Values as Moderators of the Association between Interpersonal-Psychological Constructs and Suicidal Ideation among Veterans

This study examined whether valuing relationships, achievement, and security moderated the association between interpersonal-psychological constructs (Joiner, 2005 Joiner, T. E. Jr. (2005). Why people die by suicide. Cambridge, MA: Harvard University Press.[Crossref] , [Google Scholar]) and suicidal ideation (SI). A total of 122 veterans completed the Interpersonal Needs Questionnaire, Survey of Life Principles, and Beck Scale for Suicide Ideation. Valuing relationships moderated the association between thwarted belongingness and SI. Specifically, thwarted belongingness predicted SI among veterans who reported moderate and high, but not low, levels of valuing relationships. The estimated impact of perceived burdensomeness on SI was stronger at higher levels of valuing relationships, but only approached statistical significance. Valuing achievement and security did not moderate the association between perceived burdensomeness and SI. Future research should continue to examine specific values as they relate to interpersonal-psychological constructs and suicidal behavior.     

Breastfeeding: An overview of oral and general health benefits

Background

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Breastfeeding is the reference against which alternative infant feeding models must be measured with regard to growth, development and other health outcomes. Although not a systematic review, this report provides an update for dental professionals, including an overview of general and oral health–related benefits associated with breastfeeding.Types of Studies ReviewedThe authors examined the literature regarding general health protections that breastfeeding confers to infants and mothers and explored associations between breastfeeding, occlusion in the primary dentition and early childhood caries. To accomplish these goals, they reviewed systematic reviews when available and supplemented them with comparative studies and with statements and reports from major nongovernmental and governmental organizations.ResultsWhen compared with health outcomes among formula-fed children, the health advantages associated with breastfeeding include a lower risk of acute otitis media, gastroenteritis and diarrhea, severe lower respiratory infections, asthma, sudden infant death syndrome, obesity and other childhood diseases and conditions. Evidence also suggests that breastfed children may develop a more favorable occlusion in the primary dentition. The results of a systematic review in which researchers examined the relationship between breastfeeding and early childhood caries were inconclusive.Conclusions and Clinical ImplicationsThe American Academy of Pediatric Dentistry, Chicago, suggests that parents gently clean infants' gums and teeth after breastfeeding. The American Academy of Pediatrics, Elk Grove Village, Ill., recommends that breastfeeding should be exclusive for about the first six months of life and should continue, with the introduction of appropriate complementary foods, to at least age 12 months or beyond, as desired by mother and child. Dentists and staff members can take steps to ensure they are familiar with the evidence and guidelines pertaining to breastfeeding and to oral health. They are encouraged to follow the surgeon general's recommendations to promote and support optimal breastfeeding and oral health practices among their patients.     

β-Cell Lipotoxicity in Response to Free Fatty Acid Elevation in Prepubertal Youth: African American Versus Caucasian Contrast

Prepubertal African American (AA) youth compared with their Caucasian (C) peers have higher insulin secretion, which correlates positively with free fatty acid (FFA) concentration. In our continued efforts to explain the racial disparity in insulinemia, and because FFAs modulate insulin secretion, we hypothesized that AA youth would have a greater response to FFA-induced β-cell insulin secretion than C youth. We compared the short-term effects of FFA elevation on fasting and glucose-stimulated C-peptide–modeled insulin secretion in prepubertal normal-weight AA versus C peers during a 2-h hyperglycemic clamp (12.5 mmol/L) on two occasions: 1) infusion of normal saline and 2) infusion of 20% intralipid (IL). During IL infusion, insulin sensitivity (IS) declined comparably in AA and C youth. Glucose sensitivity of first- and second-phase insulin secretion showed a significant condition × race interaction being higher in AA youth. Disposition index, β-cell function relative to IS, declined with IL infusion in AA and C youth, with a significantly greater decrease in Cs compared with AAs. In conclusion, AA and C prepubertal youth both demonstrated a decline in β-cell function relative to IS during IL infusion, indicative of acute lipotoxicity. The greater decline in C youth compared with AAs may suggest that C youth are more susceptible to β-cell lipotoxicity than AA youth, or alternatively, that AA youth are hypersensitive to FFA stimulation of β-cell insulin secretion, consistent with our theory.Short-term exposure to elevated free fatty acid (FFA) concentrations has a stimulatory effect on β-cell function in in vitro and in vivo animal and human studies (1–8). On the other hand, chronic exposure to sustained elevations in FFAs has been shown to decrease insulin secretion and result in β-cell lipotoxicity in in vitro rat and human islet experiments (4,9,10) and in vivo human experiments (1,5,7,11,12).We previously found that prepubertal African American (AA) youth have higher insulin secretion and an upregulated β-cell function relative to insulin sensitivity (IS) compared with their Caucasian (C) peers (13). The hyperinsulinemic response in AA youth appears to be greater than the compensatory response to their lower IS, because the disposition index (DI), which is insulin secretion relative to IS, was ∼75% higher in AA than in C youth (13). Furthermore, first- and second-phase insulin concentrations during the hyperglycemic clamp correlated positively and significantly with fasting FFA levels in AAs but not Cs, despite similar plasma FFA concentrations (13). We therefore hypothesized that the higher insulin secretion in AA prepubertal youth could be driven by a greater sensitivity to the stimulatory effects of FFA on insulin secretion and β-cell function. Thus, in the present investigation we examined the effects of FFA elevation on glucose-stimulated insulin secretion in AA and C prepubertal normal-weight children, expecting to observe a heightened response in AA children.     

TSG-6 Produced by hMSCs Delays the Onset of Autoimmune Diabetes by Suppressing Th1 Development and Enhancing Tolerogenicity

Genetic and immunological screening for type 1 diabetes has led to the possibility of preventing disease in susceptible individuals. Here, we show that human mesenchymal stem/stromal cells (hMSCs) and tumor necrosis factor-α–stimulated gene 6 (TSG-6), a protein produced by hMSCs in response to signals from injured tissues, delayed the onset of spontaneous autoimmune diabetes in NOD mice by inhibiting insulitis and augmenting regulatory T cells (Tregs) within the pancreas. Importantly, hMSCs with a knockdown of tsg-6 were ineffective at delaying insulitis and the onset of diabetes in mice. TSG-6 inhibited the activation of both T cells and antigen-presenting cells (APCs) in a CD44-dependent manner. Moreover, multiple treatments of TSG-6 rendered APCs more tolerogenic, capable of enhancing Treg generation and delaying diabetes in an adoptive transfer model. Therefore, these results could provide the basis for a novel therapy for the prevention of type 1 diabetes.Recent advances in the use of genetic and immunological screening for identification of prediabetic patients (1–3) have opened up the opportunity to prevent, delay, or halt disease progression before the diagnosis of diabetes. Based on the success in animal models (4–6), clinical trials of oral or nasal insulin (7,8) and nicotinamide (9,10) have been conducted in humans to prevent type 1 diabetes. However, despite all efforts, these clinical trials have failed to show any improvement in the prevention of type 1 diabetes.Recently, we found that intravenously administered human mesenchymal stem/stromal cells (hMSCs) were activated to express the anti-inflammatory protein tumor necrosis factor (TNF)-α–stimulated gene 6 (TSG-6), which reduced excessive inflammatory response in the myocardial-infarcted heart in mice (11), chemically and mechanically injured cornea in rodent models (12,13), and zymosan-induced peritonitis in mice (14). Specifically, our recent observation revealed that TSG-6 attenuated zymosan-induced mouse peritonitis by decreasing TLR2-mediated NF-κB signaling in resident macrophages (14). This suppressive effect of TSG-6 on NF-κB signaling could provide the rationale for TSG-6 as a potential therapy for the prevention of type 1 diabetes, since several studies have already shown that inflammation and the innate immune system contribute to induction, amplification, and maintenance of the immune cell infiltrate as well as β-cell destruction during this preclinical period (15–17). Particularly, antigen-presenting cells (APCs) from NOD mice, mainly dendritic cells (DCs) and macrophages, have been shown to secrete substantially elevated levels of interleukin-12 (IL-12) and TNF-α (18,19) due to NF-κB hyperactivity (18,20), which leads to T-helper 1 (Th1) development and overt diabetes (21).Here, we tested whether a new treatment for the prevention of type 1 diabetes could be developed using TSG-6, which hMSCs produce in response to signals from injured tissues. Our data showed that systemic administration of hMSCs to prediabetic mice delayed the onset of type 1 diabetes in NOD mice in part by secreting TSG-6.