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991.
Background: Chronic low-grade systemic inflammation is a characteristic of obesity that leads to various non-communicable diseases. Weight loss and SCFAs are potential strategies for attenuating obese systemic inflammation. Methods: Blood samples were collected from 43 obese subjects (BMI ≥ 30 kg/m2) scheduled for laparoscopic bariatric sleeve surgery, 26 obese subjects at follow-up 12–18 months post-surgery and 8 healthy weight subjects (BMI 18.5–24.9 kg/m2). Monocytes were isolated from blood and adipose tissue macrophages from visceral adipose tissue of obese subjects only. Isolated cells stimulated with 1 ng/mL LPS and treated simultaneously with 300 mM of sodium acetate or 30 mM of sodium propionate or butyrate and supernatant were harvested after 15 h incubation. TNF-α and IL-6 cytokines were measured via ELISA and mRNA gene expression of FFAR2 and FFAR3, HDAC1, HDAC2 and HDAC9, RELA and NFKB1 and MAPK1 via RT-qPCR. Results: TNF-α and IL-6 production and NFKB1 and RELA mRNA expression were significantly decreased in follow-up subjects compared to baseline. SCFAs significantly reduced TNF-α and IL-6 and altered FFAR and HDAC mRNA expression in monocytes and macrophages from obese subjects. Conclusion: Weight loss and ex vivo SCFA treatments were successful in combatting systemic inflammation in obesity. Results highlighted molecular changes that occur with weight loss and as a result of SCFA treatment.  相似文献   
992.
Routine cervical cancer screening is important for women living with HIV (WLH) due to the greater incidence and persistence of high-risk HPV (HR-HPV) infection. HR-HPV self-sampling has been proposed to overcome barriers to in-office cervical cancer screening in underserved populations. However, little is known about baseline knowledge of HR-HPV and the acceptability of HR-HPV self-sampling among WLH. This paper describes WLH’s experiences and needs regarding cervical cancer screening, specifically HR-HPV self-sampling, and seeks to reconcile their experiences with the views of their providers. In total, 10 providers and 39 WLH participated in semi-structured interviews and group discussions, respectively. Knowledge of cervical cancer and HR-HPV was generally limited among WLH; when present, it was often due to personal experience of or proximity to someone affected by cervical cancer. Most WLH were not familiar with HR-HPV self-sampling but, despite some of the providers’ skepticism, expressed their willingness to participate in a mail-based HR-HPV self-sampling intervention and highlighted convenience, ease of use, and affordability as facilitators to the uptake of HR-HPV self-sampling. The experiences identified can be used to guide patient-centered communication aimed at improving cervical cancer knowledge and to inform interventions, such as HR-HPV self-sampling, designed to increase cervical cancer screening among under-screened WLH.  相似文献   
993.
994.

Background

Many interventions that are delivered within public health services have little evidence of effectiveness. An efficient way to improve the evidence-base of public health interventions is to integrate research into system-wide practice, and to evaluate interventions in partnership with stakeholders and the local community. Evaluation of interventions that are being delivered as a part of usual practice offers valuable opportunities to contribute to the evidence base but also generates challenges. We aimed to develop innovative methods and pragmatic strategies to overcome these challenges and achieve relevant and robust evaluations within a complex and changing system.

Methods

Better Start Bradford is a partnership programme offering multiple public health interventions to young families in Bradford, a deprived and ethnically diverse northern city in the UK. Between Jan 1, 2016, and Dec 31, 2017, we have worked to integrate research and practice across these multiple interventions. We identified challenges and used a codesign approach to develop strategies to overcome them across five core stages: engaging the community and stakeholders; clarifying the design of the intervention; harnessing routinely collected data; monitoring implementation; and evaluating the process and outcomes using innovative methods.

Findings

As a result of our learning we developed comprehensive toolkits: an operational guide through the service design process including templates to ensure that evaluation needs are considered alongside operational plans; an implementation and monitoring guide including methods for selecting progression criteria to monitor performance; and an evaluation framework that incorporates implementation evaluations to enable understanding of intervention performance in practice, and quasi-experimental approaches to infer causal effects in a timely manner. We also offer strategies to harness routinely collected data to enhance the efficiency and affordability of evaluations that are directly relevant to policy and practice.

Interpretation

This framework aims to aid the translation of rigorous research methods into the standard development, monitoring, and evaluation cycles of commissioned health interventions, and to support researchers to evaluate real-life interventions. Registration is required before the tools can be downloaded, thus allowing us to commission an independent evaluation of these tools, planned for 2019.

Funding

Big Lottery Fund (as part of the A Better Start programme), National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care Yorkshire and Humber.  相似文献   
995.
A scale is developed for measuring the overprotecting vs. optimal developmental stimulation tendencies for parents of physically “vulnerable” children. A series of items were administered to parents whose parenting techniques had been rated as either highly overprotective or as optimal by a group of MDs and other professionals. Correlations were estimated between each of the items and parental tendencies as rated by professionals. Twenty-eight items were selected that provided maximum prediction of overprotection. The resulting R2 was extraordinarily high (.94). Coefficient alpha and test-retest coefficients were acceptable. It is hoped that release of the new instrument (VCOPS) at this time will allow others to join in determining the clinical and experimental validity of this scale.  相似文献   
996.
Background: The gut microbiome is important in modulating health in childhood. Metal exposures affect multiple health outcomes, but their ability to modify bacterial communities in children is poorly understood.Objectives: We assessed the associations of childhood and perinatal blood metal levels with childhood gut microbiome diversity, structure, species, gene family-inferred species, and potential pathway alterations.Methods: We assessed the gut microbiome using 16S rRNA gene amplicon sequencing and shotgun metagenomic sequencing in stools collected from 6- to 7-year-old children participating in the GESTation and Environment (GESTE) cohort study. We assessed blood metal concentrations [cadmium (Cd), manganese (Mn), mercury (Hg), lead (Pb), selenium (Se)] at two time points, namely, perinatal exposures at delivery (N=70) and childhood exposures at the 6- to 7-y follow-up (N=68). We used multiple covariate-adjusted statistical models to determine microbiome associations with continuous blood metal levels, including linear regression (Shannon and Pielou alpha diversity indexes), permutational multivariate analysis of variance (adonis; beta diversity distance matrices), and multivariable association model (MaAsLin2; phylum, family, species, gene family-inferred species, and pathways).Results: Children’s blood Mn and Se significantly associated with microbiome phylum [e.g., Verrucomicrobiota (coef=0.305, q=0.031; coef=0.262, q=0.084, respectively)] and children’s blood Mn significantly associated with family [e.g., Eggerthellaceae (coef=0.228, q=0.052)]-level differences. Higher relative abundance of potential pathogens (e.g., Flavonifractor plautii), beneficial species (e.g., Bifidobacterium longum, Faecalibacterium prausnitzii), and both potentially pathogenic and beneficial species (e.g., Bacteriodes vulgatus, Eubacterium rectale) inferred from gene families were associated with higher childhood or perinatal blood Cd, Hg, and Pb (q<0.1). We found significant negative associations between childhood blood Pb and acetylene degradation pathway abundance (q<0.1). Finally, neither perinatal nor childhood metal concentrations were associated with children’s gut microbial inter- and intrasubject diversity.Discussion: Our findings suggest both long- and short-term associations between metal exposure and the childhood gut microbiome, with stronger associations observed with more recent exposure. Future epidemiologic analyses may elucidate whether the observed changes in the microbiome relate to children’s health. https://doi.org/10.1289/EHP9674  相似文献   
997.
Inborn errors of nucleic acid metabolism often cause aberrant activation of nucleic acid sensing pathways, leading to autoimmune or autoinflammatory diseases. The SKIV2L RNA exosome is cytoplasmic RNA degradation machinery that was thought to be essential for preventing the self-RNA–mediated interferon (IFN) response. Here, we demonstrate the physiological function of SKIV2L in mammals. We found that Skiv2l deficiency in mice disrupted epidermal and T cell homeostasis in a cell-intrinsic manner independently of IFN. Skiv2l-deficient mice developed skin inflammation and hair abnormality, which were also observed in a SKIV2L-deficient patient. Epidermis-specific deletion of Skiv2l caused hyperproliferation of keratinocytes and disrupted epidermal stratification, leading to impaired skin barrier with no appreciable IFN activation. Moreover, Skiv2l-deficient T cells were chronically hyperactivated and these T cells attacked lesional skin as well as hair follicles. Mechanistically, SKIV2L loss activated the mTORC1 pathway in both keratinocytes and T cells. Both systemic and topical rapamycin treatment of Skiv2l-deficient mice ameliorated epidermal hyperplasia and skin inflammation. Together, we demonstrate that mTORC1, a classical nutrient sensor, also senses cytoplasmic RNA quality control failure and drives autoinflammatory disease. We also propose SKIV2L-associated trichohepatoenteric syndrome (THES) as a new mTORopathy for which sirolimus may be a promising therapy.  相似文献   
998.
Hepatocellular carcinoma (HCC) remains an important form of cancer-related morbidity and mortality in the U.S. and worldwide. Previous U.S.-based studies on survival suggest ethnic disparities in HCC patients, but the complex interplay of multiple factors that contribute are still incompletely understood. Here we considered the influences of risk factors contributing towards HCC survival, including ethnic background, over ten years at a premier academic medical center with a majority (57.20%) African American (AA) population. Retrospective HCC data were collected from 2008–2018 at LSUHSC-Shreveport, an urban tertiary medical center. Data included demographics, comorbidities, liver disease characteristics, and tumor parameters. Statistical analysis was performed using Chi Square and one-way ANOVA. Results: 229 HCC patients were identified (male 78.6%). The mean HCC age at diagnosis was 61 years (SD = 7.3). Compared to non-Hispanic Caucasians (42.7%), AA patients (57.2% of total) were older at presentation, had more frequent diabetes/dyslipidemia/NAFLD (45 (34.3%) compared with 19 (19.3%) in non-Hispanic Caucasians, p = 0.02), and had a larger HCC burden at diagnosis. We conclude that compared to white patients, despite having similar BMI and MELD scores and rates of portal vein thrombosis, AA patients with HCC in our cohort were older at presentation, had a significantly increased incidence of modifiable metabolic risk factors including diabetes, higher AFP values, increased incidence of gallstones, and larger sized HCCs, and were more likely to be outside Milan criteria. These findings have important prognostic and diagnostic implications for developing a more targeted HCC surveillance program.  相似文献   
999.
1000.
A novel diamine bis(4-aminophenyl)bis{3,4[(4-(8-quinolyloxymethyl carbonyl)]}methane, containing two long/bulky aromatic pendent chains was synthesized by incorporating aromatic and hetero aromatic groups with flexible linkages. Flexible, stretchable, thermally stable and processable polyimides were prepared by reacting this newly synthesized diamine with commercial tetracarboxylic acid dianhydrides like 3,3′,4,4′-benzophenone tetra carboxylic acid dianhydride (BTDA) and 4,4′-(4,4′-isopropylidenediphenoxy)diphthalic Anhydride (BPADA). Nanocomposites of polyimides were prepared using aromatic amine functionalized silica as a filler by solution casting method. The current work investigates the effects of incorporating long/bulky aromatic side chains and flexible linkages on the thermal, mechanical, electrical and optical properties of the polyimides and nanocomposites. The polyimides showed good thermal stability (T10% = 364 & 388), high flame resistance, low glass transition temperatures (Tg = 130 °C & 156 °C), very low dielectric constants (2.5 & 2.8 at 1 MHz) and good optical transparency. The neat polyimides displayed good elongation at break (133–155%) but possessed low tensile strength. The chemically imidized polyimides showed good solubility in low and high boiling solvents. Nanocomposites of polyimides based on aromatic amine functionalized silica exhibited enhanced properties with T10% values varying between 409–482 °C, Tg between 165–280 °C and higher dielectric constants (3–5.7 at 1 MHz).

Novel polyimides containing two long/bulky aromatic pendent chains and their nanocomposites with aromatic amine functionalized silica were prepared from a new diamine bis(4-aminophenyl)bis{3,4[(4-(8-quinolyloxymethyl carbonyl)phenoxy)]}methane.  相似文献   
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