Infant Feeding and Information Sources in Chilean Families Who Reported Baby-Led Weaning as a Complementary Feeding Method

Baby-Led Weaning (BLW) is a new and emerging method of introducing complementary feeding in solid consistency, without the use of a spoon and entirely guided by the baby. This study aims to analyze the implementation of the BLW approach in relation to compliance with basic components and sources of information in Chilean families. Using a cross-sectional design, we assessed early nutrition, including breastfeeding and foods offered, maternal/child characteristics and sources of information on BLW among a non-probabilistic sample of mothers of children <24 months who reported practicing BLW (n = 261, median age = 28 years) in Chile. We found that 57.5% of mothers reported their child ate the same food as the family, 44.1% shared ≥3 meals with the family, 84.7% offered ≥3 foods at each meal and 75.6% reported only occasionally offering food with a spoon. The majority reported obtaining information on BLW from social media (82%). Moreover, 56% had offered cookies, 32% added salt and 9% sugar in the first 2 years. Exclusive breastfeeding for 6 months related to higher odds of consuming family foods (OR = 2.45, 95% CI 1.24–4.84), while having received information from professional sources and social media related to lower odds (OR = 0.45, 95% CI 0.22–0.88 and OR = 0.31, 95% CI 0.15–0.66, respectively). Those who had appropriate weight gain had lower odds of consuming ≥3 foods in meals (OR = 0.35, 95% CI 0.13–0.96). Among mothers who reported practicing BLW with their children, we observed a wide variety of feeding habits, sources of information and low compliance with the studied components. Eating the same food as the family was the most prevalent component and social media was the main source of information on BLW.     

Men sexually assaulted as adults and sexually abused as boys

Previous research on sexually victimized men has mainly addressed the acute symptoms seen in hospital emergency rooms and psychiatric clinics. Findings are reported on 14 men, all but 1 of whom had been sexually traumatized much earlier in life, as boys or young adults. Several problem areas are described: repression, denial, or normalization of the trauma; self-blame and shame; posttraumatic stress disorder; male gender identity fragility; sexual orientation ambiguity and internalized homophobia; sexual difficulties; mistrustfulness of adult men; and disturbances of self-esteem and body image. Gender issues in treatment are discussed..Presented at the 13th Annual Canadian Sex Research Forum Conference, Vancouver, British Columbia, July 4–5, 1986 and the 36th Annual Meeting, Canadian Psychiatric Association, Vancouver, British Columbia, September 24–26, 1986.     

Astaxanthin as a Novel Mitochondrial Regulator: A New Aspect of Carotenoids,beyond Antioxidants

Astaxanthin is a member of the carotenoid family that is found abundantly in marine organisms, and has been gaining attention in recent years due to its varied biological/physiological activities. It has been reported that astaxanthin functions both as a pigment, and as an antioxidant with superior free radical quenching capacity. We recently reported that astaxanthin modulated mitochondrial functions by a novel mechanism independent of its antioxidant function. In this paper, we review astaxanthin’s well-known antioxidant activity, and expand on astaxanthin’s lesser-known molecular targets, and its role in mitochondrial energy metabolism.     

Increases in Lifestyle Activities as a Result of Experience Corps? Participation

Experience Corps® (EC) was designed to simultaneously increase cognitive, social, and physical activity through high-intensity volunteerism in elementary school classrooms. It is, therefore, highly likely that EC participation may alter pre-existing patterns of lifestyle activity. This study examined the impact of “real-world” volunteer engagement on the frequency of participation in various lifestyle activities over a 2-year period. Specifically, we examined intervention-related changes on reported activity levels at 12 and 24 months post-baseline using Intention-to-Treat (ITT) and Complier Average Causal Effect (CACE) analyses, which account for the amount of program exposure. ITT analyses indicated that, compared to the control group, EC participants reported modest increases (approximately half a day/month) in overall activity level, especially in intellectual and physical activities 12 months post-baseline. Increases in activity were not found at the 24-month assessment. CACE models revealed similar findings for overall activity as well as for intellectual and physical activities at 12 months. Additionally, CACE findings suggested modest increases in social activity at 12 months and in intellectual and passive activities at 24 months post-baseline. This community-based, health promotion intervention has the potential to impact lifestyle activity, which may lead to long-term increases in activity and to other positive cognitive, physical, and psychosocial health outcomes.     

Influences on the Selection of Dietetics as a Career

Objective To gather information on the factors that influence students’ decisions to choose dietetics as a career.Design Self-administered questionnaires regarding the point at which career decisions were made were completed by 1,695 students in Plan IV/V dietetics programs throughout the United States.Subjects All Plan IV/V dietetics programs that reported greater than five graduates in the academic year 1989 to 1990 were selected from the 1990-1991 Directory of Dietetic Programs for the sample population. Of the 156 schools that were mailed questionnaires, responses were received from 84 schools (54%). Almost 90% of the students were women, 10.6% were men.Statistical analyses Data were analyzed using the Statistical Package for the Social Sciences. A χ² analysis was used to examine the relationship between point of decision and factors that influenced career choice, including people who influence career choice.Results The majority of students (55%) questioned reported making their career decision in college. Students rated interest in nutrition (96.3%) and job enjoyment (93.8%) as factors that were important in their decision to pursue a career in dietetics. College catalogs were rated by 48.3% of the students as being either useful or very useful in helping them make their career selection. With respect to gender differences, women rated a diverse work environment as being very important to their career decision more frequently than men (χ²=15.44, P<.01). Women were more likely than men to rate part-time work opportunities as being very important (χ²=26.75, P<.001); and selected working with people as being very important to their career decision (χ²=17.59, P<.01).Conclusions Findings identified that recruitment strategies need to be audience specific. Because career decision making appears to occur during one of three time frames (high school, college, or work experience), recruitment activities should be developed to specifically target students at these times. One way to increase the exposure of students to the profession of dietetics is for registered dietitians to give guest lectures in introductory college courses and high school upper-class courses in health, home economics, and biology. The use of university/college catalogs as effective marketing tools should also not be underestimated.Data suggest that gender differences exist in factors that influence persons to choose dietetics as a career. To increase the number of men who pursue careers in dietetics, future research should be designed to more fully explore gender differences, so that strategies to recruit more men into the profession can be developed. J Am Diet Assoc. 1997: 97;254–257.     

Sudden Illness as a Cause of Motor-vehicle Accidents

Forty-one of the 44,255 road accidents reported to the police in one region of Sweden during 1959-63 were, or probably were, caused by sudden illness in the driver of a motor-vehicle. All 41 were males. The illness was most often due to epilepsy or myocardial infarction. Eight drivers died at the wheel from their disease. No other persons were killed in the 41 accidents. Only in 19 out of the 41 cases was there any possibility of a previous medical examination having indicated that the man was unfit to drive. In view of this, and the extremely small proportion—about 1 in 1,000—of accidents caused by sudden illness at the wheel, there is little point in providing for general measures such as periodic medical examination to prevent these accidents. Attention should be directed to other types of accidents and other groups of drivers.     

Glutamate kinase as a potential biomarker of heavy metal stress in plants

Changes of glutamate kinase activity (GKA) in plants under cadmium and zinc chronic stress reported here reveal a regulatory role of this enzyme in plant heavy metal stress adaptation and indicate its potential use as a stress biomarker. Results of the first experimental series confirmed the toxic effects of cadmium and zinc at tested levels (30, 60, 90 mg Cd kg⁻¹ and 250, 500, 750 mg Zn kg⁻¹ soil) for spinach. A significant decrease of GKA in plants grown on contaminated treatments was found. Changes of GKA of plants grown on the highest contaminated treatments in the second series of experiments showed a similar course as a curve of plant stress response indicating the process of plant adaptation to chronic stresses—the decline of GKA in period of damage of cell activities, increase of its activity in period of maximum resistance and its following decrease in period of the plant metabolism depletion.     

Improved HPLC Method Using 2,3-naphthalenedicarboxaldehyde as Fluorescent Labeling Agent for Quantification of Histamine in Human Immunoglobulin Preparations

Objectives

To develop and optimize quantitative HPLC method using 2,3-naphthalenedicarboxaldehyde (NDA) after simple and efficient solid phase extraction to determine the histamine in a biopharmaceutical (Histobulin™).

Methods

The HPLC method was established using NDA-induced Histobulin and compared with the recently reported HPLC method using o-phthaldehyde (OPA). The validated NDA-applied HPLC method was adjusted to 15 lots of Histobulin and compared by the current lot-release-test method using fluorimetry in recovery of histamine and reproducibility.

Results

Analyses of six HPLC chromatograms using NDA and OPA each were compared. NDA produced a more stable chromatogram baseline than OPA, and showed better stability. The HPLC analysis was validated in accuracy (91–103%), precision (interday/intraday assay CV ≤2.30%), and linearity of dose–response curve (R² ≥ 0.9919). The detection limit was 0.0076 μg/mL and the quantitative limit was 0.0229 μg/mL. The amount of histamine per 12 mg of immunoglobulin was determined to be 0.17 ± 0.016 μg by the HPLC and 0.025 ± 0.013 μg by the current lot-release-test method using fluorimetry.

Conclusion

NDA derivatization showed better stability compared with the OPA method. Therefore the newly established NDA-derivatizated HPLC method may be more suitable than the fluorimetric method in lot-release-tests of biopharmaceuticals.     

Survey of solvent related chronic encephalopathy as an occupational disease in European countries

OBJECTIVES—To obtain information about solvent related chronic encephalopathy (SRCE) in the countries of the European Union (EU).
METHOD—A survey was conducted in 1998 and 1999 among medical experts, authorities for health and safety, and social security institutions.
RESULTS—SRCE is an acknowledged occupational disease in most of the participating countries. However, the numbers of compensated cases differ considerably. This is mainly a consequence of national social law rather than of differences in the criteria of diagnosis. In countries with relatively high reported incidences—such as Denmark, Finland, Norway, and Sweden—the number of acknowledged cases has declined over the past 5-10 years, although the most important criteria of diagnosis and causality, according to expert opinion, equivalent diagnostic procedures, and measures for prevention within the EU are not comparable.
CONCLUSIONS—There is a need for common guidelines for early diagnosis and the evaluation of causality. Actual figures of SRCE are not suitable to estimate prospective numbers of cases. For this reason a multicentre study in EU states is necessary after a consensus of diagnostic procedure. It is likely that the number of cases will decrease as a result of changes in legislation and preventive measures—such as substitution or reduction of solvents in the products, improvement of technical equipment, and regular health surveillance. Future research activities should focus on follow up studies of prognosis, randomised clinical trials of treatment, investigation of neurotoxic mechanisms, and of the interaction of solvent mixtures.


Keywords: organic solvents; encephalopathy; occupational disease     

Patients as partners in health research: A scoping review

BackgroundThe role of patient involvement in health research has evolved over the past decade. Despite efforts to engage patients as partners, the role is not well understood. We undertook this review to understand the engagement practices of patients who assume roles as partners in health research.MethodsUsing a recognized methodological approach, two academic databases (MEDLINE and EMBASE) and grey literature sources were searched. Findings were organized into one of the three higher levels of engagement, described by the Patient and Researcher Engagement framework developed by Manafo. We examined and quantified the supportive strategies used during involvement, used thematic analysis as described by Braun and Clarke and themed the purpose of engagement, and categorized the reported outcomes according to the CIHR Engagement Framework.ResultsOut of 6621 records, 119 sources were included in the review. Thematic analysis of the purpose of engagement revealed five themes: documenting and advancing PPI, relevance of research, co‐building, capacity building and impact on research. Improved research design was the most common reported outcome and the most common role for patient partners was as members of the research team, and the most commonly used strategy to support involvement was by meetings.ConclusionThe evidence collected during this review advanced our understanding of the engagement of patients as research partners. As patient involvement becomes more mainstream, this knowledge will aid researchers and policy‐makers in the development of approaches and tools to support engagement.Patient/User InvolvementPatients led and conducted the grey literature search, including the synthesis and interpretation of the findings.     

Police Encounters Among Needle Exchange Clients in Baltimore: Drug Law Enforcement as a Structural Determinant of Health

Objectives. We piloted a monitoring mechanism to document police encounters around programs targeting people who inject drugs (PWID), and assessed their demographic predictors at 2 Baltimore, Maryland, needle exchange program (NEP) sites.Methods. In a brief survey, 308 clients quantified, characterized, and sited recent police encounters. Multivariate linear regression determined encounter predictors, and we used geocoordinate maps to illustrate clusters.Results. Within the past 6 months, clients reported a median of 3 stops near NEP sites (interquartile range [IQR] = 0–7.5) and a median of 1 arrest in any location (IQR = 0–2). Three respondents reported police referral to the NEP. Being younger (P = .009), being male (P = .033), and making frequent NEP visits (P = .02) were associated with reported police stops. Among clients reporting arrest or citation for syringe possession, Whites were significantly less likely than non-Whites to report being en route to or from an NEP (P < .001). Reported encounters were clustered around NEPs.Conclusions. Systematic surveillance of structural determinants of health for PWID proved feasible when integrated into service activities. Improved monitoring is critical to informing interventions to align policing with public health, especially among groups subject to disproportionate levels of drug law enforcement.Laws and policing practices are broadly understood to act as structural determinants of health for people who inject drugs (PWID). In many US jurisdictions, laws have historically prevented over-the-counter sale and possession of syringes, reflecting a theory that legal restrictions on access to clean injection equipment can deter drug abuse.1 Other policies have banned federal, state, and municipal appropriations for needle exchange programs (NEPs), vastly underresourcing these public health initiatives and facilitating infectious disease spread among PWID and across communities.1,2 Possession of injecting equipment is generally a crime under state laws prohibiting drug paraphernalia, authorizing syringe confiscation and arrest of PWID by street-level law enforcement officers.3In the past 2 decades, an extensive evidence base demonstrating NEPs to be both efficacious in reducing the transmission of infectious disease (such as HIV and HCV) and cost-effective without increasing drug abuse3a has helped shift the US policy environment relating to syringe access. To date, 28 states have established regulation of retail sale and possession of syringes; NEPs have received official authorization in at least 18 states, sometimes only in the context of a public health emergency.3 Elsewhere, NEP clients gained formal or informal exemption from drug paraphernalia laws to encourage program use.4 These shifts have occurred in the context of other drug policy reforms that have begun the process of aligning the criminal justice regime with sound public health science.5,6There is considerable evidence, however, that policy reform is in and of itself insufficient to align police practices with public health prevention efforts in the realm of substance abuse.7–10 Wide enforcement discretion, management failures, and other gaps in the policy implementation process10 leave room for police officers to continue to confiscate legal injection equipment and interfere with the functioning of NEPs even after legal sanction.9,11,12Even under a favorable policy regime, policing practices can adversely affect the behavior and health of PWID. A number of studies from the United States and elsewhere suggest that police encounters are associated with higher odds of HIV infection, drug overdose, and other deleterious outcomes among PWID.10,13–25 Extrajudicial police practices such as unauthorized confiscation of injection equipment and physical abuse are widespread and have shown especially robust associations with risk behavior and adverse health outcomes among PWID, including HIV seroconversion.14,23,26–37 In a national survey of NEPs in the United States, 43% reported that their clients experience police harassment on at least a monthly basis.8 Aside from direct police interference with NEP program operations,10,18–21,25 experience and perceptions of police practices can deter uptake of disease prevention services by PWID.13–17,38–40 Disproportionate police presence in communities of color and racially biased policing practices likely exacerbate racial disparities in HIV acquisition and other health outcomes.13–17,38Although police interference has been sporadically documented and linked to risky injection behaviors among PWID populations, little research has attempted to evaluate mechanisms for systematically measuring the extent or prevalence of these adverse interactions. According to our previous research, only a small minority of NEPs in the United States report consistently monitoring adverse events involving police and program clients or staff.8 To our knowledge, those programs that do have a system for documenting police encounters have not formally described their methods or analyzed their findings. We piloted and evaluated a surveillance system to document levels of reported police interaction with NEP clients in an urban setting of Baltimore, Maryland. In light of the racially charged nature of drug law enforcement,41–44 our hypothesis was that non-White NEP clients would report higher levels of police encounters than White clients.     

Oxidative Damage to DNA and Lipids as Biomarkers of Exposure to Air Pollution

Background

Air pollution is thought to exert health effects through oxidative stress, which causes damage to DNA and lipids.

Objective

We determined whether levels of oxidatively damaged DNA and lipid peroxidation products in cells or bodily fluids from humans are useful biomarkers of biologically effective dose in studies of the health effects of exposure to particulate matter (PM) from combustion processes.

Data sources

We identified publications that reported estimated associations between environmental exposure to PM and oxidative damage to DNA and lipids in PubMed and EMBASE. We also identified publications from reference lists and articles cited in the Web of Science.

Data extraction

For each study, we obtained information on the estimated effect size to calculate the standardized mean difference (unitless) and determined the potential for errors in exposure assessment and analysis of each of the biomarkers, for total and stratified formal meta-analyses.

Data synthesis

In the meta-analysis, the standardized mean differences (95% confidence interval) between exposed and unexposed subjects for oxidized DNA and lipids were 0.53 (0.29–0.76) and 0.73 (0.18–1.28) in blood and 0.52 (0.22–0.82) and 0.49 (0.01–0.97) in urine, respectively. The standardized mean difference for oxidized lipids was 0.64 (0.07–1.21) in the airways. Restricting analyses to studies unlikely to have substantial biomarker or exposure measurement error, studies likely to have biomarker and/or exposure error, or studies likely to have both sources of error resulted in standardized mean differences of 0.55 (0.19–0.90), 0.66 (0.37–0.95), and 0.65 (0.34–0.96), respectively.

Conclusions

Exposure to combustion particles is consistenly associated with oxidatively damaged DNA and lipids in humans, suggesting that it is possible to use these measurements as biomarkers of biologically effective dose.     

'Reluctant pioneer': A qualitative study of doctors' experiences as patients with long COVID

BackgroundThe coronavirus disease (COVID‐19) pandemic has had far‐reaching effects upon lives, healthcare systems and society. Some who had an apparently ''mild'' COVID‐19 infection continue to suffer from persistent symptoms, including chest pain, breathlessness, fatigue, cognitive impairment, paraesthesia, muscle and joint pains. This has been labelled ''long COVID''. This paper reports the experiences of doctors with long COVID.MethodsA qualitative study; interviews with doctors experiencing persistent symptoms were conducted by telephone or video call. Interviews were transcribed and analysis conducted using an inductive and thematic approach.ResultsThirteen doctors participated. The following themes are reported: making sense of symptoms, feeling let down, using medical knowledge and connections, wanting to help and be helped, combining patient and professional identity. Experiencing long COVID can be transformative: many expressed hope that good would come of their experiences. Distress related to feelings of being ‘let down’ and the hard work of trying to access care. Participants highlighted that they felt better able to care for, and empathize with, patients with chronic conditions, particularly where symptoms are unexplained.ConclusionsThe study adds to the literature on the experiences of doctors as patients, in particular where evidence is emerging and the patient has to take the lead in finding solutions to their problems and accessing their own care.Patient and Public contributionThe study was developed with experts by experience (including co‐authors HA and TAB) who contributed to the protocol and ethics application, and commented on analysis and implications. All participants were given the opportunity to comment on findings.     

Total and individual carotenoid profiles in Solanum phureja of cultivated potatoes: I. Concentrations and relationships as determined by spectrophotometry and HPLC

Total and individual carotenoid concentrations were determined by spectrophotometry and HPLC, in raw tubers of a sample of 23 accessions of Solanum phureja potatoes taken at random from the world germplasm collection following its stratification on tuber flesh color. Lutein, zeaxanthin, violaxanthin, antheraxanthin and β-carotene were detected in all accessions and three distinct patterns of carotenoid accumulation were evidenced by cluster analysis. Accessions in group 1 showed the highest concentrations of total carotenoids (1258–1840 μg 100 g⁻¹ FW) comprised largely of zeaxanthin (658–1290 μg 100 g⁻¹ FW) with very low or no presence of β-carotene (below 5.4 μg 100 g⁻¹ FW). Accessions in group 2 presented moderate total carotenoid concentrations with violaxanthin, antheraxanthin, lutein and zeaxanthin as the major carotenoids. Accessions in group 3 showed low concentrations of total carotenoids (97–262 μg 100 g⁻¹ FW) and very low or no zeaxanthin, with lutein and violaxanthin as the predominant carotenoids and relatively high concentrations of β-carotene (up to 27 μg 100 g⁻¹ FW). Five accessions with significant concentrations of zeaxanthin were identified with the accession 703566 showing the highest concentration (1290 μg 100 g⁻¹ FW). This value is to our knowledge higher than any value previously reported for potatoes, including those achieved through genetic modification. For the 23 S. phureja accessions, total carotenoid concentration was positively and significantly correlated with antheraxanthin and zeaxanthin concentrations, and negatively and significantly correlated with β-carotene concentration.     

Sarcopenia and Appendicular Muscle Mass as Predictors of Impaired Fasting Glucose/Type 2 Diabetes in Elderly Women

Elderly women exhibit a high risk of type 2 diabetes (T2D), but no definitive data exist about the possible role of postmenopausal increases in visceral adiposity, the loss of lean body mass, or decreases in the sum of the lean mass of arms and legs (appendicular skeletal muscle mass (ASMM)). This retrospective, longitudinal study investigated whether body composition (bioelectrical impedance analysis) predicted the development of impaired fasting glucose (IFG) or T2D in a cohort of 159 elderly women (age: 71 ± 5 years, follow-up: 94 months) from southern Italy (Clinical Nutrition and Geriatric Units of the “Mater Domini” University Hospital in Catanzaro, Calabria region, and the “P. Giaccone ”University Hospital in Palermo, Sicily region). Sarcopenia was defined in a subgroup of 128 women according to the EWGSOP criteria as the presence of low muscle strength (handgrip strength <16 kg) plus low muscle mass (reported as appendicular skeletal muscle mass <15 kg). Participants with a low ASMM had a higher IFG/T2D incidence than those with a normal ASMM (17% vs. 6%, p-adjusted = 0.044); this finding was independent of BMI, fat mass, waist circumference, and habitual fat intake (OR = 3.81, p = 0.034). A higher incidence of IFG/T2D was observed in the subgroup with sarcopenia than those without sarcopenia (33% vs. 7%, p-adjusted = 0.005) independent of BMI and fat mass (OR = 6.75, p = 0.007). In conclusion, this study demonstrates that elderly women with low ASMM had a higher probability of developing IFG/T2D. Further studies are needed to confirm these results in men and in other age groups.     

Nitrogen Balance after the Administration of a Prolonged-Release Protein Substitute for Phenylketonuria as a Single Dose in Healthy Volunteers

Nitrogen balance is the difference between nitrogen excreted as urea and nitrogen ingested, mainly in proteins. Increased circulating concentrations of amino acids (AA) in the bloodstream are usually associated with proportional increases in the production and excretion of urea. Previously, we reported results from a randomized, controlled, single-dose, crossover trial in healthy adult volunteers (n = 30) (Trial Registration: ISRCTN11016729), in which a Test product (prolonged-release AA mixture formulated with Physiomimic Technology™ (PT™)) significantly slowed down the release and reduced the peak plasma concentrations of essential AAs compared with a free AA mixture (Reference product) while maintaining essential AA bioavailability. Here, we report an assessment of the nitrogen balance from the same study. The amount of nitrogen contained in plasma AAs, levels of blood urea nitrogen (BUN) (p < 0.0001) and changes in BUN (p < 0.0001) were smaller after the Test product compared with the Reference product. These findings suggest that the production of urea in proportion to systemic AA availability was significantly smaller after the administration of the Test product compared with the Reference product and that the test product conferred the increased utilization of AAs for protein synthesis and reduced their oxidation and conversion to urea. In the clinical setting, it is possible that the effects of PT™ observed on the disposition of free AAs in this study may translate to health benefits in terms of physiological body composition and growth if used for the treatment of subjects with phenylketonuria (PKU). Further investigation in patients with PKU is warranted.     

‘As soon as you've been there,it makes it personal’: The experience of health‐care staff shadowing patients at the end of life

BackgroundPatient shadowing is an experiential technique intended to enable those who shadow to understand care experience from the patient''s point of view. It is used in quality improvement to bring about change that focuses on what is important for patients.AimTo explore the acceptability of patient shadowing for health‐care staff, the impact of the experience and subsequent motivations to make improvements.MethodA qualitative study with a diverse sample of 20 clinical and non‐clinical health‐care staff in different end‐of‐life settings. Data were analysed thematically.ResultsAnticipated anxieties about shadowing did not materialize in participant accounts, although for some it was a deeply emotional experience, intensified by being with patients who were at the end of life. Shadowing not only impacted on participants personally, but also promoted better insights into the experience of patients, thus focusing their improvement efforts. Participants reported that patients and families who were shadowed welcomed additional caring attention.ConclusionWith the right preparation and support, patient shadowing is a technique that engages and motivates health‐care staff to improve patient‐centred care.     

Erythrocyte arginase activity as an indicator of lead exposure

ABSTRACT A semi-automated method has been developed for the determination of the arginase activity of erythrocytes using dried blood spots, which are easy to prepare on site in a factory for later laboratory analysis. The mean arginase activity of erythrocytes in 49 men occupationally exposed to lead was 62·9 IU/g·Hb (SD, 14·4 IU/g·Hb); in 45 men not exposed to lead the mean was 44·6 IU/g·Hb (SD, 11·6 IU/g·Hb). A significantly higher mean arginase activity was found in the specimens from lead-exposed workers (p < 0·001). The correlation coefficient between blood lead and erythrocyte arginase was r = 0·67 (p < 0·001). The degree of correlation between blood lead and lead indicators including arginase was r = 0·75 for urine δ-aminolaevulinic acid, r = 0·67 for erythrocyte arginase, r = 0·66 for urine lead, and r = 0·63 for coproporphyrin. Erythrocyte arginase showed no significant correlation in the liver function tests, GOT, GPT, and albumin in serum. When 40 μg/100 g of blood lead concentration was fixed as the basic value and 56·2 IU/g·Hb of erythrocyte arginase activity was set as the screening value in lead-exposed workers, the sensitivity and specificity of the arginase test were 0·96 and 0·65, respectively. Thus the validity of the test was calculated to be 1·61. These results show that the arginase level of erythrocytes can be considered to be one of the significant indicators of occupational exposure to lead because it reflects well the dose-response relationship of lead in the human body. Our method allows rapid analysis of erythrocyte arginase and thus should be useful in screening for lead exposure.     

Inflammation as well as angiogenesis may participate in the pathophysiology of brain radiation necrosis

Radiation necrosis (RN) after intensive radiation therapy is a serious problem. Using human RN specimens, we recently proved that leaky angiogenesis is a major cause of brain edema in RN. In the present study, we investigated the same specimens to speculate on inflammation''s effect on the pathophysiology of RN. Surgical specimens of symptomatic RN in the brain were retrospectively reviewed by histological and immunohistochemical analyses using hematoxylin and eosin (H&E) staining as well as immunohistochemical staining for VEGF, HIF-1α, CXCL12, CXCR4, GFAP, CD68, hGLUT5, CD45, IL-1α, IL-6 TNF-α and NF-kB. H&E staining demonstrated marked angiogenesis and cell infiltration in the perinecrotic area. The most prominent vasculature was identified as thin-walled leaky angiogenesis, i.e. telangiectasis surrounded by prominent interstitial edema. Two major cell phenotypes infiltrated the perinecrotic area: GFAP-positive reactive astrocytes and CD68/hGLUT5-positive cells (mainly microglias). Immunohistochemistry revealed that CD68/hGLUT5-positive cells and GFAP-positive cells expressed HIF-1α and VEGF, respectively. GFAP-positive cells expressed chemokine CXCL12, and CD68/hGLUT5-positive cells expressed receptor CXCR4. The CD68/hGLUT5-positive cells expressed pro-inflammatory cytokines IL-1α, IL-6 and TNF-α in the perinecrotic area. VEGF caused leaky angiogenesis followed by perilesional edema in RN. GFAP-positive cells expressing CXCL12 might attract CXCR4-expressing CD68/hGLUT5-positive cells into the perinecrotic area. These accumulated CD68/hGLUT5-positive cells expressing pro-inflammatory cytokines seemed to aggravate the RN edema. Both angiogenesis and inflammation might be caused by the regulation of HIF-1α, which is well known as a transactivator of VEGF and of the CXCL12/CXCR4 chemokine axis.     

Utility of action checklists as a consensus building tool

The present study’s objective was to determine the mechanisms for enhancing the utility of action checklists applied in participatory approach programs for workplace improvements, to identify the benefits of building consensus and to compare their applicability in Asian countries to find the most appropriate configuration for action checklists. Data were collected from eight trainees and 43 trainers with experience in Participatory Action-Oriented Training. Statistical analysis was performed in SPSS using the package PASW, version 19.0. The difference in the mean score for the degree of the utility of action checklists between countries was analyzed using ANOVA methods. Factor analysis was performed to validate the action checklists’ utility. Pearson Correlation Coefficients were then calculated to determine the direction and strength of the relationship between these factors. Using responses obtained from trainees’ in-depth interviews, we identified 33 key statements that were then classified into 11 thematic clusters. Five factors were extracted, namely “ease of application”, “practical solutions”, “group interaction”, “multifaceted perspective” and “active involvement”. The action checklist was useful for facilitating a participatory process among trainees and trainers for improving working conditions. Action checklists showed similar patterns of utility in various Asian countries; particularly when adjusted to local conditions.