Can skin cancer prevention and early detection be improved via mobile phone text messaging? A randomised,attention control trial

ObjectiveTo test the impact of a theory-based, SMS (text message)-delivered behavioural intervention (Healthy Text) targeting sun protection or skin self-examination behaviours compared to attention control.MethodOverall, 546 participants aged 18–42 years were randomised using a computer-generated number list to the skin self-examination (N = 176), sun protection (N = 187), or attention control (N = 183) text messages group. Each group received 21 text messages about their assigned topic over 12 months (12 weekly messages for 3 months, then monthly messages for the next 9 months). Data were collected via telephone survey at baseline, 3, and 12 months across Queensland from January 2012 to August 2013.ResultsOne year after baseline, the sun protection (mean change 0.12; P = 0.030) and skin self-examination groups (mean change 0.12; P = 0.035) had significantly greater improvement in their sun protection habits (SPH) index compared to the attention control group (reference mean change 0.02). The increase in the proportion of participants who reported any skin self-examination from baseline to 12 months was significantly greater in the skin self-examination intervention group (103/163; 63%; P < 0.001) than the sun protection (83/173; 48%) or attention control (65/165; 36%) groups. There was no significant effect of the intervention for participants' self-reported whole-body skin self-examination, sun tanning, or sunburn behaviours.ConclusionThe Healthy Text intervention was effective in inducing significant improvements in sun protection and any type of skin self-examination behaviours.Trial registrationThe Australian and New Zealand Clinical Trials register (ACTRN12612000577819).FundingCancer Australia 1011999.     

The smoking ban next door: Do hospitality businesses in border areas have reduced sales after a statewide smoke-free policy?

IntroductionDespite numerous studies demonstrating no significant economic effects on hospitality businesses following a statewide smoke-free (SF) policy, regional concerns suggest that areas near states without SF policies may experience a loss of hospitality sales across the border. The present study evaluated the impact of Ohio's statewide SF policy on taxable restaurant and bar sales in border and non-border areas.MethodsSpline regression analysis was used to assess changes in monthly taxable sales at the county level in full-service restaurants and bars in Ohio. Data were analyzed from four years prior to policy implementation to three years post-policy. Change in the differences in the slope of taxable sales for border (n = 21) and non-border (n = 67) counties were evaluated for changes following the statewide SF policy enforcement, adjusted for unemployment rates, general trends in the hospitality sector, and seasonality.ResultsAfter adjusting for covariates, there was no statistically significant change in the difference in slope for taxable sales for either restaurants (β = 0.9, p = 0.09) or bars (β = 0.2, p = 0.07) following the SF policy for border areas compared to non-border areas of Ohio.ConclusionsBorder regions in Ohio did not experience a significant change in bar and restaurant sales compared to non-border areas following a statewide SF policy. Results support that Ohio's statewide SF policy did not impact these two areas differently, and provide additional evidence for the continued use of SF policies to provide protection from exposure to secondhand smoke for both workers and the general public.     

RICH2 is implicated in viraemic control of HIV-1 in black South African individuals

An intronic single nucleotide polymorphism (SNP) in RICH2 (rs2072255; 255ⁱ), in complete linkage disequilibrium (LD) with an exonic SNP (rs2072254; 254^e), has been identified in a genome wide association study to be associated with progression to AIDS in Caucasian individuals. RICH2 links tetherin to the cortical actin network and the RICH2/tetherin interaction has been shown to be important for the downstream activation of NF-κβ and the consequential promotion of proinflammatory responses. We investigated the role of these two SNPs in natural control of HIV-1 in black South Africans including healthy controls (HCs; N = 102) and antiretroviral-naive HIV-1-infected controllers (HICs; N = 52) and progressors (N = 74). HICs were stratified as elite controllers (ECs; N = 11), viraemic controllers (VCs; N = 30), high viral load (VL) long term non-progressors (HVL LTNPs; N = 11) and also according to VL < 400 RNA copies/ml (HICs VL < 400; N = 20) and VL > 400 RNA copies/ml (HICs VL > 400; N = 32). Results showed that in contrast to Caucasians who had very strong LD between these SNPs (r² = 0.97), black populations exhibited low LD (r² = 0.11–0.27), however a 254^e minor allele was always present with a 255ⁱ minor allele but not vice versa. The SNPs did not show significant over- or underrepresentation in any particular group, however the combination of 254^e major allele homozygosity and 255ⁱ heterozygosity (254^eAA/255ⁱGA) was underrepresented in HICs (OR = 3.26; P = 0.04) and VCs (OR = 7.77; P = 0.02) compared to HCs, and in HICs VL > 400 compared to both HCs (P = 0.002) and progressors (P = 0.02). A lower CD4⁺ T-cell count was associated with 254^eAA/255ⁱGA and 255ⁱ (GA + AA) in the total HIV-1-infected group (P = 0.043) and progressors (P = 0.017), respectively. In silico analysis predicted loss of an exonic splice enhancer site with the 254^e-G allele. We postulate that altered splicing of RICH2 will affect levels of RICH2 expression and consequently NF-κβ activation. These findings point to a role for RICH2 and tetherin in viraemic natural control of HIV-1.     

Implementing classroom physical activity breaks: Associations with student physical activity and classroom behavior

ObjectiveTo investigate the relation of classroom physical activity breaks to students' physical activity and classroom behavior.MethodsSix elementary-school districts in California implemented classroom physical activity interventions in 2013–2014. Students' (N = 1322) accelerometer-measured moderate-to-vigorous physical activity (MVPA) during school and teachers' (N = 397) reports of implementation and classroom behavior were assessed in 24 schools at two time points (both post-intervention). Mixed-effects models accounted for nested data.ResultsMinutes/day of activity breaks was positively associated with students' MVPA (βs = .07–.14; ps = .012–.016). Students in classrooms with activity breaks were more likely to obtain 30 min/day of MVPA during school (OR = 1.75; p = .002). Implementation was negatively associated with students having a lack of effort in class (β = − .17; p = .042), and student MVPA was negatively associated with students being off task or inattentive in the classroom (β = − .17; p = .042). Students provided with 3–4 physical activity opportunities (classroom breaks, recess, PE, dedicated PE teacher) had ≈ 5 more min/day of school MVPA than students with no opportunities (B = 1.53 min/opportunity; p = .002).ConclusionsImplementing classroom physical activity breaks can improve student physical activity during school and behavior in the classroom. Comprehensive school physical activity programs that include classroom-based activity are likely needed to meet the 30 min/day school physical activity guideline.     

Participant-level meta-analysis of mobile phone-based interventions for smoking cessation across different countries

With meta-analysis, participant-level data from five text messaging-based smoking cessation intervention studies were pooled to investigate cessation patterns across studies and participants. Individual participant data (N = 8315) collected in New Zealand (2001–2003; n = 1705), U.K. (2008–2009; n = 5792), U.S. (2012; n = 503; n = 164) and Turkey (2012; n = 151) were collectively analyzed in 2014. The primary outcome was self-reported 7-day continuous abstinence at 4 weeks post-quit day. Secondary outcomes were: (1) self-reported 7-day continuous abstinence at 3 months and (2) self-reported continuous abstinence at 6 months post-quit day. Generalized linear mixed models were fit to estimate the overall treatment effect, while accounting for clustering within individual studies. Estimates were adjusted for age, sex, socioeconomic status, previous quit attempts, and baseline Fagerstrom score. Analyses were intention to treat. Participants lost to follow-up were treated as smokers. Twenty-nine percent of intervention participants and 12% of control participants quit smoking at 4 weeks (adjusted odds ratio [aOR] = 2.89, 95% CI [2.57, 3.26], p < .0001). An attenuated but significant effect for cessation for those in the intervention versus control groups was observed at 3 months (aOR = 1.88, 95% CI [1.53, 2.31]) and 6 months (aOR = 2.24, 95% CI [1.90, 2.64]). Subgroup analyses were conducted but few significant findings were noted. Text messaging-based smoking cessation programs increase self-reported quitting rates across a diversity of countries and cultures. Efforts to expand these low-cost and scalable programs, along with ongoing evaluation, appear warranted.     

Perceived effectiveness of HPV test as a primary screening modality among US providers

BackgroundThe human papillomavirus (HPV) test, administered alone without the Papanicolaou (Pap) test, was recently recognized as a cervical cancer screening option in the United States by the Society of Gynecologic Oncology and the American Society for Colposcopy and Cervical Pathology, and the Food and Drug Administration has approved an HPV test for primary screening.MethodsSurveys of US internists, family practitioners, nurse practitioners, and obstetrician–gynecologists were conducted in 2009 and 2012 to investigate providers' perceptions of the effectiveness of the HPV test administered alone as a population-based screening modality (2009: N = 1040, 141–494 per provider group; 2012: N = 1039, 155–435 per provider group).ResultsThe majority in each provider group agreed that the HPV test administered alone is an effective screening modality in 2009 (75.3%–86.1%) and 2012 (79.5%–91.8%), and agreement rose significantly during this time period among family practitioners (χ² = 15.26, df = 1, p < 0.001) and nurse practitioners (χ² = 4.53, df = 1, p = 0.033).ConclusionsAgreement that the HPV test administered alone is an effective cervical cancer screening modality was widespread among providers in both 2009 and 2012, however implementation of guidelines for screening with the HPV test may be influenced by many other factors including reimbursement and patient preferences.     

Estimating the daily intake of essential and nonessential elements from lamb m. longissimus thoracis et lumborum consumed by the population in Missouri (United States)

This paper estimated the daily intake of essential and nonessential elements from lamb muscle longissimus thoracis et lumborum (m. LTL) available to the population in Missouri. Missouri grain-finished (n = 36), Missouri grass-finished (n = 40) and imported New Zealand grass-finished (n = 40) lamb m. LTL were purchased and assayed for their element composition. Total mercury in samples was quantified by atomic absorption spectrometry and other elements were analyzed by inductively coupled plasma-optical emission spectrometry. Analysis of certified reference materials (DORM-2 and TORT-2) gave recovery rates ranging from 86 to 108% and 85 to 104%, respectively. The abundance of essential elements in Missouri grain-finished and Missouri grass-finished lamb m. LTL followed the order: Potassium > phosphorus > sodium > magnesium > calcium > zinc > iron. The order in the imported New Zealand grass-finished group was: Potassium > phosphorus > sodium > calcium > magnesium > zinc > iron. Since many variables lacked normality, non-parametric (Kruskal–Wallis) comparison test was performed and the results suggested no significant difference (P > 0.05) in element composition among the lamb m. LTL groups. The estimated daily intake of 14 elements from consumption of 100 g lamb m. LTL posed no hazard to consumers.     

The −2518 bp promoter polymorphism at CCL2/MCP1 influences susceptibility to mucosal but not localized cutaneous leishmaniasis in Brazil

Mucosal leishmaniasis (ML) follows localized cutaneous leishmaniasis (CL) caused by Leishmania braziliensis. Proinflammatory responses mediate CL self-healing but are exaggerated in ML. Proinflammatory monocyte chemoattractant protein 1 (MCP-1; encoded by CCL2) is associated with CL. We explore its role in CL/ML through analysis of the regulatory CCL2 ?2518 bp promoter polymorphism in CL/ML population samples and families from Brazil. Genotype frequencies were compared among ML/CL cases and control groups using logistic regression and the family-based association test (FBAT). MCP-1 was measured in plasma and macrophages. The GG recessive genotype at CCL2 ?2518 bp was more common in patients with ML (N = 67) than in neighborhood control (NC; N = 60) subjects (OR 1.78; 95% CI 1.01–3.14; P = 0.045), than in NC combined with leishmanin skin-test positive (N = 60) controls (OR 4.40; 95% CI 1.42–13.65; P = 0.010), and than in controls combined with CL (N = 60) patients (OR 2.78; 95% CI 1.13–6.85; P = 0.045). No associations were observed for CL compared to any groups. FBAT (91 ML and 223 CL cases in families) confirmed recessive association of ML with allele G (Z = 2.679; P = 0.007). Higher levels of MCP-1 occurred in plasma (P = 0.03) and macrophages (P < 0.0001) from GG compared to AA individuals. These results suggest that high MCP-1 increases risk of ML.     

Resilience Scale-25 Spanish version: Validation and assessment in eating disorders

ObjectivesTo validate into Spanish the Wagnild and Young Resilience Scale — 25 (RS-25), assess and compare the scores on the scale among women from the general population, eating disorder (ED) patients and recovered ED patients.MethodThis is a cross-sectional study. ED participants were invited to participate by their respective therapists. The sample from the general population was gathered via an open online survey. Participants (N general population = 279; N ED patients = 124; and N recovered ED patients = 45) completed the RS-25, the World Health Organization Quality of Life Scale-BREF and the Hospital Anxiety and Depression Scale. Mean age of participants ranged from 28.87 to 30.42 years old. Statistical analysis included a multi-group confirmatory factor analysis and ANOVA.ResultsThe two-factor model of the RS-25 produced excellent fit indexes. Measurement invariance across samples was generally supported. The ANOVA found statistically significant differences in the RS-25 mean scores between the ED patients (Mean = 103.13, SD = 31.32) and the recovered ED participants (Mean = 138.42, SD = 22.26) and between the ED patients and the general population participants (Mean = 136.63, SD = 19.56).DiscussionThe Spanish version of the RS-25 is a psychometrically sound measurement tool in samples of ED patients. Resilience is lower in people diagnosed with ED than in recovered individuals and the general population.     

Association between Florida's smoke-free policy and acute myocardial infarction by race: A time series analysis, 2000–2013

IntroductionRacial disparities in acute myocardial infarctions (AMIs) are increasing over time. Previous studies have shown that the implementation of smoke-free policies is associated with reduced AMI rates. The objective of this study was to determine the association between smoke-free policy and AMI hospitalization rates and smoking by race.MethodsHealthcare Cost and Utilization Project data from Florida from 2000–2013 were analyzed using interrupted time series analysis to determine the relationship between Florida's smoke-free restaurant and workplace laws and AMI among the total adult population (aged ≥ 18 years), by age, race, and gender. Behavioral Risk Factor Surveillance System data from Florida from 2000 to 2010 were analyzed using logistic regression to determine the association between policy and the adult smoking prevalence.ResultsAfter implementation of the smoke-free policy, no statistically significant associations between AMI hospitalization rates or smoking prevalence were detected in the total population. In the subgroup analysis, the policy was associated with declines in AMI hospitalization rates among non-Hispanic white adults aged 18–44 years (β = − 0.001 per 10,000, p-value = 0.0083). No other relationships with AMI hospitalization rates and smoking prevalence were found in the subgroup analysis.ConclusionsMore comprehensive smoke-free and tobacco control policies are needed to further reduce AMI hospitalization rates, particularly among minority populations. Further research is needed to understand and address how the implementation of smoke-free policies affects secondhand smoke exposure among racial and ethnic minorities.     

Reduction in emergency department visits for children's asthma,ear infections,and respiratory infections after the introduction of state smoke-free legislation

Despite the benefits of smoke-free legislation on adult health, little is known about its impact on children's health. We examined the effects of tobacco control policies on the rate of emergency department (ED) visits for childhood asthma (N = 128,807), ear infections (N = 288,697), and respiratory infections (N = 410,686) using outpatient ED visit data in Massachusetts (2001 − 2010), New Hampshire (2001–2009), and Vermont (2002 − 2010). We used negative binomial regression models to analyze the effect of state and local smoke-free legislation on ED visits for each health condition, controlling for cigarette taxes and health care reform legislation. We found no changes in the overall rate of ED visits for asthma, ear infections, and upper respiratory infections after the implementation of state or local smoke-free legislation or cigarette tax increases. However, an interaction with children's age revealed that among 10–17-year-olds state smoke-free legislation was associated with a 12% reduction in ED visits for asthma (adjusted incidence rate ratios (aIRR) 0.88; 95% CI 0.83, 0.95), an 8% reduction for ear infections (0.92; 0.88, 0.97), and a 9% reduction for upper respiratory infections (0.91; 0.87, 0.95). We found an overall 8% reduction in ED visits for lower respiratory infections after the implementation of state smoke-free legislation (0.92; 0.87, 0.96). The implementation of health care reform in Massachusetts was also associated with a 6–9% reduction in all children's ED visits for ear and upper respiratory infections. Our results suggest that state smoke-free legislation and health care reform may be effective interventions to improve children's health by reducing ED visits for asthma, ear infections, and respiratory infections.     

Sex differences in the association between dietary restraint,insulin resistance and obesity

Background & aimsRestrained food consumption may alter metabolic function and contribute to eventual weight gain; however, sex differences in these relationships have not been assessed. The objective of this study was to examine the relationship between restrained eating and insulin resistance and the influence of body mass index and sex on this relationship in a large community sample of both men and women. We hypothesized that restrained eating would be related to insulin resistance and this relationship would be influenced by sex and body mass index.MethodsIn this cross-sectional, observational study, we studied 487 individuals from the community (men N = 222, women N = 265), who ranged from lean (body mass index 18.5–24.9 kg/m², N = 173), overweight (body mass index 25–29.9 kg/m², N = 159) to obese (body mass index > 30 kg/m², N = 155) weight categories. We assessed restrained eating using the Dutch Eating Behavior Questionnaire and obtained fasting morning plasma insulin and glucose on all subjects.ResultsIn men, but not in women, restrained eating was related to homeostatic model assessment of insulin resistance (HOMA-IR) (p < 0.0001). Furthermore, HOMA-IR was significantly higher in men who were high- versus low-restrained eaters (p = 0.0006).ConclusionsThis study is the first to report sex differences with regard to the relationship between restrained eating and insulin resistance. Our results suggest that high restrained eating is associated with insulin resistance in men but not in women.     

Occupational exposure to particulate matter from three agricultural crops in California

Agricultural work is a major contributor to California's and the nation's economy and employs a large number of workers. However, agricultural work can have numerous risks, such as exposure to elevated levels of particulate matter (PM) and other airborne pollutants with potential adverse health effects. To determine the magnitude of occupational exposures, PM levels were assessed for 89 workers from three major crops in California; almonds, melons and tomatoes. Personal samples were collected for PM_2.5 and inhalable PM using personal sampling equipment. Geometric mean concentrations from personal exposure for workers in almonds (inhalable PM = 4368 μg/m³, PM_2.5 = 122 μg/m³, N = 5), tomatoes (inhalable PM = 1410 μg/m³, PM_2.5 = 12 μg/m³, N = 33), and melons (inhalable PM = 1118 μg/m³, PM_2.5 = 19 μg/m³, N = 51) showed high PM exposure when working with these three crops. Large exposure differences by crop were more common than by task (i.e. harvesting, packing and weeding) among the three crops studied. This is the largest study of agricultural workers engaged in hand harvesting, a significant employer of farm labor, and relatively high levels of exposure to PM were measured.     

A Phase 1 clinical trial of a DNA vaccine for Venezuelan equine encephalitis delivered by intramuscular or intradermal electroporation

Venezuelan equine encephalitis virus (VEEV), a mosquito-borne alphavirus, causes periodic epizootics in equines and is a recognized biological defense threat for humans. There are currently no FDA-licensed vaccines against VEEV. We developed a candidate DNA vaccine expressing the E3-E2-6K-E1 genes of VEEV (pWRG/VEE) and performed a Phase 1 clinical study to assess the vaccine's safety, reactogenicity, tolerability, and immunogenicity when administered by intramuscular (IM) or intradermal (ID) electroporation (EP) using the Ichor Medical Systems TriGrid™ Delivery System. Subjects in IM-EP groups received 0.5 mg (N = 8) or 2.0 mg (N = 9) of pWRG/VEE or a saline placebo (N = 4) in a 1.0 ml injection. Subjects in ID-EP groups received 0.08 mg (N = 8) or 0.3 mg (N = 8) of DNA or a saline placebo (N = 4) in a 0.15 ml injection. Subjects were monitored for a total period of 360 days. No vaccine- or device-related serious adverse events were reported. Based on the results of a subject questionnaire, the IM- and ID-EP procedures were both considered to be generally acceptable for prophylactic vaccine administration, with the acute tolerability of ID EP delivery judged to be greater than that of IM-EP delivery. All subjects (100%) in the high and low dose IM-EP groups developed detectable VEEV-neutralizing antibodies after two or three administrations of pWRG/VEE, respectively. VEEV-neutralizing antibody responses were detected in seven of eight subjects (87.5%) in the high dose and five of eight subjects (62.5%) in the low dose ID-EP groups after three vaccine administrations. There was a correlation between the DNA dose and the magnitude of the resulting VEEV-neutralizing antibody responses for both IM and ID EP delivery. These results indicate that pWRG/VEE delivered by either IM- or ID-EP is safe, tolerable, and immunogenic in humans at the evaluated dose levels.Clinicaltrials.gov registry number NCT01984983.     

Mucoviscous characteristics of Klebsiella pneumoniae strains: A factor of clinical severity?

IntroductionHypermucoviscous Klebsiella pneumoniae (KP) strains are responsible for complicated bacteremia with multiple septic sites (liver, central nervous system, muscles). We aimed to compare the clinical severity of patients presenting with KP bacteremia based on the hypermucoviscous or non-hypermucoviscous characteristic of the strains.MethodsObservational retrospective study successively including all patients with KP bacteremia from May 2013 to March 2015 at the tertiary medical center of New Caledonia. The hypermucoviscous characteristic was defined by the string test results and molecular analysis to determine the capsular serotype.ResultsA total of 55 bacteremic patients were included in the study; 27% of isolated strains were hypermucoviscous. Hypermucoviscous strains accounted for two-thirds of community-acquired infections (72.5% vs. 33.4%, p = 0.01). The rate of intensive care hospitalization was high (hypermucoviscous 46.7%; standard 52.5%) without any difference between the two groups. No significant difference was observed in case fatality (hypermucoviscous 46.7% vs. standard 15%, p = 0.07) but patients with hypermucoviscous strains had longer hospital stays (73.5 days versus 50.7 days, p = 0.04) and longer persistence of positive blood cultures despite an appropriate treatment (OR 1.41, 95% CI: 1.0–1.96, p = 0.045).ConclusionHypermucoviscous KP bacteremia account for most community-acquired Klebsiella infections in New Caledonia and are associated with longer hospital stay and persistence of positive blood cultures despite the implementation of an appropriate treatment.     

Correlates of Early versus Later Initiation into Sex Work in Two Mexico–U.S. Border Cities

PurposeTo examine correlates of early initiation into sex work in two Mexico–U.S. border cities.MethodsFemale sex workers (FSWs) ≥18 years without known HIV infection living in Tijuana and Ciudad Juarez who had recent unprotected sex with clients underwent baseline interviews. Correlates of initiation into sex work before age 18 were identified with logistic regression.ResultsOf 920 FSWs interviewed in Tijuana (N = 474) and Ciudad Juarez (N = 446), 9.8% (N = 90) were early initiators (<18 years) into sex work. Median age of entry into sex work was 26 years (range: 6–58). After adjusting for age, compared to older initiators, early initiators were more likely to use inhalants (21.1% vs. 9.6%, p = .002), initiate sex work to pay for alcohol (36.7% vs. 18.4%, p < .001), report abuse as a child (42.2% vs. 18.7%, p < .0001), and they were less likely to be migrants (47.8% vs. 62.3%, p = .02). Factors independently associated with early initiation included inhalant use (adjOR = 2.39), initiating sex work to pay for alcohol (adjOR = 1.88) and history of child abuse (adjOR = 2.92). Factors associated with later initiation included less education (adjOR = 0.43 per 5-year increase), migration (adjOR = 0.47), and initiating sex work for better pay (adjOR = 0.44) or to support children (adjOR = 0.03).ConclusionsDifferent pathways for entering sex work are apparent among younger versus older females in the Mexico–U.S. border region. Among girls, interventions are needed to prevent inhalant use and child abuse and to offer coping skills; among older initiators, income-generating strategies, childcare, and services for migrants may help to delay or prevent entry into sex work.     

PK/PD targets of amikacin and gentamicin in ICU patients

ObjectivesWe aimed to evaluate the probability to achieve PK-PD targets in patients with sepsis hospitalized in the intensive care unit (ICU) after a single dose of 30 mg/kg of amikacin or 8 mg/kg of gentamicin.Patients and methodsThis single-center prospective study included 138 ICU patients with severe sepsis or septic shock with an indication for intravenous amikacin (N = 89) or gentamicin (N = 49). Maximum concentration (C_max) was measured 30 minutes after infusion completion. PK/PD objectives were respectively C_max ≥ 60 mg/L and ≥ 30 mg/L for amikacin and gentamicin for empirical therapy, and a C_max/MIC ratio ≥ 8, as per French guidelines.ResultsThe median Simplified Acute Physiology Score II was 43 and ICU case fatality rate was 34.8%. A causative bacterial agent was identified in 94 patients (68.1%). Three pathogens had acquired aminoglycoside resistance and 15 were naturally resistant. The targeted C_max for the first dose was achieved in 53 patients (59.6%) receiving amikacin, and one (2.2%) patient receiving gentamicin. C_max/MIC ratio ≥ 8 was obtained in all patients infected with susceptible pathogens (N = 72). Factors associated with C_max ≥ 60 mg/L of amikacin in multivariate analysis were dose per kg of adapted body weight (OR = 1.39, P < 0.001) and renal clearance estimated with CKD-EPI formula (OR = 0.98, P = 0.003).ConclusionsDespite high doses, amikacin and gentamicin first C_max remain dramatically low in ICU patients. However, an adequate C_max/MIC ratio was reached in all patients.     

Mode-specific physical activity and leukocyte telomere length among U.S. adults: Implications of running on cellular aging

BackgroundPrevious research demonstrates that physical activity participation is associated with longer leukocyte telomere length, with shorter leukocyte telomere length being a hallmark characteristic of cellular aging. What remains under-investigated, however, is whether there is a mode-specific association of physical activity on leukocyte telomere length, which was this study's purpose.MethodsData from the 1999–2002 National Health and Nutrition Examination Survey were used (N = 6474 adults analyzed). Leukocyte telomere length was assessed using quantitative polymerase chain reaction. Physical activity was assessed via self-report, with participants classified as meeting physical activity guidelines (≥ 2000 metabolic equivalent of task-min-month) for 9 separate physical activities, including aerobics (unweighted percent meeting guidelines: 2.98%; n = 193), basketball (2.0%; n = 129), bicycling (3.71%; n = 240), dance (2.30%; n = 149), running (3.09%; n = 200), stair climbing (1.33%, n = 86), swimming (1.85%, n = 120), walking (13.53%; n = 876), and weight lifting (2.61%; n = 169).ResultsIn a single multivariable linear regression model including the independent variables of age, gender, race-ethnicity, weight status, total cholesterol, C-reactive protein, total metabolic equivalent of task-min-month of physical activity and the 9 binary meeting physical activity guideline variables, the only mode of physical activity that was significantly associated with leukocyte telomere length was meeting physical activity guidelines from running (β = 0.06; 95% CI: 0.01–0.11; P = 0.03).ConclusionRunning-specific physical activity was the only evaluated physical activity associated with leukocyte telomere length, which may provide one potential mechanism (i.e., leukocyte telomere length) through which running-based physical activity may help to prevent cardiovascular disease and premature mortality.     

Problematic intake of high-sugar/low-fat and high glycemic index foods by bariatric patients is associated with development of post-surgical new onset substance use disorders

Bariatric or weight loss surgery (WLS) patients are overrepresented in substance abuse treatment, constituting about 3% of admissions; about 2/3 of such patients deny problematic substance use prior to WLS. It is important to advance our understanding of the emergence of substance use disorders (SUDs) – particularly the New Onset variant – after WLS. Burgeoning research with both animal models and humans suggests that “food addiction” may play a role in certain forms of obesity, with particular risk conferred by foods high in sugar but low in fat. Therefore, we hypothesized that WLS patients who reported pre-WLS problems with High-Sugar/Low-Fat foods and those high on the glycemic index (GI) would be those most likely to evidence New Onset SUDs after surgery. Secondary data analyses were conducted using a de-identified database from 154 bariatric surgery patients (88% female, M_age = 48.7 yrs, SD = 10.8, M_{time since surgery} = 2.7 yrs, SD = 2.2 yrs). Participants who endorsed pre-surgical problems with High-Sugar/Low-Fat foods and High GI foods were at greater risk for New Onset SUD in the post-surgical period. These findings remained significant after controlling for other predictors of post-surgical SUD. Our findings provide evidence for the possibility of addiction transfer among certain bariatric patients.     

Are secondhand smoke-related diseases of children associated with parental smoking cessation? Determinants of parental smoking cessation in a population-based cohort study

ObjectiveLittle is known about whether secondhand smoke (SHS)-related diseases of young children, such as asthma, induce parental smoking cessation during the early child-rearing period. Our objective was therefore to show the association in addition to other potential determinants of parental cessation.MethodsWe analyzed data from the Longitudinal Survey of Newborns in the 21st Century in Japan, from 0.5 years (N = 47,015) to 4.5 years (N = 39,817), having selected participants whose parents smoked at baseline (maternal smoking N = 8,037; paternal smoking N = 28,486). Multivariable log-binomial regression models were used to calculate the prevalence ratios for parental smoking cessation according to the onset of SHS-related diseases of their children, using inverse probability weight to account for non-response at follow-up.ResultsA total of 16.7% of smoking mothers and 14.5% of smoking fathers had stopped smoking at follow-up. The onset of SHS-related children's diseases was not statistically significantly associated with either maternal or paternal smoking cessation after multivariable adjustments. Strong determinants were, for example, number of cigarettes smoked per day and partner's smoking status during follow-up.ConclusionSHS-related children's diseases were not associated with parental smoking cessation. It may therefore be necessary to provide additional support for parental smoking cessation within their child's medical care setting.