years; 47% female). Lower leptin response to meal testing was associated with greater WLM in terms of BMI percent change in those receiving exenatide compared to placebo (p = 0.007) after adjusting for sex, age and BMI. There were no other significant predictors of WLM., Conclusions: Prior to exenatide, lower leptin response to meals was associated with improved WLM with exenatide compared to placebo. The mostly null findings of this study suggest that GLP1-RA treatment may produce similar WLM for adolescents with obesity regardless of age, BMI, sex and eating behaviours., (© 2024 The Authors. Pediatric Obesity published by John Wiley & Sons Ltd on behalf of World Obesity Federation.)

Background: When the first known US case of COVID-19 (Coronavirus Disease 2019) was reported in early 2020, little was known about the impact of this novel virus on the cystic fibrosis community. As the majority of individuals with CF have chronic lung disease, this population was initially considered to be at high risk for severe disease as infection with a multitude of viruses has proven to cause pulmonary exacerbation. SARS-CoV-2 virus has proven challenging to study given the multiple disease manifestations, range of severity, and wave-like phenomenon that varies geographically. People with CF who become infected with COVID-19 can be asymptomatic or have symptoms ranging from mild cough and congestion to full respiratory failure, similar to the manifestations seen in non-CF individuals. By studying the seroprevalence, clinical course, and antibody durability due to COVID-19 and vaccinations, we will be better equipped to provide appropriate and informed care to people with CF., Methods: Between July 2020 and April 2021 we enrolled 123 people with CF (pwCF) who receive care at the MN CF Center. We monitored their serology every 6 months for SARS-CoV-2 immunoglobulins (nucleocapsid and spike IgG) for evidence of natural and induced immunity. Medication use, pulmonary function, exacerbation history, and hospitalizations were extracted via electronic medical record (EMR)., Results: 84% (101/120) of enrolled participants were vaccinated against SARS-CoV-2 during the study. Eighty three percent of the cohort showed evidence of either natural or induced "immunity." The average duration of antibody from induced immunity in participants was 6.1 months and from natural immunity was 7.4 months with an overall average duration of antibody of 6.8 months. Earliest antibody detected was 12 days after a single dose of the BNT162b2 vaccine and antibody was detectable across a span of 13 months. Eleven percent of vaccinated individuals did not have measurable IgG. 36% of non-responders (NRs) were solid organ transplant patients on chronic immunosuppressive therapy. Only 3 people within this cohort were hospitalized due to COVID pneumonia and all three survived., Conclusion: To our knowledge, this is the first report on the seroprevalence and longevity of SARS-CoV-2 IgG to 1 year in adults with CF after the widespread availability of SARS-CoV-2 vaccinations. These data show that pwCF respond to the COVID vaccination and produce long-lasting antibodies similar to the general population., Competing Interests: Authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest in the subject matter or materials discussed in this manuscript., (© 2024 The Authors. Published by Elsevier Ltd.)

Introduction: Despite widespread recognition of the health and social risks posed by parental incarceration (PI) and homelessness, these challenges are rarely considered in unison. We sought to (a) assess the experiences of homelessness among youth with and without a history of PI and (b) compare the health and healthcare utilization among youth with a combined history of PI and homelessness., Method: Examining data from eighth-, ninth-, and 11th-grade public school participants in the 2019 Minnesota Student Survey ( N = 110,904), we calculated univariate and multivariate analyses to characterize the health status and care utilization of youth who have experienced PI, past-year homelessness, or both., Results: We observed higher prevalence of homelessness among youth with a history of PI compared to those without. The group with dual PI-homelessness experience had a higher proportion of youth that were younger, male, and non-White; and living in poverty or urban areas compared to youth with PI history only. Even after accounting for demographic factors, the dual PI-homelessness group evidenced higher expected odds for several physical health conditions (e.g., asthma, diabetes), and differences in care utilization indicators relative to individual PI and homelessness groups., Discussion: Findings suggest that PI may be overrepresented among recently homeless youth and that youth with such dual experience possess distinct, and often elevated, health service needs. Health, education, housing, and other systems may need intersectoral strategies to better identify and support this at-risk subset of youth through clinical and policy approaches. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Pantothenic acid, also referred to as vitamin B 5 , is a water-soluble vitamin that has essential functions in the body as a component of coenzyme A (CoA) and acyl carrier protein (ACP). It is widely distributed in animal and plant-source foods. Nutritional deficiency of pantothenic acid is rare and toxicity negligible. Information on pantothenic acid intakes in the Nordic countries is limited and biomarker data from Nordic and Baltic populations is missing. Due to a lack of data, no dietary reference values (DRVs) were given for pantothenic acid in the Nordic Nutrition Recommendations (NNR) since 2012. The aim of this scoping review was to examine recent evidence relevant for updating the DRVs for NNR2023. Scientific literature since 2012 on associations of pantothenic acid with health-related issues in Nordic and Baltic countries was searched. No health concerns related to pantothenic acid were identified., Competing Interests: The authors have not received any funding or benefits from industry or elsewhere to conduct this study., (© 2023 Riitta Freese et al.)

Niacin is the precursor to pyridine nucleotides NAD (nicotinamide adenine dinucleotide) and NADP (nicotinamide adenine dinucleotide phosphate). Niacin (vitamin B 3 ) is the common term for nicotinic acid, nicotinamide and derivatives that exhibit the biological activity of nicotinamide. Furthermore, the indispensable amino acid tryptophan is the substrate for de novo synthesis of NAD. Thus, the requirements and intake of niacin are expressed as niacin equivalents (NE). The focus of interest for niacin over the last decade has primarily been on pharmacological doses of nicotinic acid as a lipid-lowering agent and other NAD precursors as potential enhancers of cellular NAD + concentrations. None of these studies, however, makes a useful contribution to understanding dietary requirements in healthy populations. The requirement for niacin is estimated based on the relationship between intake and biochemical indices of niacin status, primarily urinary excretion of nicotinamide metabolites., Competing Interests: The authors have not received any funding or benefits from industry or elsewhere to conduct this study., (© 2023 Riitta Freese and Vegard Lysne.)

Purpose: The aim of this study was to utilize an intersectional framework to examine academic faculty's lived experiences during COVID-19. Specifically, we set out to: (1) describe the multiple intersectional identities ( e.g. , gender, race/ethnicity, rank, caregiver status, disability status) represented by the faculty, (2) examine potential disparities in well-being, workload, and productivity linked to these intersectional factors, and (3) identify qualitative themes endorsed by faculty as they relate to lived experiences during COVID-19. Methods: This was a cross-sectional mixed-methods research study. The Center for Women in Medicine and Science (CWIMS) at the University of Minnesota developed and implemented a survey between February-June of 2021 in response to national reports of disparities in the impacts of COVID-19 on faculty with lived experiences from multiple intersections. Results: There were 291 full-time faculty who participated in the study. Quantitative findings indicated that faculty with multiple intersectional identities ( e.g. , woman+assistant professor+caregiver+underrepresented in medicine) reported greater depression symptoms, work/family conflict, and stress in contrast to faculty with fewer intersectional identities. Furthermore, faculty with more intersectional identities reported higher clinical workloads and service responsibilities and lower productivity with regard to research article submissions, publications, and grant submissions in contrast to faculty with fewer intersectional identities. Qualitative findings supported quantitative findings and broadened understanding of potential underlying reasons. Conclusions: Findings confirm anecdotal evidence that faculty with lived experiences from multiple intersections may be disproportionately experiencing negative outcomes from the pandemic. These findings can inform decisions about how to address these disparities moving into the next several years with regard to promotion and tenure, burnout and well-being, and faculty retention in academic medical settings. Given these findings, it is also important to intentionally plan responses for future public health crises to prevent continued disparities for faculty with multiple intersectional identities.

Objective: To examine the effect of virtual care on urine testing, antibiotic prescription patterns, and outcomes of care in urinary tract infection (UTI) management., Methods: We conducted retrospective analysis of adults treated for UTI in an ambulatory setting across a large health system from March 2020-2021. Outcomes included urine testing, antibiotic prescription, and retreatment or hospitalization, stratified by in-person vs virtual visit. Multivariable logistic regression was performed to examine factors contributing to outcomes., Results: Significantly fewer patients seen virtually had urine testing as compared to those seen in-person (19% vs 69%, P <.001). On multivariable logistic regression analysis, virtual visit was the most significant predictor of urine testing, associated with an 86% reduction in the odds of urine testing (odds ratio (OR) 0.14, P <.001). Having a complicated UTI did not affect the likelihood of urine testing (OR 1.0, P = .95). Patients seen virtually were more likely to have a subsequent repeat ambulatory UTI visit (OR 1.16) or repeat antibiotic prescription (1.06) more than 2 weeks after the index encounter, though no more likely to be hospitalized for UTI (OR 1.00)., Conclusion: Virtual care for UTI is associated with a significant reduction in urine testing and an increase in repeat UTI encounters and additional antibiotics among patients with complicated and uncomplicated UTIs., Competing Interests: Declaration of Competing Interest SPE: consultant and speaker for Boston Scientific, PI of clinical trial and consultant for urotronic, investment interest for percuvision. The other authors report no conflict of interest., (Copyright © 2023. Published by Elsevier Inc.)

Background: Individuals convicted of a sexual offense (ICSO) can be treated with testosterone-lowering medication (TLM) in order to support the control of paraphilic sexual fantasies and to decrease the risk of sexual recidivism. However, due to partly severe side effects, TLM should not be a lifelong treatment., Aim: The aim of the current study was to further evaluate the Change or Stop Testosterone-Lowering Medication (COSTLow)-R Scale in forensic outpatient aftercare practice. The scale was developed to assist forensic professionals in deciding on whether to change or stop TLM treatment in ICSO., Methods: The COSTLow-R Scale was applied retrospectively in a forensic-psychiatric outpatient institution in Hesse, Germany, on 60 ICSO. TLM was terminated in 24 patients (40%). Moreover, 10 forensic professionals of the institution as well as an experienced working group within the institution focusing on the treatment of ICSO, qualitatively evaluated the COSTLow-R Scale by participating in an open designed survey., Outcomes: The COSTLow-R Scale ratings as assessed by forensic professionals were collected. In addition, a survey was performed among these professionals about the usefulness of the scale and their practical experiences with it., Results: A binary logistic regression analysis was conducted to ascertain the predictive power of the scale regarding the stopping of TLM. Three items of the COSTLow-R Scale significantly predicted stopping decisions: the possibility of psychotherapy before TLM treatment, psychopathic traits, and a substantial decrease of paraphilic severity. Thus, a decision towards stopping TLM was more likely for patients who showed greater treatment readiness before starting TLM, lower psychopathy scores, and a higher decrease of paraphilic severity. The forensic professionals described the scale as a good and structured tool that displays which aspects are important to consider during TLM treatment decisions., Clinical Implications: The COSTLow-R Scale provides structure to the decision of whether to change or stop TLM and should thus be implemented in the forensic treatment process of patients with TLM more frequently., Strengths and Limitations: Although the small sample size limits generalizability of the findings, the present study was conducted directly in a forensic outpatient practice and, therefore, has high external validity and a strong impact on the life and health of patients treated with TLM., Conclusion: The results indicate that the COSTLow-R Scale can be a useful instrument facilitating the TLM decision-making process by providing a structured compendium of criteria. Further research is still needed to evaluate the scale and to provide additional evidence for the results of the current study., (© The Author(s) 2023. Published by Oxford University Press on behalf of The International Society of Sexual Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)