Community-based physical activity and wheelchair mobility programs for individuals with spinal cord injury in Canada: Current reflections and future directions

Rationale: A clear need has been identified to find strategies and opportunities, beyond services provided during rehabilitation, to enhance community-based mobility and leisure-time physical activity (LTPA) participation among members of the spinal cord injury (SCI) population.

Method: This review of existing mobility and LTPA programs that are available for individuals with SCI in Canada reflects the authors’ current knowledge of existing evidence-based and community-based programs. The authors aim to highlight the gaps between existing programs and future needs.

Results: The major gaps identified in this brief clinical report include the need for: community-based mobility training programs, patient reported outcomes, assessment of long-term impact of programs, identifying the best approaches for program delivery, and developing researcher-stakeholder partnerships.

Conclusion: Evidence-based mobility programs and community-based LTPA do exist, and the available research shows their promise. Despite the growing research for LTPA and mobility programs among adults with SCI, many gaps remain. Additional partnerships, community engagement practices, service program funding and health policy changes are needed to address the highlighted gaps to optimize community-based programs and enhance the lives of adults with SCI.     

IGF‐1 Receptor Expression on Circulating Osteoblast Progenitor Cells Predicts Tissue‐Based Bone Formation Rate and Response to Teriparatide in Premenopausal Women With Idiopathic Osteoporosis

We have previously reported that premenopausal women with idiopathic osteoporosis (IOP) have profound microarchitectural deficiencies and heterogeneous bone remodeling. Those with the lowest bone formation rate have higher baseline serum insulin‐like growth factor‐1 (IGF‐1) levels and less robust response to teriparatide. Because IGF‐1 stimulates bone formation and is critical for teriparatide action on osteoblasts, these findings suggest a state of IGF‐1 resistance in some IOP women. To further investigate the hypothesis that osteoblast and IGF‐1‐related mechanisms mediate differential responsiveness to teriparatide in IOP, we studied circulating osteoblast progenitor (COP) cells and their IGF‐1 receptor (IGF‐1R) expression. In premenopausal women with IOP, peripheral blood mononuclear cells (PBMCs) were obtained at baseline (n = 25) and over 24 months of teriparatide treatment (n = 11). Flow cytometry was used to identify and quantify COPs (non‐hematopoetic lineage cells expressing osteocalcin and RUNX2) and to quantify IGF‐1R expression levels. At baseline, both the percent of PBMCs that were COPs (%COP) and COP cell‐surface IGF‐1R expression correlated directly with several histomorphometric indices of bone formation in tetracycline‐labeled transiliac biopsies. In treated subjects, both %COP and IGF‐1R expression increased promptly after teriparatide, returning toward baseline by 18 months. Although neither baseline %COP nor increase in %COP after 3 months predicted the bone mineral density (BMD) response to teriparatide, the percent increase in IGF‐1R expression on COPs at 3 months correlated directly with the BMD response to teriparatide. Additionally, lower IGF‐1R expression after teriparatide was associated with higher body fat, suggesting links between teriparatide resistance, body composition, and the GH/IGF‐1 axis. In conclusion, these assays may be useful to characterize bone remodeling noninvasively and may serve to predict early response to teriparatide and possibly other bone formation–stimulating medications. These new tools may also have utility in the mechanistic investigation of teriparatide resistance in premenopausal IOP and perhaps in other populations. © 2017 American Society for Bone and Mineral Research.     

Engaging Agribusinesses: Feasibility and Cost of an ATV Safety Poster Project

ABSTRACT

Objectives: All-terrain vehicle (ATV)-related deaths and injuries continue to be a significant problem. Influential change agents such as agribusinesses could be important partners for improving safety behaviors among rural ATV users. Our objective was to determine how effectively an injury prevention project could engage agribusinesses through the postal service and to assess their willingness to display a safety poster. Methods: One thousand two hundred forty-four agribusinesses received an ATV safety poster and a postcard survey by mail. A randomized sampling of these businesses was surveyed by telephone 4–7 weeks later. Telephone survey questions included whether they recalled receiving the poster, and if so, whether, where and how long the poster was displayed. Results: One hundred six postcards were returned. Of the 192 eligible business persons contacted by telephone, 89% agreed to participate. Approximately one-third of telephone survey participants recalled receiving the poster. Among these, 81% with walk-in customers posted it, and 74% still had it displayed 1 month later. Of participants who did not recall receiving the poster, 83% stated they would have displayed the poster. The cost of displaying each poster in a business was 16.6 cents/day during the first month. Final costs/day would be much less because of continued display. Conclusion: A high percentage of agribusinesses displayed or would have displayed an ATV safety poster, and most displayed it beyond 1 month. Unfortunately, participant recruitment via postal delivery alone was challenging. Nevertheless, mass mailing of injury prevention materials to be displayed in the retail setting may be a low cost method for raising safety awareness.     

Organic toxicants and mutagens in ashes from eighteen municipal refuse incinerators

Ashes, obtained from about one-fourth of the operating municipal refuse incinerators in the United States, were analyzed for a range of organic toxicants and mutagens. Thirty percent of the ash samples, which consisted of bottom ash or bottom ash-fly ash mixtures, contained 20–74% organic matter. Thirty percent of the ashes contained direct-acting and/or promutagens which revertedSalmonella typhimurium TA98 or TA100. Sixty percent of the ashes contained more than 5 ng/g of polychlorinated biphenyls. The concentration of tetra- and pentachlorinated biphenyls were higher than the mono-, di-, hepta- and octachlorinated biphenyls. A similar distribution of congeners was seen in polychlorinated dibenzodioxins found in the ashes. The major volatileN-nitroso compounds found in the ashes wereN-nitrosodimethylamine andN-nitrosomorpholine. Other classes of compounds which were found in the ashes included chlorinated benzenes, phthalates, and substituted benzothiophenes.     

Some factors affecting mutant numbers in the Salmonella/microsome assay

Carcinogenesis, 1, 911–923, Number 11 1980 Page 913, Fig. 1 The symbols have been left out of this, Theysould read: 0.25 mM, 0.5 mM, o 1mM NADP (concentration insoft agar).     

Amylase increases energy and nutrient density of Super Cereal Plus porridge as prepared and accepted by Rwandan caregivers

Adding amylase to Super Cereal Plus (SC+A) improves energy and nutrient intake as porridge energy density reaches 1.0 kcal/g, meeting the recommended ≥0.8 kcal/g for prepared foods for young children. Caregiver response to SC+A in terms of adjusting porridge preparation using printed pictogram instructions was not yet investigated. The study assessed (a) porridge preparation by caregivers; (b) porridge energy density; (c) sensory porridge acceptability; and (d) understanding of preparation instructions. An 8‐day follow‐up intervention study was conducted amongst caregivers of children aged 6–23 months (n = 238) in Rwanda. Caregivers prepared porridge using SC+A whilst referring to printed pictogram instructions at the study site on Days 1 and 8 and received flour for preparation at home on Days 2–7. At the site, data were collected on porridge preparation procedures, energy density, consistency, acceptability, and interviews (n = 12), and focus group discussions (n = 6) were conducted. Mean porridge dry matter (DM) increased from 21.3 ± 4.4% (Day 1) to 25.1 ± 4.8% (Day 8; p < 0.0005). Flour and water were mixed before cooking by 95% of the participants, as per printed instructions. Sensory porridge acceptability was high, and the printed instructions enabled caregivers to prepare an accepted and energy dense porridge. The preferred water/flour volume ratio was 2.5 instead of 3. In conclusion, Rwandan caregivers prepared well‐accepted SC+A porridges with a preferred consistency and mean DM content of 25.1% (1.0 kcal/g), after 1 week practicing at home. This supports introducing SC+A with the tested instructions at scale.     

Synthesis of HDAC Inhibitor Libraries via Microscale Workflow

An integrated workflow has been established that enables the synthesis, purification, and subsequent biological testing of compound libraries on a microgram scale. This approach utilizes mass directed preparative HPLC in conjunction with charged aerosol detection (CAD) to generate solutions of investigational compounds at high purity and standardized concentrations, facilitating high fidelity biological testing. This new workflow successfully delivered libraries of histone deacetylase (HDAC) inhibitors that afforded biological data consistent with that obtained from standard scale parallel medicinal chemistry techniques. The advantages of this new approach to library synthesis include greatly reduced material requirements and amenability to high-throughput experimentation.     

Early-stage Triple-negative Breast Cancer: Time to Optimize Personalized Strategies

Triple-negative breast cancer (TNBC) accounts for approximately 15%-20% of breast cancers diagnosed worldwide, which amounts to almost 200 000 cases each year. Although historically TNBC is considered difficult to treat with a poor prognosis, there is emerging evidence showing excellent response rates in a subset of TNBC patients. Attempts to de-escalate chemotherapy in hormone-receptor-positive (HR+) and HER2-neu amplified breast cancer subtypes have been successful. At present, robust strategies to personalize therapy in early-stage TNBC do not exist, and despite excellent response rates in a subset of patients, all patients are exposed to the same several cycles of cytotoxic chemotherapy. Personalizing therapy in TNBC represents a challenge due to the scarcity of treatment options outside of cytotoxic chemotherapy and limited predictive and prognostic biomarkers to tailor treatment. Recent developments in understanding TNBC biology have sparked interest in exploring treatment optimization and personalization with the goal of achieving excellent response rates and long-term clinical outcomes, while simultaneously reducing physical, psychological, and financial toxicities for select patients. Here, we provide an update on the current evidence to support future studies examining de-escalating chemotherapy in patients with low-risk TNBC and adjuvant intensification strategies to improve outcomes for patients who are at high risk for systemic failure despite current standard-of-care treatments.