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The purpose of this study was to investigate the current status of what men who have sex with men (MSM) know about anal cancer in terms of self-care behaviors/practices, human papillomavirus (HPV) knowledge, risk awareness, anal cancer screening history, the need to be screened, and how demographic or behavioral practices were associated with knowledge and awareness.A convenience sampling method was employed. Participants were recruited in 2014-2015 in venues such as Pride Center events as well as in bars, restaurants, and cafes that cater to a gay clientele. Participants' knowledge of HPV and anal cancer were examined using the Anal Cancer Knowledge Questionnaire (ACKQ). The 65-item survey consisted of demographic variables, questions related to anal health behaviors, practices, and perceptions, HPV and anal cancer knowledge, and HPV and anal cancer risk awareness.The sample consisted of 163 men. The mean age of the participants was 49.6 years. The majorities were white (62.6%), followed by Hispanic (26.4%) and Black (8.0%). Study participants were, to a great extent, uninformed and largely unaware of the link between HPV and anal cancer and the risk that HPV and anal cancer presented to MSM. One-way analysis of variance (ANOVA) indicated that HPV knowledge, P .001, and risk awareness, P .001, differed by HIV status.In spite of efforts in recent years to raise HPV and anal cancer awareness, those groups most at risk appear to remain uncertain of risk, screening, and measures to protect themselves from the adverse implications of HPV infection.

Aims: Nutritional status can be compromised by food insecurity which is common among HIV infected persons. Providing food assistance is expected to improve food insecurity and nutritional status among persons infected with HIV. This study aimed at examining the relationship of participating in the Supplemental Nutrition Assistance Program (SNAP), the largest food assistance program in the United States, with food security and nutritional status among HIV infected adults. Study Design : A cross - sectional study de sign was used in this study. Place and Duration of Study: This study was conducted in Miami, FL, USA, between April 2011 and August 2012. Methodology: We included 159 HIV infected individuals in this study, 113 participants were SNAP recipients while 46 w ere not. All study participants were, however, eligible to participate in SNAP. Each participant completed demographic and food security surveys as well as dietary and nutrition status assessment. Statistical analyses were conducted using univariate and mu ltivariate analyses.

As morbid obesity increasingly affects Hispanic Americans, the incidence of bariatric procedures among this population is rising. Despite this, prospective research on the effects of comprehensive postoperative education-centered interventions on weight loss and physical activity focused on Hispanic Americans is lacking.To examine whether a comprehensive nutrition education and behavior modification intervention improves weight loss and physical activity in Hispanic Americans with obesity following Roux-en-Y gastric bypass surgery (RYGB).A prospective randomized-controlled trial was conducted between November 2008 and April 2010. At 6 months following RYGB, 144 Hispanic Americans with obesity were randomly assigned to a comprehensive nutrition and lifestyle educational intervention (n=72) or a noncomprehensive approach (comparison group n=72). Those in the comprehensive group received education sessions every other week for 6 weeks in small groups and frequent contact with a registered dietitian. Those in the comparison group received brief, printed healthy lifestyle guidelines. Patients were reassessed at 12 months following surgery. Main outcome measures were excess weight loss and physical activity changes over time. Statistical analyses used t test, ?(2) test, Wilcoxon signed rank, Mann-Whitney U test, and intent-to-treat analysis, significance P0.05.Participants (mean age 44.5 ± 13.5 years) were mainly Cuban-born women (83.3%). Mean preoperative excess weight and body mass index (calculated as kg/m(2)) were 72.20 ± 27.81 kg and 49.26 ± 9.06, respectively. At 12 months following surgery, both groups lost weight significantly, but comprehensive group participants experienced greater excess weight loss (80% vs 64% from preoperative excess weight; P0.001) and greater body mass index reduction (6.48 ± 4.37 vs 3.63 ± 3.41; P0.001) than comparison group participants. Comprehensive group participants were significantly more involved in physical activity (+14 min/wk vs ?4 min/wk; P0.001) than comparison group participants. Mean protein intake was significantly lower in the comparison group than that in the comprehensive group (P0.024).Findings support the importance of comprehensive nutrition education for achieving more effective weight reduction in Hispanic Americans following RYGB.

Objective Nursing facilities often provide enhanced or fortified foods as part of a "food-first" approach to increasing nutrient intakes in residents with inadequate intakes or who are experiencing weight loss. The study objective was to determine whether energy and protein enhancement of a small number of menu items would result in increased three-meal (breakfast, lunch, and supper) calorie and protein intakes in long-term care residents. Design A randomized cross-over design was used to compare investigator-weighed food intakes under three menu conditions: control (no meals enhanced); lunch only enhanced; and both breakfast and lunch enhanced. Two breakfast foods (juice and hot cereal) and two lunch foods (soup and potato side dish) were chosen for enhancement. Subjects/setting Participants were 33 nursing home residents from a facility in South Florida (average age=87.3 years). Statistical analysis Repeated-measures analysis of variance was used to test the effects of the within-subjects factor (control, lunch enhanced, breakfast and lunch enhanced conditions), the between-subjects factor (smaller vs bigger eater), and the interaction on intakes (gram, kilocalories, and protein). Results Results revealed that bigger eaters consumed considerably more calories when breakfast foods, but not lunch foods, were enhanced. Smaller eaters achieved an increase in energy intake when either breakfast or lunch was enhanced. Overall daily protein intakes were not substantially increased by food enhancement. These data suggest that for an enhanced food program to be most effective for smaller eaters, who are at greatest risk for undernutrition and weight loss, it should include several enhanced foods at more than one meal.

A survey of 60 rural, 62 urban Alaska women (64% Alaska Native) indicated positive dietary and lifestyle habits. Diets were characterized by boiled meats, high intakes of omega-3 fish, sea mammals and few desserts. Food insecurity reported by 39% rural and 7% of urban. Hunger was reported by 16% of rural and 5% of urban women. Traditional activities were walking, harvesting fish and picking berries. One third of calories came from non-traditional sugared and fruit juice beverages. Few respondents reported chronic diseases. Nutrition and health educational interventions in Alaska Native communities should reinforce existing positive lifestyle habits, involve Elders and tribal leaders, and incorporate Native values, customs and traditions.

The effects of stress on mothers' recall for a major hurricane were studied. Stress was objectively defined as low, moderate, or high according to the severity of home damage. This study of 96 mothers was conducted concurrently with L. E. Bahrick, J. F. Parker, R. Fivush, and M. Levitt (1998), allowing the authors to compare child and adult recall as a function of the same stressor. There was a quadratic relationship between storm severity and total recall for adults, similar to their children. Mothers' recall increased from low to moderate severity, but recall at moderate severity did not differ from high severity. These findings help clarify the effects of stress on the amount and type of information adults recall in retrospective accounts of naturalistic, temporally extended events.

Objectives Coronary heart disease (CHD) is the leading cause of death in the United States and Europe. This study identified and compared nutritional knowledge associated with CHD risk factors among tri-ethnic college students.Design A quantitative, cross-sectional, observational study using questionnaires.Setting University laboratory.Method Three hundred college students, 50 per cent male and 50 per cent female, completed self-administered surveys of demographics, CHD knowledge, and Cardiovascular Risk Assessment. Data were analysed by gender and ethnicity using one-way ANOVA, Pearson correlations, and Chi-square test.Results The mean percentage of correctly answered CHD knowledge questions for all subjects was 70.7 ± 7.9 per cent. The CHD knowledge was significantly higher ( p=0.039) for White non-Hispanic males than Black non-Hispanic males. A large percentage of the subjects selected'do not know' in response to the family history of heart disease (27.2 per cent) and diabetes (15.6 per cent) questions. A significant inverse correlation ( p=0.032) was found between the CHD knowledge and CHD risk point standards in White non-Hispanic females. Overall, significant inverse correlations were found between CHD knowledge and intakes of calories ( p=0.010), carbohydrates ( p=0.016), total fat ( p=0.024), and cholesterol ( p=0.023).Conclusion Nutrition knowledge of CHD risk factors are key in changing nutrition behaviour, and future studies should investigate the effectiveness of nutrition education that specifically addresses ethnic differences needs and strengths of college students.

The aging content in 11 undergraduate nutrition textbooks (8 introductory, 3 life cycle) was evaluated using content analysis. Repeated measures ANOVAs with Bonferroni post hoc procedures and t- tests were used. The 259 relevant pages largely focused on geriatrics (physiological decline, chronic diseases). Gerontological aspects were underemphasized. Mean number of pages on aging was significantly higher in life cycle (M = 37) than in introductory textbooks (M = 18), t (9) = 3.42, p.008. In introductory textbooks, mean percentage of pages on aging (M = 3.2%) was significantly less than for maternal (M = 4.6%) and childhood topics (M = 6.2%), p.05. Overall, topic omissions included discussion of ageism, death, dying, and dignity; and end-of-life decisions related to nutrition and hydration. Women and minorities were proportionately represented in generally positive photographs. Aging terminology was 81% neutral (older, aging), 14% negative (impaired, senile), and 5% positive (active, independent). These textbooks may not help students acquire the broad knowledge needed to work with older adults or develop positive attitudes about aging. Recommendations for authors, publishers, and instructors are provided.

Objectives We used stress process theory to identify family caregiving variables that are salient to the experience of managing older adults' home enteral nutrition. In this article, we describe the specific tasks family caregivers performed and their unique training needs in the context of caregiver preparedness, competence, effectiveness, and health care use. Design Hospital billing lists from two university-affiliated institutions in Miami, FL, were used to identify older adults who had enteral tubes placed over a 6-month period. Consent was obtained from those older adults discharged for the first time on home enteral nutrition and their family caregivers at the first scheduled outpatient visit. Subjects/setting In-home interviews were conducted with a diverse sample of 30 family caregivers (14 white, 8 Hispanic, 7 African-American, 1 Asian) during their first 3 months (mean=1.83±0.69 months) of home enteral nutrition caregiving. Statistical analyses performed Descriptive statistics were used to summarize data for all variables; χ 2 analysis was conducted to analyze differences in categorical variables. One-way analysis of variance was used to analyze mean differences among caregivers grouped by ethnicity for total number of hours and tasks performed. Post hoc comparisons were conducted using the Tukey HSD test. The Spearman rho correlations were calculated to assess bivariate associations between quantitative variables. Results Caregivers reported providing from 6 to 168 hours of care weekly (mean=61.87±49.67 hours), in which they performed an average of 19.73±8.09 caregiving tasks daily. Training needs identified were greatest for technical and nutrition-related tasks. Preparedness for caregiving scores were low (mean=1.72, maximum=4.0) and positively correlated with caregiver competence ( P P= .004). Preparedness negatively correlated with health care use ( P =.03). Conclusions Caregivers of older adults on home enteral nutrition need training for multiple nutrition-related and caregiving tasks. Multidisciplinary interventions, involving dietitian expertise, are needed to better prepare caregivers to improve both caregiver effectiveness and enteral nutrition outcomes.

The literature on the potential clinical and non-clinical benefits of participation in food assistance programs for people living with HIV in developed countries is scarce. We conducted a cross-sectional study of 165 HIV infected adults to determine the impact of the Supplemental Nutrition Assistance Program (SNAP) on HIV disease status and health related quality of life (HQROL). There was no significant association between SNAP participation and disease status; CD4 cell count (β = 0.02, P = 0.837) and viral load (β = 0.02, P = 0.836). The mean scores for all the HRQOL domains were lower compared to the US population, but none were associated with SNAP participation. Higher scores on the general health domain, were marginally associated with SNAP participation (β = 0.16, P = 0.071). In this study, SNAP participation was not significantly associated with less disease progression, and only marginally associated with quality of life among this population of HIV infected individuals.

The study examined relationships between physical activity (PA) and Metabolic Syndrome (METS) in Jamaican adolescents. A descriptive, cross-sectional survey examined 276 students from 10 Jamaican h...

OBJECTIVE To evaluate weight concerns, weight-loss practices (including smoking) in an ethnically diverse group of university students (58% Hispanic). METHODS Students (n=1,852) completed a survey addressing lifestyle behaviors and weight-control practices. RESULTS A greater percentage of females than males practiced weight-loss behaviors. More Hispanic and non-Hispanic white students reported dieting, exercising, and using weight loss pills to lose weight. Only 4 of the females reported their primary reason for smoking was to control their weight. CONCLUSION Gender as well as ethnicity was a dominant factor influencing weight-loss behaviors/concerns of these young adults.

We studied the development of leaf characters in two Southeast Asian dipterocarp forest trees under different photosynthetic photon flux densities (PFD) and spectral qualities (red to far-red, R:FR). The two species, Hopea helferi and H. odorata, are taxonomically closely related but differ in their ecological requirements; H. helferi is more drought tolerant and H. odorata more shade tolerant. Seedlings were grown in replicated shadehouse treatments of differing PFD and R:FR. We measured or calculated (1) leaf and tissue thicknesses; (2) mesophyll parenchyma, air space, and lignified tissue volumes; (3) mesophyll air volumes (V(mes)/A(surf)) and surfaces (A(mes)/A(surf)); (4) palisade cell length and width; (5) chlorophyll/cm and a/b; (6) leaf absorption; and (7) attenuance/absorbance at 652 and 550 nm. These characters varied in response to light conditions in both taxa. Characters were predominantly affected by PFD, and R:FR slightly influenced many characters. Leaf characters of H. odorata were more plastic in response to treatment conditions. Characters were correlated with each other in a complex fashion. Variation in leaf anatomy is most likely a consequence of increasing leaf thickness in both taxa, which may increase mechanical strength and defense against herbivory in more exposed environments. Variation in leaf optical properties was most likely affected by pigment photo-bleaching in treatments of more intense PFD and was not correlated with A(max). The greater plasticity of leaf responses in H. odorata helps explain the acclimation over the range of light conditions encountered by this shade-tolerant taxon. The dense layer of scales on the leaf undersurface and other anatomical characters in H. helferi reduced gas exchange and growth in this drought-tolerant tree.

The study examined relationships between physical activity (PA) and Metabolic Syndrome (METS) in Jamaican adolescents. A descriptive, cross-sectional survey examined 276 students from 10 Jamaican high schools. The National Cholesterol Education Program (NCEP) Adult Treatment Panel III and the International Diabetes Federation (IDF) criteria determined the metabolic risks. The Physical Activity Questionnaire for Children measured PA levels. Mean age was 15.6 (± 1.2). Percentage of subjects classified with METS varied by criterion used; IDF (6.9%) and NCEP (12.4%). While 56% of the subjects classified with METS were physically inactive, logistic regression showed no relationships between PA and individual METS risk factors overall (p>0.05). Females were 15 times less physically active and had significantly (p

This study examined the relationship between perceived (stated) levels of function and the measured (observed) performance in squatting and stair climbing activities of 20 patients with chronic low back pain (CLBP) and 20 healthy volunteers. Subjects were asked through an interview to self-assess their ability to comfortably perform stair climbing and squatting as well as other tolerances. The subjects were then asked to perform the activities and their performance levels were recorded. Results revealed that patients' estimate of squatting and stair climbing abilities as well as their demonstrated levels were significantly lower (p0.001) than those of the healthy subjects. There was a significant difference between groups in terms of the time required to perform squatting but not stair climbing. Both groups underestimated their physical capabilities. Findings indicate that the use of actual performance measurement combined with self-report of functional abilities is needed when assessing performance levels of healthy subjects as well as patients with CLBP.

Respiratory inductive plethysmography (RIP) is a well-accepted noninvasive technology for monitoring breathing patterns in adults. Prior attempts to calibrate this device in babies have been fraught with technical difficulties, thereby limiting applications in this population. Recently, a new method, qualitative diagnostic calibration (QDC), has been shown to provide accurate calibration of tidal volume in adults. The QDC method is based upon principles of the isovolume maneuver and carried out during natural breathing without specialized respiratory maneuvers or postural changes. We calibrated RIP with QDC in the supine posture and compared tidal volume (VT) measured with RIP to VT by a face mask-pneumotachograph (PNT) in 21 healthy full-term newborns in supine and prone postures. Eleven of the babies were calibrated during active sleep and 10 in quiet sleep. The mean VT in the supine and prone postures were 19 and 25 ml, respectively. In the supine and prone postures, weighted mean difference between RIP (VT) and PNT (VT) and 95% confidence intervals were -0.05 ml (-0.27, 0.18) and -0.32 ml (-0.08, 0.55), respectively. There was no difference in the accuracy of RIP relative to PNT calibrated during active sleep when thoracoabdominal incoordination was present or quiet sleep when it was not in either the supine or the prone postures. Therefore, in full-term infants, RIP calibrated with QDC solely in the supine posture provides clinically acceptable measurements of VT in both supine and prone postures.

The few previous studies of the nutritional status and dietary intakes of the homeless have been limited by small sample sizes. We collected information from a multiethnic sample of 277 homeless men and women in Miami, Fla. Data collected included a brief personal history, anthropometric variables, and a detailed 24-hour dietary recall. An additional 24-hour dietary recall was collected from a subsample of 36 men. Socioeconomic characteristics of our sample were similar to that of other samples of the homeless. Using measurements of the upper arm muscle area, we identified wasting malnutrition in 20% of the men. Dietary intakes (percentage of the Recommended Dietary Allowances [RDAs] +/- standard error of the mean) for energy (82 +/- 2.88%), calcium (63 +/- 3.28%), zinc (56 +/- 2.61%), and vitamin B-6 (68 +/- 3.93%) were significantly below RDA guidelines for all ethnic groups. In addition, thiamin (75 +/- 6.34%) intakes for whites and vitamin A (61 +/- 12.53%) and riboflavin (74 +/- 7.72%) intakes for Hispanics were below RDA guidelines. Compared with men, women consumed significantly less energy, calcium, and zinc.

This study examined the pressure volumetric characteristics (compliance) of Jobst (Jobst Institute, Toledo, Ohio), Barton-Carey (Barton-Carey Co., Perrysburg, Ohio), and Tubigrip (SePro Healthcare Inc., Moorestown, N.J.) pressure garments for arms after repeated saturation with lubricating substances and repeated washing/drying cycles. The three treatment groups were each composed of one sleeve from each of the manufacturers and were subjected to 20 washing/drying cycles. In addition, the sleeves in treatment groups 2 and 3 were saturated with cocoa butter and Lubriderm moisturizer, respectively, before each cycle. Circumferential measurements were taken on the proximal forearm of the sleeve at varying degrees of pressure with a Grafco standard sphygmomanometer (Graham Field Inc., Hauppauge, N.Y.) and a Gulick anthropometric tape measure (Creative Engineering, Plymouth, Mich.). Measurements were taken initially and after every fifth washing/drying cycle. Analysis of variance revealed significant results for the main effects and some interactions at the 0.01 level. Overall results showed little change in the Jobst and Barton-Carey garments, whereas the Tubigrip garments displayed an inconsistent pattern.

Medical, legal, and bioethical discussions have focused on withholding or withdrawing nourishment from adults who are terminally ill or in persistent vegetative states, yet few discussions have considered the dietitian's role. In June 1990, the Supreme Court upheld an individual's right to refuse life-prolonging procedures, provided those wishes had been clearly documented. This decision, and The American Dietetic Association's 1987 guidelines for feeding the terminally ill, may enable dietitians to evaluate complicated situations regarding feeding and nonfeeding of patients. A survey sent to 590 registered dietitians in The American Dietetic Association's Nutrition Support dietetic practice group resulted in a 42% (n = 250) response rate. In general, dietitians were more willing to discontinue total parenteral nutrition than to discontinue enteral, noninvasive enteral, or oral feedings. They thought that feeding could be discontinued if it causes pain or worsens the condition, if death is imminent, or if the patient has requested that feeding be stopped. University courses and continuing education programs on the ethics and legalities of feeding terminally or critically ill adults will enable dietitians to take active roles in the decision-making process and to promote awareness of relevant issues with patients and families.

Objectives. We assessed outcomes of an integrated nutrition and exercise program designed for Older Americans Act Nutrition Program participants as part of the Administration on Aging’s You Can! campaign. Methods. A 10-site intervention study was conducted. Preintervention and postintervention assessments focused on nutrition and physical activity stages of change, self-reported health status, dietary intakes, physical activity, and program satisfaction. Results. Of 999 enrollees, the 620 who completed the program were aged 74.6 years on average; 82% were women, and 41% were members of racial/ethnic minority groups. Factors associated with program completion were site, health conditions, and nutrition risk. Seventy-three percent and 75% of participants, respectively, made a significant advance of 1 or more nutrition and physical activity stages of change; 24% reported improved health status. Daily intake of fruit increased 1 or more servings among 31% of participants; vegetables, 37%; and fiber, 33%. Daily steps increased 35%; blocks walked, 45%; and stairs climbed, 24%. Program satisfaction was 99%. Conclusions. This easy-to-implement program improves diets and activity levels. Local providers should offer more such programs with the goal of enabling older Americans to take simple steps toward successful aging.

Using content analysis, this study evaluated the aging content and context in 11 nutrition sub-specialty textbooks: community nutrition (n = 3), diet therapy (n = 4), and nutrition and aging (n = 4). Pages with paragraphs on aging were identified in community nutrition and diet therapy textbooks, and 10% random samples of pages were evaluated in nutrition and aging textbooks. Paragraphs were assigned to one of four categories: gerontology, nutrition as primary, nutrition as secondary, or tertiary prevention. A total of 310 pages was qualitatively analyzed using NUD*IST 5 software and quantitatively with percentages. Only 7% of community nutrition and 2% of diet therapy pages were devoted to aging. There was little integration of aging beyond the chapters on aging. Community nutrition had the most gerontology (30%) and primary prevention (43%) content. Diet therapy and nutrition and aging had more secondary prevention (33% and 42%, respectively) and tertiary prevention (27% each) content. Some important databases and studies were absent. Of the 1,239 ageism words, 10% were positive, 53% neutral, and 36% negative. Photographs were generally positive. Women, but not minorities, reflected current older adult demographics. Future textbook editions should address aging more comprehensively and positively to better prepare dietitians for the job market. Recommendations for authors, course instructors, and publishers are given.

Nutritional status during HIV infection is related to disease outcome and health status. While HIV disease continues to put infected individuals at nutritional risk, nutritional issues have shifted from undernutrition and weight loss to obesity and metabolic imbalances even though inadequacy in nutrient intake persists. Nutrition education targeted at improving dietary habits through improvements in nutrition knowledge, self-efficacy and readiness to change are critical to reduce nutritional risks in HIV infected patients. This pilot study, conducted between January 2012 and September 2012, evaluated the effect of a nutrition education on nutrition knowledge and behavior, dietary intake, and nutritional status of HIV infected adults. Forty-five individuals were randomized into intervention (30 participants) and control (15 participants) groups. They completed pretest, posttest, and 3 months follow-up assessments and surveys administered before and after the intervention program. Although there were no significant differences in some of the outcome measures between the groups, we observed a trend towards improved nutrition knowledge and self-efficacy scores in the intervention group compared to the control group. In addition, fewer individuals in the control group progressed in the stage of change continuum compared to the intervention group for all dietary habits assessed. This study serves as a platform for developing nutrition education tools to address the nutritional and health needs of this population.

Objectives To compare obese versus non-obese Jamaican adolescents’ risk for type 2 diabetes (T2D) and cardiovascular diseases (CVDs); and to explore a suitable and economical method of screening for these risk factors in the school settings. Design A descriptive cross-sectional study of adolescents’ risk for T2D and CVD. All the participants were examined at their respective schools. Setting Jamaica, West Indies. Population 276 Jamaican adolescents aged 14–19 years, randomly selected from grades 9 to 12 from 10 high schools on the island and included both boys and girls. All ethnicities on the island were represented. Main outcome measures High fasting blood glucose, total cholesterol, glycated haemoglobin (HbA1c), blood pressure, body mass index (BMI), waist circumference, waist-to-hip ratio, family history of obesity, T2D and CVDs, low physical activity, and presence of Acanthosis Nigricans. All blood measures were analysed using the finger prick procedure. Results Waist circumference, waist-to-hip ratio, Acanthosis Nigricans, total cholesterol, family history of T2D and blood pressure were the strongest predictors of BMI (p=0.001). Over one-third of the participants were overweight. Jamaican adolescent females had a significantly higher number of risk factors and were less physically active than males (p

TEXT: Public health data show that African-Americans have not adopted health-promoting behaviors of diet and exercise. In an effort to find other motivating or moderating variables, this study was designed to determine how spirituality relates to health promoting behaviors in African-American women. Burkhardt's theoretical framework for spirituality is referred to as harmonious interconnectedness. This was adopted and measures were selected for the three elements of the framework: connectedness with self, others, and environment. African-American women (n=286) residing in Florida between 18 and 82 years of age completed questionnaires: Rosenberg's SelfEsteem Scale, Health Promoting Lifestyle Profile II, Spiritual Perspective Scale, Brief Block Food Frequency, and socio-demographic information. Hierarchical multivariate multiple regression identified 40% of the variability of diet to be explained by socio-demographic (education) and spirituality variables (stress management and health responsibility) (p

The preparation of 4-de-N-methylfortimicin A analogs as well as the preparation of 4-de-N-methyl-4-N-(beta-aminoethyl)-4-N-ethylfortimicin B is reported. It was shown that the 4-N-methyl group in fortimicin analogs is essential for antibacterial activity since neither the 4-de-N-methylfortimicin A nor the 4-de-N-methyl-4-N-(beta-aminoethyl)-4-N-ethylfortimicin B exhibited useful biological activity.

Suppose the same nonlinear function involving k parameters is fit to each of t populations. Suppose further it is of interest to compare a specific parameter of the models across the populations. Such comparisons can be expressed as linear hypotheses about the parameters of the nonlinear models. A weighted linear least squares (WLLS) procedure is proposed to test these linear hypotheses. The advantages and disadvantages of the WLLS procedure are discussed. This procedure is also compared to a nonlinear least squares procedure for testing these hypotheses in nonlinear models.

The synthesis of 2-deoxyfortimicins A (15) and B (11) and 1-deamino-2-deoxy 2-epi-amino-fortimicins A (18) and B (12) is described. Two routes have been developed for synthesis of the key intermediate 2-O-methanesulfonylfortimicin B (7). One route involves selective blocking of fortimicin B with N-benzyloxycarbonyl groups followed by formation of a 4, 5-salicylaldehyde oxazolidine derivative. Subsequent mesylation followed by deblocking gave 7. A more efficient route to 7 involves concomitant salicylaldehyde SCHIFF base and 4, 5-oxazolidine formation followed by mesylation and hydrolysis. The formation of 1, 2(R)-epiminofortimicinB (8) from 7 followed by RANEY nickel reduction gave 2-deoxyfortimicin B and 1-deamino-2-deoxy-2-epi-aminofortimicin B, which were converted to the corresponding fortimicin A derivatives by selective N-blocking. N-acylation and subsequent deblocking. The antibacterial activities of the new fortimicin A derivatives are presented.

Fortimicin A and a number of 4-N-acylfortimicins B, although stable as either the fully protonated hydrochloride or sulfate salts, undergo degradation as the free bases in aqueous solution. Detailed studies with fortimicin A and 4-N-acetylfortimicin B have shown that degradation occurs, in part, by simple cleavage of the 4-N-acyl groups with formation of fortimicin B, and, in part, by rearrangement to the 2′-N-acylfortimicins B (the isofortimicin rearrangement). The conversions of the rearrangement products into 2′-N-glycylfortimicin A, 2′-N-acetylfortimicin A, and the 2′-N-(2-aminoethyl)fortimicins A and B are described. The antibacterial activities of the new fortimicin A derivatives are presented.

Selective 4- N -acylation of fortimicin B ( 2 ) has been accomplished by 4- N -acylation of 1,2′,6′-tri- N -benzyloxycarbonylfortimicin B ( 4 ) followed by hydrogenolysis of the N -protecting benzyloxycarbonyl groups. In this manner, fortimicin B was converted into fortimicin A ( 1 ), and a series of 4- N -acylfortimicins B ( 3 ) was prepared for antibacterial assay. The key intermediate 1.2,6-tri- N -benzyloxycarbonyl-fortimicin B, was prepared either directly from fortimicin B or by converting fortimicin A into 1,2′,6′,2″-tetra- N -benzyloxycarbonylfortimicin A ( 6a ), followed by selective hydrolysis of the 4- N -( N -benzyloxycarbonyl)glycyl group of the latter.

The preparation of 1, 2-anhydro-2', 6'-di-N-benzyloxycarbonyl-1 -deaminofortimicin B-4, 5-carbamate (4) and its conversion to the two diastereomeric 2', 6'-di-N-benzyloxycarbonyl-1-deamino-2-deoxy-1, 2-epoxyfortimicin B-4, 5-carbamates 7 and 13 are described. The olefin 4 was used for preparation of 1-deamino-2-deoxyfortimicin A (6d) while the β-epoxide 13 was used for the preparation of 1, 2-di-epi-fortimicin A (17b) and 2-amino-1-deamino-2-deoxy-1-hydroxyfortimicin A (19c). The in vitro antibacterial activities of 6d, 17b and 19c are reported.

The conversion of fortimicin E, a minor metabolite from the Micromonospora olivoasterospora fermentation which also produces fortimicin A and fortimicin B, to four 4-N-aminoacylfortimicins E was accomplished. The new 4-N-aminoacylfortimicins E showed only weak antimicrobial activity against several Gram-negative and Gram-positive microorganisms.