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Conjunctival melanoma is a rare malignant condition of the ocular surface. It is potentially lethal, with regional lymph node spread often preceding distant solid-organ metastasis. Due to its rarity and the long latency between treatment and local recurrence or the development of metastases, it is difficult to study. The literature is composed entirely of case series of varying quality, and there is significant variability in the management of this condition. This commentary attempts to distil the evidence base to provide practical management tips for the clinician. [ABSTRACT FROM AUTHOR]

Purpose: Non-invasive three-dimensional (3D) stereophotogrammetry is becoming increasingly popular in many fields. However, few studies have focused on its periocular application. We aimed to provide evidence for the periocular application of a novel anthropometric procedure using 3D stereophotogrammetry by evaluating its reliability. Methods: Fifty-one Caucasians were recruited (102 eyes; mean age, 31.9 ± 13.6 years). Two sets of 3D images were acquired for each subject, and two measurement sessions were performed on each image by two raters. Fifty-two periocular landmarks were identified, and then 49 corresponding linear, curvilinear, and angular measurements were evaluated for intrarater, interrater, and intramethod reliability. Results: Our findings showed highly reliable results for mean absolute difference (0.59 and 0.68 unit), relative error measurement (2.66% and 3.08%), technical error of measurement (0.59 and 0.66 unit), relative technical error of measurement (2.71% and 2.96%), and intraclass correlation coefficient (0.98) for intrarater 1 and intrarater 2 reliability; respectively 0.94 unit, 4.06%, 0.89 unit, and 3.94%, as well as 0.97 for interrater reliability; and respectively 0.98 unit, 4.66%, 0.96 unit, and 4.64%, as well as 0.96 for intramethod reliability. Conclusions: This imaging system and the landmark identification protocol are highly reliable. The collected measurements and their errors can be applied for the comparison of reliability among various 3D imaging systems and populations. It could be utilized for planning surgeries and evaluating treatment outcomes for physicians in ophthalmology, plastic and esthetic surgery, and in the maxillofacial field where periocular morphology alterations are made. [ABSTRACT FROM AUTHOR]

The RAS-RAF-MEK-ERK signaling pathway (MAPK signaling pathway) plays a significant role in multiple pathological behaviors and is most frequently dysregulated in more than 30% of human cancers. As key elements in this pathway, MEK1/2 play crucial roles in tumorigenesis and the inhibition of apoptosis, which makes their inhibition an attractive antitumor strategy. Dozens of potent non-ATP-competitive allosteric MEK1/2 inhibitors have been developed that have produced substantial improvement in clinical outcomes over the past decade. However, the efficacy of these agents is limited, and response rates are variable in a wide range of tumors that harbor RAS and RAF mutations due to the development of resistance, which is derived mainly from the persistence of MAPK signaling and increased activation of the mutual feedback networks. Both intrinsic and acquired resistance to MEK inhibitors necessitates the synergistic targeting of both pathways to restore the therapeutic effects of a single agent. In this review, the significant role of the MAPK pathway in carcinogenesis and its therapeutic potential are comprehensively examined with a focus on MEK inhibitors. Then, the activation of feedback networks accompanying MEK inhibition is briefly reviewed. Combination strategies that involve the simultaneous inhibition of the original and resistance pathways are highlighted and elaborately described on the basis of the latest research progress. Finally, the obstacles to the development of MEK-related combination systems are discussed in order to lay the groundwork for their clinical application as frontline treatments for individual patients with MAPK-hyperactivated malignancies. [ABSTRACT FROM AUTHOR]

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Background: This meta-analysis was conducted to assess the risk of dermatological toxicities of combined BRAF and MEK inhibition versus BRAF inhibition alone in melanoma patients. Methods: We considered relevant prospective randomized phase I, II, and III trials of melanoma patients on the combined BRAF and MEK inhibition versus BRAF inhibition, describing events of rash, photosensitivity reaction (PR), hyperkeratosis (HK), alopecia, cutaneous squamous-cell carcinom(cSCC), skin papilloma(SP), pruritus, and hand-foot syndrome(HFS), as eligible for inclusion. Results: Eight trials comprising 3163 patients were included in the meta-analysis. The relative risks(RRs) of developing all-grade rash with combined BRAF and MEK inhibition versus BRAF inhibition was 1.59 (95%CI, 1.35–1.86, p < 0.00001), HK 0.33(95%CI, 0.16–0.66, p = 0.002), SP 0.09(95%CI, 0.04–0.24, p < 0.00001), alopecia 0.30(95%CI, 0.19–0.48, p < 0.00001), cSCC 0.23(95%CI, 0.17–0.31, p < 0.00001), HFS 0.18(95%CI, 0.13–0.26, p < 0.00001) and PR 0.40(95%CI, 0.26–0.61, p < 0.0001), while the RRs of high-grade dermatological toxicities from all included trials were: rash 0.54(95%CI, 0.20–1.43, p = 0.21), HK 0.18(95%CI, 0.06–0.53, p = 0.002), SP 0.14(95%CI, 0.02–1.16, p = 0.07), alopecia 0.72(95%CI, 0.14–3.62, p = 0.69), cSCC 0.23(95%CI, 0.17–0.33, p < 0.00001), HFS 0.40(95%CI, 0.08–2.06, p = 0.27), and PR 0.14(95%CI, 0.04–0.51, p = 0.003), respectly. Conclusion: Our analysis of data has demonstrated that combined BRAF and MEK inhibitor-based treatment is associated with an increased risk of all-grade rash and a decreased risk of all-grade and high-grade HK, SP, alopecia, cSCC, HFS, and PR compared with single BRAF inhibitor alone in melanoma patients. Appropriate prevention and management are recommended. [ABSTRACT FROM AUTHOR]

Copyright of Der Ophthalmologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Ophthalmologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Ophthalmologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Otorhinolaryngologia Hungarica / Fül-Orr-Gégegyógyászat is the property of Hungarian Society of Oto-Rhino-Laryngology, Head & Neck Surgery and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Due to the lack of tumor suppressor function of the fragile histidine triad (FHIT) gene product, sebaceous gland carcinomas can develop., Objective: The model of the sebocyte cell line SZ95 was used to identify methylated CpG islands at the 5'-end of the FHIT gene and the decrease of gene expression as well as the increase of double-stranded (ds) DNA breaks were examined., Material and Methods: Methylation, immunofluorescence analysis, promotor sequencing and treatment of SZ95 cells with 5‑azacytidine/trichostatin A (TSA)., Results: The cultivation was accompanied by an increasing methylation of the CpG islands, a decrease of the FHIT gene expression and an accumulation of ds-DNA breaks. Treatment with 5‑azacytidine/TSA showed a decrease in DNA methylation and a re-expression of FHIT transcripts., Discussion: Epigenetic changes in the cellular genome are caused by in vitro cell culture. Consequently, a positive selection of sebocytes with an epigenetically inactivated FHIT locus occurs., (© 2022. The Author(s).)

Introduction: The utilization of endoscopy in lacrimal surgeries has been increasing in the recent past with increasing indications. With the advent of newer generation of telescopes, the practice and learning of endoscopic lacrimal surgeries is expected to improve further. Areas covered: This review provides an overview about endoscope assistance in all conditions that involve pathologies of the lacrimal drainage apparatus. The authors have reviewed recently published literature on the techniques and outcomes of endoscopic dacryocystorhinostomy (DCR) in different scenarios such as acute dacryocystitis, pediatric cases, cases with sinonasal anomalies, traumatic nasolacrimal duct obstructions (NLDO) and revision DCRs. Furthermore, promising new avenues such as the 3D endoscopes, variable viewing endoscopes, dacryoendoscopes, navigation-assisted and augmented reality endoscopic lacrimal surgeries have been discussed. Expert commentary: The aim for clinicians should now move on to addressing lacrimal pathologies with traditionally less favorable outcomes and reducing the failure rates with the technological assistance. As more ophthalmology training programs include structured training modules on endoscopic lacrimal surgery, the popularity, the safety and indications of endoscopic lacrimal surgery by ophthalmologists is expected to increase. [ABSTRACT FROM AUTHOR]

Copyright of Der Ophthalmologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Context: Obesity, diabetes and cardiovascular disease (CVD) have reached epidemic proportions among Native Hawaiians/Pacific Islanders (NHPI). Culturally responsive interventions that account for their interpersonal, sociocultural and socioeconomic realities are a public health priority. Objective: To describe cultural adaptation and culturally grounded approaches to developing health interventions for NHPI and to review the culturally responsive approaches used by, and outcomes from, two long-standing community-based participatory research projects (CBPR) in Hawai‘i: PILI ‘Ohana and KāHOLO Projects. Methods: A literature review of 14 studies from these two projects was done to exemplify the methods applied to culturally adapting existing evidence-based interventions and to developing novel interventions from the ‘ground up’ to address health disparities in NHPI. Of the 14 studies reviewed, 11 were studies of the clinical and behavioural outcomes of both types of interventions. Results: Both culturally adapted and culturally grounded approaches using community-based assets and NHPI cultural values/practices led to establishing sustainable and scalable interventions that significantly improved clinical measures of obesity, diabetes and hypertension. Conclusion: Several recommendations are provided based on the lessons learned from the PILI ‘Ohana and KāHOLO Projects. Multidisciplinary and transdisciplinary research using CBPR approaches are needed to elucidate how human biology is impacted by societal, environmental and psychological factors that increase the risk for cardiometabolic diseases among NHPI to develop more effective health promotion interventions and public health policies. [ABSTRACT FROM AUTHOR]

Introduction: Conjunctival neoplasms span from benign lesions to life-threatening malignancies. A wide range of treatment modalities has been developed, spanning from observation, simple excision and topical chemotherapy to advanced surgical techniques combined with adjuvant therapies including cryotherapy, topical and systemic chemotherapy, immune-modulating agents, anti-viral therapy, and radiotherapy. Areas covered: This review provides an overview of treatment modalities employed in conjunctival neoplasms as well as management guidelines for selected groups of conjunctival tumors. A literature search was performed using the keywords ‘Conjunctival neoplasms’ [MeSH], ‘Conjunctival AND neoplasia’, ‘Conjunctiva AND neoplasia’, ‘Conjunctival tumors’ in combination with ‘Chemotherapy’, ‘Topical chemotherapy’, ‘Mitomycin C’, ‘5-fluorouracil’, ‘Interferon alpha 2b’, ‘anti-VEGF’, ‘Brachytherapy’, ‘Radiation’, ‘Radiotherapy’, ‘Cryotherapy’, ‘Surgery’, ‘Systemic chemotherapy’, and ‘Lymphoma’. Expert commentary: The efficacy of the different adjuvant therapies is debated. However, there is no doubt that adjuvant therapy reduces the risk of recurrence. Therefore, we recommend that ocular oncologists use an adjuvant therapy together with surgery for conjunctival melanoma. The treatment of malignant conjunctival tumors should be centralized in each country and placed in a few hands. This, combined with large multicenter studies, will provide valuable new information, benefit our patients, and improve the prognosis in the future. [ABSTRACT FROM PUBLISHER]

Non-coding RNAs (ncRNAs) are a growing class of transcripts, with lengths ranging from tens to several thousand of bases, involved in the regulation of a large number of biological processes and diseases. Many of these ncRNAs have emerged as the molecules of interest for prognostic, diagnostic, and therapeutic purposes in many diseases including cancer. Although ncRNAs do not encode proteins, they fold into complex structures to interact with target proteins, DNA, or other RNAs. In contrast to microRNAs (miRNAs) where researchers mainly focused on the nucleotide sequence for target prediction in the past, folding and structural conservation seems to be important to encode functions and interactions of long non-coding RNA (lncRNA). In this chapter, we discuss methods and tools available for the structural modeling of ncRNAs together with various examples from the literature where structural modeling helped decipher the function of ncRNAs. We also provide a step-by-step procedure to design 3D structures of ncRNAs combining state-of-the-art tools available toward the design of novel RNA therapeutics., (© 2022. The Author(s), under exclusive license to Springer Nature Switzerland AG.)

Background: Growing evidence supports an individualised approach rather than radical surgery for conjunctival melanoma (CM). This study aimed to compare the long-term outcome between individualised and conventional exenteration techniques., Methods: Our study retrospectively recruited advanced CM (clinical T3 stage) patients treated with individualised (13 cases) or conventional (18 cases) exenteration from June 2014 to April 2019. The individualised approach preserved at least three quadrants of the orbit, and the conventional procedures removed at least one third of the orbital tissues. The medical records were collected and analyzed during April 2020, including demographics, tumour characteristics, surgical details, postoperative rehabilitation and tumour-related prognosis., Results: The tumour basal diameter was statistically (P = 0.011) larger in the conventional group (23.3 ± 7.6 mm) than in the individualised group (15.4 ± 6.3 mm). More tissues were preserved in the individualised group, resulting in a shorter duration of wound healing (2.1 ± 0.6 vs. 3.6 ± 2.0 weeks, P = 0.018) and less incidence of hollow appearance (15% vs. 72%, P = 0.003) than the conventional group. After follow-up for 39.3 ± 17.3 months, a comparison of survival curves showed no significant differences (P = 0.638) between the two groups. The 1- and 2-year overall survival rates were estimated as 100% and 80.0% in the individualised group, and 93.8% and 72.5% in the conventional group, respectively. Low or mixed pigmentation was identified as the risk factor for tumour-related mortality based on multivariate regression analysis., Conclusions: The individualised approach to exenteration offers improved aesthetic results while still maximises the curable chance for advanced CM., (© 2021. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)

Human migration is not a new phenomenon, but it has changed significantly with the advance of globalization. We focus on differences in the published literature concerning migration and health (EU vs the US), centering specifically on reproductive health outcomes. We conducted a literature search in the Pubmed and Embase databases. We reviewed papers that contrast migrants to native-born populations and analyzed differences between countries as well as challenges for future research. The prevalence of low birthweight among migrants varies by the host country characteristics as well as the composition of migrants to different regions. The primary driver of migrant health is the migrant 'regime' in different countries at specific periods of time. Future health outcomes of immigrants will depend on the societal characteristics (legal protections, institutions and health systems) of host countries. [ABSTRACT FROM AUTHOR]

In addition, it would be interesting to combine 3D imaging and a computer vision algorithm with a periocular landmark detection system for improving the accuracy as well as provide patients best care using state-of-the-art technologies including artificial intelligence. Dear Editor, With great interest, we read the article "Analysis of surgical outcome after upper eyelid surgery by computer vision algorithm using face and facial landmark detection" by our highly appreciated colleagues Ilke Bahçeci Simsek and Can Sirolu [[1]]. References 1 Bahceci Simsek I, Sirolu C. Analysis of surgical outcome after upper eyelid surgery by computer vision algorithm using face and facial landmark detection. [Extracted from the article]

Objectives: The aims of this study were to evaluate the isolated prevalence of real-time reverse transcriptase-polymerase chain reaction (RT-PCR)-confirmed SARS-CoV-2 on the ocular surface without systemic infection in hospitalized asymptomatic patients and to determine the risk for ophthalmologists and medical staff to be infected by prescreened asymptomatic patients in a tertiary eye care center., Methods: In this prospective, observational study, bilateral swaps of the conjunctiva in the lower fornices as well as nasopharyngeal swaps were collected in 1145 hospitalized asymptomatic patients of a tertiary eye care center. Real-time reverse transcriptase-polymerase chain reaction (RT-PCR) analysis was performed for each swap to evaluate the prevalence of SARS-CoV-2. Demographic data and potential risk factors for an isolated infection of the ocular surface were noted., Results: Two thousand two hundred eighty-eight (99.9%) of all 2290 tested eyes had negative results in the RT-PCR analysis of the conjunctival swabs. One patient had bilateral false-positive results in the conjunctival swabs. None of the 1145 patients had any positive RT-PCR-confirmed result in the nasopharyngeal swabs., Conclusions: The risk for an isolated conjunctival viral activity in patients with a negative nasopharyngeal swab-based RT-PCR seems to be absent or extremely low, suggesting no need to perform additional conjunctival swabs in patients with negative nasopharyngeal swabs. Furthermore, the risk of a work-related SARS-CoV-2 infection due to direct contact with preselected asymptomatic patients in an eye care center is very low, especially when additional hygiene standards and safe distances are respected carefully. This might reassure medical staff and reduce the fear of SARS-CoV-2 infection.

Background: The birth weight reference curve to estimate the newborns at risk in need of assessment and monitoring has been established. The previous reference curves from Indonesia, approximately 8 years ago, were based on the data collected from teaching hospitals only with limited gestational ages. The aims of the study were to update the reference curves for birth weight, supine length and head circumference for Indonesia, and to compare birth weight curves of boys and girls, first child and later children, and the ones in the previous studies. Methods: Data were extracted from the Maternal-Perinatal database between 1998-2007. Only live singletons with recorded gestational ages of 26 to 42 weeks and the exact time of admission to the neonatal facilities delivered or referred within 24 h of age to Sardjito Hospital, five district hospitals and five health centers in Yogyakarta Special Territory were included. Newborns with severely ill conditions, congenital anomaly and chromosomal abnormality were excluded. Smoothening of the curves was accomplished using a third-order polynomial equation. Results: Our study included 54,599 singleton live births. Growth curves were constructed for boys (53.3%) and girls (46.7%) for birth weight, supine length, and head circumference. At term, mean birth weight for each gestational age of boys was significantly higher than that of girls. While mean birth weight for each gestational age of first-born-children, on the other hand was significantly lower than that of later-born-children. The mean birth weight was lower than that of Lubchenco's study. Compared with the previous Indonesian study by Alisyahbana, no differences were observed for the aterm infants, but lower mean birth weight was observed in preterm infants. Conclusions: Updated neonatal reference curves for birth weight, supine length and head circumference are important to classify high risk newborns in specific area and to identify newborns requiring attention. [ABSTRACT FROM AUTHOR]

Background/objectives: Obesity and diabetes rates are high in Native Hawaiians (NHs) who commonly have mixed ancestries. People of Asian ancestry experience a high risk of type 2 diabetes despite the relatively low body weight. We evaluated the impact of ethnic admixture on diabetes risk among NHs in the Multiethnic Cohort (MEC).Subjects/methods: On the basis of self-reports, 11 521 eligible men and women were categorized into NH/white, NH/other, NH alone, NH/Asian and the most common three ancestry admixture, NH/Chinese/white. Cox proportional hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated with the NH/white category as the reference group; covariates included known confounders-that is, body mass index (BMI), dietary and other lifestyle factors.Results: The NH alone category had the highest proportion of overweight and obese individuals and the NH/Asian category the lowest proportion. During 12 years of follow-up after cohort entry at 56 years, 2072 incident cases were ascertained through questionnaires and health plan linkages. All NH categories had higher HRs than the NH/white category before and after adjustment for BMI. In the fully adjusted models, the NH/Asian category showed the highest risk (HR=1.45; 95% CI: 1.27-1.65), followed by NH/other (HR=1.20; 95% CI: 1.03-1.39), NH/Chinese/white (HR=1.19; 95% CI: 1.04-1.37) and NH alone (HR=1.19; 95% CI: 1.03-1.37). The elevated risk by Asian admixture was more pronounced in normal weight than overweight/obese individuals.Conclusions: These findings indicate that Asian admixture in NHs is associated with a higher risk for type 2 diabetes independent of known risk factors and suggest a role for ethnicity-related genetic factors in the development of this disease. [ABSTRACT FROM AUTHOR]

This article is part of topical collection on Perspectives on COVID-19 Dear Editor, In our prospective study, we looked deeply into the possibility that SARS-CoV-2 may hide on the ocular surface of pre-screened asymptomatic patients in a tertiary eye care center [[1]]. In addition, SARS-CoV-2 was detected in ocular tissues, tears, and conjunctival secretions of patients with systemic SARS-CoV-2 infection [[2]-[4]]. Therefore, a potential hiding place on the ocular surface after systemic SARS-CoV-2 infection seems to be possible, especially in patients showing unspecific conjunctivitis during COVID-19 or in patients with ongoing systemic symptoms [[4]-[9]]. [Extracted from the article]

Background: Three-dimensional (3D) imaging has become increasingly popular in aesthetic surgery. However, few studies have emphasized its application in the periocular region., Objective: To provide evidence supporting the reliability of generalizing periocular measurements obtained using caliper-derived direct anthropometry and 2-dimensional (2D) photogrammetry to 3D stereophotogrammetry., Materials and Methods: Periocular surfaces were captured using a stereophotogrammetry system for 46 normal Caucasian individuals. Twenty-two periocular variables were directly, 2-dimensionally, and 3-dimensionally measured. Reliability of these measurements was evaluated and compared with each other., Results: The results revealed that, for direct (intra-rater reliability only), 2D, and 3D anthropometry, overall intra-rater and inter-rater intraclass correlation coefficient estimates were 0.88, 0.99 and 0.97, and 0.98 and 0.92, respectively; mean absolute differences were 0.84 mm, 0.26 and 0.36 units, and 0.35 and 0.67 units, respectively; technical error of measurement (TEM) estimates were 0.85 mm, 0.25 and 0.36 units, and 0.32 and 0.65 units, respectively; relative error measurement estimates were 6.46%, 1.69% and 2.74%, and 1.67% and 5.11%, respectively; and relative TEM estimates were 6.25%, 1.62% and 2.78%, and 2.12% and 5.12%, respectively., Conclusion: Stereophotogrammetry and the authors' landmark location protocol yield very good reliability for a series of 2D and 3D measurements.

Objective: To investigate overall, spontaneous, and medically indicated preterm birth (PTB) rates between US-born and non-US-born Asian women living in California., Study Design: Nulliparous women with a singleton livebirth and Asian race in California between 2007 and 2011 were investigated. The prevalence of overall (<37 weeks), spontaneous, and medically indicated PTB was examined by self-reported race and place of birth among ten Asian subgroups., Results: There were marked differences in PTB rates between the individual Asian subgroups. After adjustments, non-US-born Chinese, Japanese, Vietnamese, and Indian women had lower odds of overall PTB and Chinese, Vietnamese, Cambodian, and Indian women had lower odds of spontaneous PTB compared with their US-born counterparts., Conclusion: Further investigation of biological and social factors contributing to these lower odds of spontaneous PTB among the non-US-born Asian population could potentially offer clues for reducing the burden of PTB among the US born.

Objective Bronchopulmonary dysplasia (BPD) increases the risk for developing pulmonary hypertension (PH). However, the risk factors associated with BPD-associated PH remain unclear. Our primary aim was to determine perinatal risk factors associated with the development of PH in infants with BPD. Study Design We retrospectively reviewedmedical records of 303 infants born at ≤ 28 weeks' gestation. Infants were categorized as having no,mild,moderate, or severe BPD. PH was diagnosed by echocardiogram. Data were analyzed using Fisher exact test, twosample t-test, and multivariable logistic regression. Results The incidence of PH in our cohort was 12%. Infants with PH had lower birth weights and gestational ages (p < 0.001). After controlling for confounding variables, severe BPD (p < 0.001), and higher Clinical Risk Index for Babies (CRIB) scores (p = 0.04) were associated with the development of PH. Conclusion Severe BPD increases the risk for developing PH. Higher CRIB scores correlate with PH development in infants with BPD. We speculate that CRIB scores may allow for early categorization of preterm infants with a higher likelihood of developing PH. [ABSTRACT FROM AUTHOR]

Objectives. We examined potential synergistic effects of racial and socio-economic inequality associated with small-for-gestational-age (SGA) birth. Methods. Electronic medical records from singleton births to White and Black women in 10 US states and the District of Columbia (n = 121 758) were linked to state-level indicators of structural racism, including the ratios of Blacks to Whites who were employed, were incarcerated, and had a bachelor's or higher degree. We used state-level Gini coefficients to assess income inequality. Generalized estimating equations models were used to quantify the adjusted odds of SGA birth associated with each indicator and the joint effects of structural racism and income inequality. Results. Structural racism indicators were associated with higher odds of SGA birth, and similar effects were observed for both races. The joint effects of racial and income inequality were significantly associated with SGA birth only when levels of both were high; in areas with high inequality levels, adjusted odds ratios ranged from 1.81 to 2.11 for the 3 structural racism indicators. Conclusions. High levels of racial inequality and socioeconomic inequality appear to increase the risk of SGA birth, particularly when they co-occur. [ABSTRACT FROM AUTHOR]

OBJECTIVE Asian Americans manifest type 2 diabetes at low BMI levels but may not undergo diagnostic testing for diabetes if the currently recommended BMI screening cut point of ≥25 kg/m² is followed. We aimed to ascertain an appropriate lower BMI cut point among Asian-American adults without a prior diabetes diagnosis. RESEARCH DESIGN AND METHODS We consolidated data from 1,663 participants, ages ≥45 years, without a prior diabetes diagnosis, from population- and community-based studies, including the Mediators of Atherosclerosis in South Asians Living in America study, the North Kohala Study, the Seattle Japanese American Community Diabetes Study, and the University of California San Diego Filipino Health Study. Clinical measures included a 2-h 75-g oral glucose tolerance test, BMI, and glycosylated hemoglobin (HbA1c). RESULTS Mean age was 59.7 years, mean BMI was 25.4 kg/m², 58% were women, and type 2 diabetes prevalence (American Diabetes Association 2010 criteria) was 16.9%. At BMI ≥25 kg/m², sensitivity (63.7%), specificity (52.8%), and Youden index (0.16) values were low; limiting screening to BMI ≥25 kg/m² would miss 36% of Asian Americans with type 2 diabetes. For screening purposes, higher sensitivity is desirable to minimize missing cases, especially if the diagnostic test is relatively simple and inexpensive. At BMI ≥23 kg/m², sensitivity (84.7%) was high in the total sample and by sex and Asian-American subgroup and would miss only ~15% of Asian Americans with diabetes. CONCLUSIONS The BMI cut point for identifying Asian Americans who should be screened for undiagnosed type 2 diabetes should be <25 kg/m², and ≥23 kg/m² may be the most practical. [ABSTRACT FROM AUTHOR]

Background: Adequate nutrition during infancy is essential to ensure the growth, health, and development of children to their full potential. Even with its known advantages, breastfeeding rates are sub-optimal the world over. Objectives are to identify the reasons mothers give for stopping exclusive breastfeeding, to know the common breastfeeding problems and intervention factors effecting breastfeeding. Methods: a prospective survey was conducted on mothers delivered in RLJH & RC attached to SDUMC, Kolar from January 2011 to December 2011 or 500 mothers (whichever is earlier). These mothers and relatives were counselled immediately after delivery about the merits of breastfeeding. A 3-step questionnaire is followed. Conclusion: Our study recorded an increasing trend towards initiation of breastfeeding. Mothers parents and in-laws were found to be influential in the decision making process of child rearing practices. Postnatal counselling brought down top feeding for the first 3 days. Timely intervention in the form of postnatal counselling to both family and the mother was found to be effective. Primigravida status was noted to significantly affect breastfeeding. Psychological factors, social beliefs, caesarean section and breast and nipple problems are significant reasons that mothers give for not breastfeeding exclusively. Cultural and traditional practices have considerable implications on breastfeeding, and in the overall well-being and health of the mother and the infant. Breastfeeding programs should take into account traditional beliefs and concepts when communicating with families about practices such as food restriction and food avoidance. [ABSTRACT FROM AUTHOR]

Background: Transcription factor CP2 (TFCP2) is overexpressed in hepatocellular carcinoma(HCC) and correlated with the progression of the disease. Here we report the use of an integrated systems biology approach to identify genome-wide scale map of TFCP2 targets as well as the molecular function and pathways regulated by TFCP2 in HCC. Methods: We combined Chromatin immunoprecipitation (ChIP) on chip along with gene expression microarrays to study global transcriptional regulation ofTFCP2 in HCC. The biological functions, molecular pathways, and networks associated with TFCP2 were identified using computational approaches. Validation of selected target gene expression and direct binding of TFCP2 to promoters were performed by ChIP -PCR and promoter reporter. Results: TFCP2 fostered a highly aggressive and metastatic phenotype in different HCC cells. Transcriptome analysis showed that alteration of TFCP2 in HCC cells led to change of genes in biological functions involved in cancer, cellular growth and proliferation, angiogenesis, cell movement and attachment. Pathways related to cell movement and cancer progression were also enriched. A quest for TFCP2-regulated factors contributing to metastasis, by integration of transcriptome and ChIP on chip assay, identified fibronectin 1 (FN1) and tight junction protein 1 (TJP1) as targets of TFCP2, and as key mediators of HCC metastasis. Promoter reporter identified the TFCP2-responsive region, and located the motifs of TFCP2-binding sites in the FN1 promoter, which then was confirmed by ChIP-PCR. We further showed that FN1 inhibition blocks the TFCP2-induced increase in HCC cell aggression, and that overexpression of TFCP2 can rescue the effects of FN1 inhibition. Knock down of TJP1 could also rescue, at least in part, the aggressive effect of TFCP2 knockdown in HCC cells. Conclusions: The identification of global targets, molecular pathways and networks associated with TFCP2, together with the discovery of the effect of TFCP2 on FN1 and TJP1 that are involved in metastasis, adds to our understanding of the mechanisms that determine a highly aggressive and metastatic phenotype in hepatocarcinogenesis. [ABSTRACT FROM AUTHOR]

Aims/hypothesis: Dietary patterns have been associated with the incidence of type 2 diabetes, but little is known about the impact of ethnicity on this relationship. This study evaluated the association between four a priori dietary quality indexes and risk of type 2 diabetes among white individuals, Japanese-Americans and Native Hawaiians in the Hawaii component of the Multiethnic Cohort. Methods: After excluding participants with prevalent diabetes and missing values, the analysis included 89,185 participants (11,217 cases of type 2 diabetes). Dietary intake was assessed at baseline with a quantitative food frequency questionnaire designed for use in the relevant ethnic populations. Sex- and ethnicity-specific HRs were calculated for the Healthy Eating Index-2010 (HEI-2010), the Alternative HEI-2010 (AHEI-2010), the Alternate Mediterranean Diet Score (aMED) and the Dietary Approaches to Stop Hypertension (DASH). Results: We observed significant inverse associations between higher DASH index scores and risk of type 2 diabetes in white men and women, as well as in Japanese-American women and Native Hawaiian men, with respective risk reductions of 37%, 31%, 19% and 21% (in the highest compared with the lowest index category). A higher adherence to the AHEI-2010 and aMED diet was related to a 13-28% lower risk of type 2 diabetes in white participants but not in other ethnic groups. No significant associations with risk of type 2 diabetes were observed for the HEI-2010 index. Conclusions/interpretation: The small ethnic differences in risk of type 2 diabetes associated with scores of a priori-defined dietary patterns may be due to a different consumption pattern of food components and the fact that the original indexes were not based on diets typical for Asians and Pacific Islanders. [ABSTRACT FROM AUTHOR]

Copyright of Aquichan is the property of Universidad de la Sabana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Native Hawaiians/Pacific Islanders experience a high prevalence of overweight/obesity. The Diabetes Prevention Program Lifestyle Intervention (DPP-LI) was translated into a 3-month community-based intervention to benefit these populations. The weight loss and other clinical and behavioral outcomes of the translated DPP-LI and the socio-demographic, behavioral, and biological factors associated with the weight loss were examined. A total of 239 Native Hawaiian/Pacific Islander adults completed the translated DPP-LI through four community-based organizations (CBOs). Changes from pre- to post-intervention assessments in weight, blood pressure, physical functioning, exercise frequency, and fat in diet were measured. Significant improvements on all variables were found, with differences observed across the four CBOs. CBOs with predominately Native Hawaiian and ethnically homogenous intervention groups had greater weight loss. General linear modeling indicated that larger baseline weight and CBO predicted weight loss. The translated DPP-LI can be effective for Native Hawaiians/Pacific Islanders, especially when socio-cultural, socio-economic, and CBO-related contextual factors are taken into account. [ABSTRACT FROM AUTHOR]

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Objectives. We identified potential determinants and cause-specific sources of excess infant mortality among Native Hawaiians. Methods. We compared infant mortality rates among Native Hawaiians and Whites by using data from the 2002 to 2009 Hawaii State Linked Birth/Infant Death Cohort File. We evaluated the components of excess infant mortality by age and underlying cause of death as well as maternal sociodemographic, behavioral, and chronic condition disparities. Results. The Native Hawaiian infant mortality rate was more than twice that for Whites (7.9 vs 3.5/1000 live births). Excess Native Hawaiian infant mortality was equally apportioned to neonatal and postneonatal deaths. Preterm-related causes of death accounted for 43.9% of the infant mortality disparity, followed by sudden unexpected infant death (21.6%) and injury (5.6%). In multivariable models, maternal educational inequality accounted for the largest portion of the neonatal mortality disparity (20.9%); younger maternal age (12.2%) and smoking (9.5%) were the only significant contributors to the postneonatal mortality disparity. Conclusions. Addressing educational inequalities, promoting safe sleep practices, and reducing smoking among Native Hawaiian mothers would help to eliminate excess infant mortality. [ABSTRACT FROM AUTHOR]

Though many countries are on-track in reducing poverty, less than a quarter of developing countries are on-track for achieving the goal of halving undernutrition. Maternal undernutrition is widely prevalent among women in the developing countries and encompasses both chronic energy as well as micronutrient deficiencies. Maternal undernutrition leads to intrauterine growth restriction and consequent low birth weight, stunting, wasting, underweight and other micronutrient deficiencies along with conditions predisposing to mortality. There are no effective therapies to reverse intrauterine growth restriction; hence focus should be on preventive strategies. In developing countries, the interventions likely to have the largest impact on intrauterine growth include caloric and micronutrient supplementation before and during pregnancy, coupled with supportive strategies for improving nutrition. [ABSTRACT FROM AUTHOR]