Publications by authors named "David J Lee"

291 Publications

Pests, diseases, and aridity have shaped the genome of Corymbia citriodora.

Commun Biol 2021 May 10;4(1):537. Epub 2021 May 10.

University of Queensland/QAAFI, Brisbane, QLD, Australia.

Corymbia citriodora is a member of the predominantly Southern Hemisphere Myrtaceae family, which includes the eucalypts (Eucalyptus, Corymbia and Angophora; ~800 species). Corymbia is grown for timber, pulp and paper, and essential oils in Australia, South Africa, Asia, and Brazil, maintaining a high-growth rate under marginal conditions due to drought, poor-quality soil, and biotic stresses. To dissect the genetic basis of these desirable traits, we sequenced and assembled the 408 Mb genome of Corymbia citriodora, anchored into eleven chromosomes. Comparative analysis with Eucalyptus grandis reveals high synteny, although the two diverged approximately 60 million years ago and have different genome sizes (408 vs 641 Mb), with few large intra-chromosomal rearrangements. C. citriodora shares an ancient whole-genome duplication event with E. grandis but has undergone tandem gene family expansions related to terpene biosynthesis, innate pathogen resistance, and leaf wax formation, enabling their successful adaptation to biotic/abiotic stresses and arid conditions of the Australian continent.
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http://dx.doi.org/10.1038/s42003-021-02009-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8110574PMC
May 2021

National Estimates of Prevalence, Time-Trend, and Correlates of Smoking in US People Living with HIV (NHANES 1999-2016).

Nicotine Tob Res 2021 Apr 15. Epub 2021 Apr 15.

Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.

Objective: Approximately one in four deaths among people living with HIV (PLWH) in the United States can be attributed to cigarette smoking. Using a nationally representative sample of PLWH, this study examines the prevalence, time-trends, and correlates of current cigarette smoking among PLWH compared to people without HIV.

Design: Secondary analysis of population-based cross-sectional biobehavioral survey.

Methods: Data were pooled from the 1999-2016 National Health and Nutrition Examination Survey (NHANES). All adults (20-59 years) who self-reported their smoking status and were tested for HIV (HIV+ = 152; HIV- = 26 305) were included in the analysis. Prevalence with 95% confidence interval (95% CI), trend analysis by year and group (HIV+/HIV-), and multivariable logistic regression analyses were performed with the complex survey design adjustments.

Results: Overall, 47.0% of PLWH were current smokers compared to 25.5% of those without HIV. From 1999 to 2016, the decline in smoking in PLWH was comparable to those without HIV (10.7% vs. 8.0%). PLWH smokers were more likely than PLWH nonsmokers to be substance users (adjusted odds ratio [aOR] = 17.52; 95% CI = 2.04 to 27.8). Compared to smokers without HIV, PLWH smokers were more likely to be older (1.10; 1.06 to 1.14), males (7.96; 2.50 to 25.40), non-Hispanic Black (10.45; 4.13 to 26.45), with depression (Patient Health Questionnaire-9 sum score ≥5) (3.79; 1.22 to 11.79), and less likely to be gay (0.02; 0.00 to 0.07).

Conclusion: Cigarette smoking among PLWH is a major public health problem in the United States. Targeted and tailored smoking cessation interventions that incorporate assessment and treatment of depression and co-occurring substance use are critical for PLWH, especially among those who are disproportionately affected by smoking and HIV (sexual minority).

Implications: This study offers important research implications in four areas:1. The decline in smoking among PLWH over 18 years has been modest, and half of PLWH are still smokers.2. More resources and efforts should be allocated to reduce cigarette smoking among PLWH.3. There is a critical need to develop and test culturally tailored smoking cessation interventions for minority subgroups who are most impacted by HIV infection and smoking (non-Hispanic Blacks and men who have sex with men)4. Smoking cessation interventions designed for PLWH should incorporate assessment and treatment of depression and substance use.
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http://dx.doi.org/10.1093/ntr/ntaa277DOI Listing
April 2021

Factors Associated With Self-Perceived Hearing Handicap in Adults From Hispanic/Latino Background: Findings From the Hispanic Community Health Study/Study of Latinos.

Ear Hear 2021 Feb 19. Epub 2021 Feb 19.

Department of Communication Sciences & Disorders, University of South Florida, Tampa, Florida, USA; School of Aging Studies, University of South Florida, Tampa, Florida, USA; Division of Human Communication, Development & Hearing, The University of Manchester, Manchester, UK; University of Miami Health System, Miller School of Medicine, Miami, Florida, USA; Department of Communication Sciences and Disorders, Northwestern University, Chicago, Illinois, USA; National Institute on Deafness and Other Communication Disorders, Bethesda, Maryland, USA.

Objectives: We sought to determine what factors, including acculturation (language and social contact preferences), were associated with self-perceived hearing handicap among adults from Hispanic/Latino background. We utilized the Aday-Andersen behavioral model of health services utilization to frame our hypotheses that predisposing characteristics (age, sex, education, city of residence, Hispanic/Latino background, and acculturation), enabling resources (annual income and current health insurance coverage), and need (measured hearing loss and self-reported hearing loss) would be related to clinically-significant self-perceived hearing handicap as measured by the Hearing Handicap Inventory - Screening (HHI-S) version.

Design: We analyzed baseline data collected from 2008 to 2011 as part of the multisite Hispanic Community Health Study/Study of Latinos. Data were from 6585 adults with hearing loss (defined by a worse-ear 500, 1000, 2000, and 4000 Hz pure-tone average [PTA] of ≥25 dB HL and/or a 4000, 6000, and 8000 Hz high-frequency PTA of ≥25 dB HL) aged 18 to 74 years from various Hispanic/Latino backgrounds. We conducted a series of multivariable logistic regression models examining the roles of independent variables of interest representing predisposing, enabling, and need indicators on the occurrence of clinically-significant self-perceived hearing handicap (e.g., HHI-S score > 8).

Results: Among included participants, 953 (14.5%) had an HHI-S score >8. The final model revealed significant associations between predisposing characteristics, enabling resources, need, and HHI-S outcome. Predisposing characteristics and need factors were associated with higher odds of reporting self-perceived hearing handicap (HHI-S score >8) including acculturation as measured by the Short Acculturation Scale for Hispanics (odds ratio [OR] = 1.28, 95% confidence interval [CI]: 1.09-1.50), female sex (OR = 1.72, 95% CI: 1.27-2.33), and poorer worse ear 500, 1000, 2000, and 4000 Hz PTA (OR = 1.02, 95% CI: 1.01-1.03); suggesting that a 5-decibel increase in a person's PTA was consistent with 10% higher odds of a HHI-S score of >8. Greater enabling resources were associated with lower odds of reporting clinically-significant self-perceived hearing handicap: compared with individuals with income <$10,000/year, the multivariable-adjusted OR among individuals with income $40,000 to $7500/year was 0.55 (95% CI: 0.33-0.89) and among individuals with income >$75,000/year was 0.28 (95% CI: 0.13-0.59]; p-trend < 0.0001).

Conclusions: Our findings suggest there are associations between predisposing, enabling and need variables consistent with the Aday-Andersen model and self-perceived hearing handicap among adults from Hispanic/Latino background. The influence of language and culture on perceived hearing loss and associated handicap is complex, and deserves more attention in future studies. Our findings warrant further investigation into understanding the role of language and language access in hearing health care utilization and outcomes, as the current body of literature is small and shows mixed outcomes.
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http://dx.doi.org/10.1097/AUD.0000000000000995DOI Listing
February 2021

Multimorbidity patterns and their relationship to mortality in the US older adult population.

PLoS One 2021 20;16(1):e0245053. Epub 2021 Jan 20.

Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, United States of America.

Background: Understanding patterns of multimorbidity in the US older adult population and their relationship with mortality is important for reducing healthcare utilization and improving health. Previous investigations measured multimorbidity as counts of conditions rather than specific combination of conditions.

Methods: This cross-sectional study with longitudinal mortality follow-up employed latent class analysis (LCA) to develop clinically meaningful subgroups of participants aged 50 and older with different combinations of 13 chronic conditions from the National Health Interview Survey 2002-2014. Mortality linkage with National Death Index was performed through December 2015 for 166,126 participants. Survival analyses were conducted to assess the relationships between LCA classes and all-cause mortality and cause specific mortalities.

Results: LCA identified five multimorbidity groups with primary characteristics: "healthy" (51.5%), "age-associated chronic conditions" (33.6%), "respiratory conditions" (7.3%), "cognitively impaired" (4.3%) and "complex cardiometabolic" (3.2%). Covariate-adjusted survival analysis indicated "complex cardiometabolic" class had the highest mortality with a Hazard Ratio (HR) of 5.30, 99.5% CI [4.52, 6.22]; followed by "cognitively impaired" class (3.34 [2.93, 3.81]); "respiratory condition" class (2.14 [1.87, 2.46]); and "age-associated chronic conditions" class (1.81 [1.66, 1.98]). Patterns of multimorbidity classes were strongly associated with the primary underlying cause of death. The "cognitively impaired" class reported similar number of conditions compared to the "respiratory condition" class but had significantly higher mortality (3.8 vs 3.7 conditions, HR = 1.56 [1.32, 1.85]).

Conclusion: We demonstrated that LCA method is effective in classifying clinically meaningful multimorbidity subgroup. Specific combinations of conditions including cognitive impairment and depressive symptoms have a substantial detrimental impact on the mortality of older adults. The numbers of chronic conditions experienced by older adults is not always proportional to mortality risk. Our findings provide valuable information for identifying high risk older adults with multimorbidity to facilitate early intervention to treat chronic conditions and reduce mortality.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0245053PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7816983PMC
May 2021

Injectable Polymeric Delivery System for Spatiotemporal and Sequential Release of Therapeutic Proteins To Promote Therapeutic Angiogenesis and Reduce Inflammation.

ACS Biomater Sci Eng 2020 02 24;6(2):1217-1227. Epub 2020 Jan 24.

Department of Bioengineering, University of Colorado Denver|Anschutz Medical Campus, 12800 E. 19th Avenue, Aurora, Colorado 80045, United States.

Myocardial infarction (MI) causes cardiac cell death, induces persistent inflammatory responses, and generates harmful pathological remodeling, which leads to heart failure. Biomedical approaches to restore blood supply to ischemic myocardium, via controlled delivery of angiogenic and immunoregulatory proteins, may present an efficient treatment option for coronary artery disease (CAD). Vascular endothelial growth factor (VEGF) is necessary to initiate neovessel formation, while platelet-derived growth factor (PDGF) is needed later to recruit pericytes, which stabilizes new vessels. Anti-inflammatory cytokines like interleukin-10 (IL-10) can help optimize cardiac repair and limit the damaging effects of inflammation following MI. To meet these angiogenic and anti-inflammatory needs, an injectable polymeric delivery system composed of encapsulating micelle nanoparticles embedded in a sulfonated reverse thermal gel was developed. The sulfonate groups on the thermal gel electrostatically bind to VEGF and IL-10, and their specific binding affinities control their release rates, while PDGF-loaded micelles are embedded in the gel to provide the sequential release of the growth factors. An in vitro release study was performed, which demonstrated the sequential release capabilities of the delivery system. The ability of the delivery system to induce new blood vessel formation was analyzed in vivo using a subcutaneous injection mouse model. Histological assessment was used to quantify blood vessel formation and an inflammatory response, which showed that the polymeric delivery system significantly increased functional and mature vessel formation while reducing inflammation. Overall, the results demonstrate the effective delivery of therapeutic proteins to promote angiogenesis and limit inflammatory responses.
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http://dx.doi.org/10.1021/acsbiomaterials.9b01758DOI Listing
February 2020

Field methods for above and belowground biomass estimation in plantation forests.

MethodsX 2021 19;8:101192. Epub 2020 Dec 19.

Forest Research Institute, University of the Sunshine Coast, Maroochydore Dc, Queensland, Australia.

A practical and cost-effective destructive sampling method for estimating above and belowground biomass of subspecies grown in plantations is described. The methodology includes details on selecting sample trees, weighing tree components in the field, excavating root systems and obtaining fresh weights and laboratory analyses of components to determine oven dry weights. The development of these sampling procedures is a basic step towards successful, consistent collection of biomass data in 18-20 years old plantation forests. This methodology was developed for eucalypt hardwood timber plantations in Queensland, Australia. However, these procedures can be applied to plantations elsewhere as well as to trees in native forest environments with minor modifications. The methodology developed for field sampling of the tree components and the derivation of allometric relationships for predicting individual tree biomass (above and belowground) highlighted the following:•Accurate quantification of above and belowground biomass of eucalypts.•Description of measured variables for developing allometric relationships.•Integration of field and laboratory measurements to streamline data collection.
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http://dx.doi.org/10.1016/j.mex.2020.101192DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7771103PMC
December 2020

Comparing cancer risk estimates using occupational record linkage approaches in male Florida firefighters.

Am J Ind Med 2021 02 1;64(2):78-83. Epub 2020 Dec 1.

Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA.

Background: Firefighters have an increased risk of cancer, but variations in reported results could be due to differences in occupational case ascertainment. This study compares cancer risk estimates generated by identifying firefighters from their occupational title available in the Florida Cancer Data System (FCDS) versus identification by a linkage method between the FCDS and the Florida State Fire Marshal's Office.

Methods: Florida firefighter employment records (1972-2012; n = 109,009) were linked with FCDS data (1981-2014; ~3.3 million records), identifying 3760 primary cancers in male firefighters. Using the FCDS occupational data field we identified 1831 male cancer cases in those classified as firefighters, first-line supervisors of firefighting and prevention workers, fire inspectors, emergency medical technicians, or paramedics. Age and calendar year-adjusted odds ratios (aOR) and 95% confidence intervals for firefighters versus non-firefighters were calculated for both groups.

Results: For skin cancers the risk estimate for FCDS-indentified firefighters was substantially lower than in the employment-record-linked firefighters (aOR = 1.06; 0.87-1.29 vs. 1.54; 1.37-1.73), but for endocrine system cancers it was greater (aOR = 2.36; 1.77-3.14 vs. 2.08; 1.71-2.53). Remaining cancer risk estimates were in the same direction for the two samples except for lymphoma (aOR = 1.10; 0.90-1.34 vs. 0.86; 0.75-0.99).

Conclusion: Reliance on occupational title in cancer registry records to characterize firefighter cancer risk may result in estimates that are over- or underestimated depending on cancer site. The authors recommend moving toward national linkages between cancer registries and certification or other administrative records, which are a vital resource for firefighter cancer research.
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http://dx.doi.org/10.1002/ajim.23205DOI Listing
February 2021

Finding incident cancer cases through outpatient oncology clinic claims data and integration into a state cancer registry.

Cancer Causes Control 2021 Feb 22;32(2):199-202. Epub 2020 Nov 22.

Florida Department of Health, Tallahassee, FL, USA.

Cancer data from population-based cancer registries under-report cancer cases, especially for cancers primarily diagnosed and treated in outpatient clinical settings, away from hospital-based cancer registrars. Previously, we developed alternative methods of cancer case capture including a claims-based method, which identified a large proportion of cancer cases missed by traditional population-based cancer registries. In this study, we adapted a claims-based method for statewide implementation of cancer surveillance in Florida. Between 2010 and 2017 the claims-based method identified 143,083 cancer abstracts, of which 42% were new and 58% were previously registered. The claims-based method led to the creation of 53,419 new cancer cases in the state cancer registry, which made up 9.3% of all cancer cases registered between 2010 and 2017. The types of cancers identified by the claims-based method were typical of the kinds primarily diagnosed and treated in outpatient oncology clinic settings, such as hematological malignancies, prostate cancer, melanoma, breast cancer, and bladder cancer. These cases were added to the Florida cancer registry and may produce an artefactual increase in cancer incidence, which is believed to be closer to the actual burden of cancer in the state.
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http://dx.doi.org/10.1007/s10552-020-01368-zDOI Listing
February 2021

The National Student Neurosurgical Research Conference: A Research Conference for Medical Students.

World Neurosurg 2021 Feb 29;146:e398-e404. Epub 2020 Oct 29.

The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA; The Brown University Department of Neurosurgery, Providence, Rhode Island, USA.

Objective: Medical students interested in neurosurgery are increasingly involved in research, and research conferences have proven valuable for developing medical research experience and exposure. A research conference was designed for medical students interested in neurosurgery to present research.

Methods: Our team designed an annual research conference at the Warren Alpert Medical School of Brown University in conjunction with the Neurosurgery and Neurology Departments. In February 2019, we hosted the first Student Neurosurgical and Neurological Research Conference (SNRC), the first national research conference, to our knowledge, designed for medical students to present neurosurgical research in the United States. The conference consisted of student poster/oral presentations, keynote speeches from clinical faculty, and surgical skills workstations. In February 2020, we hosted the second SNRC. After each conference, participants (n = 55) completed a survey to assess student perspectives of the conference.

Results: Fifty-five medical students from around the nation attended the conferences to present their research. One hundred percent of participants affirmed that the conference fulfilled their primary reason for attending, which for most (54.5%) was the opportunity to present research. Thematic analysis revealed that students especially appreciated the "lower stress environment" and "opportunity to get feedback on their research." Notably, 97.6% of students felt the conference strengthened or increased their interest in neurosurgery.

Conclusions: Participants felt that the SNRC was a valuable opportunity to present research in an environment conducive for practice and improvement. Research conferences primarily for medical students may support the development of young researchers while increasing and strengthening interest in the field of neurosurgery.
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http://dx.doi.org/10.1016/j.wneu.2020.10.108DOI Listing
February 2021

Implementing a Novel Workplace Smoking Cessation Intervention Targeting Hispanic/Latino Construction Workers: A Pilot Cluster Randomized Trial.

Health Educ Behav 2020 Oct 16:1090198120960395. Epub 2020 Oct 16.

University of Miami Miller School of Medicine, Miami, FL, USA.

Background: U.S. Hispanic/Latino construction workers constitute a large and historically underserved group in terms of smoking cessation services. Using formative research, we developed a worksite smoking cessation intervention tailored to the life/work circumstances of these workers.

Aims: This study aims to examine the feasibility, acceptability, and potential efficacy of the developed intervention "Enhanced Care" (EC; one group behavioral counseling session provided around the food truck + fax referral to tobacco quitline [QL] + 8-week nicotine replacement treatment [NRT]) compared with "Standard Care" (SC; fax referral to tobacco QL + 8-week NRT) in a pilot, two-arm, cluster randomized controlled trial.

Method: In collaboration with construction site safety managers, a sample of 17 construction sites (EC: nine sites/65 smokers; SC: eight sites/69 smokers) was enrolled. Participants received two follow-ups at 3 and 6 months after enrollment. Feasibility outcomes were enrollment rate, adherence to treatment, and 6-month retention rates. The primary efficacy outcome was 6 months prolonged abstinence verified by expired carbon monoxide <10 ppm.

Results: Enrollment rate was high (85.9%). Six-month follow-up rates were acceptable (EC = 76.9%, SC = 66.6%). Adherence to treatment was better in the EC group (received worksite intervention: EC = 93.8%, SC = 88.4%; contacted by QL: EC = 49.2%, SC = 40.6%). Abstinence rates were 27.7% for the EC and 20.3% for the SC ( = .315).

Discussion: The developed intervention was feasible and acceptable, and it substantially improved abstinence among Hispanic/Latino workers. The involvement of safety managers was essential to the implementation of the intervention. Training safety managers to deliver the intervention has great potential to implement a sustainable smoking cessation service in the construction sector.
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http://dx.doi.org/10.1177/1090198120960395DOI Listing
October 2020

Current Smoking Raises Risk of Incident Hypertension: Hispanic Community Health Study-Study of Latinos.

Am J Hypertens 2021 03;34(2):190-197

Department of Epidemiology, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA.

Background: Hypertension has been implicated as a smoking-related risk factor for cardiovascular disease but the dose-response relationship is incompletely described. Hispanics, who often have relatively light smoking exposures, have been understudied in this regard.

Methods: We used data from a 6-year follow-up study of US Hispanic adults aged 18-76 to address the dose-response linking cigarette use with incident hypertension, which was defined by measured blood pressure above 140/90 mm Hg or initiation of antihypertensive medications. Adjustment was performed for potential confounders and mediators, including urinary albumin-to-creatinine ratio which worsened over time among smokers.

Results: Current smoking was associated with incident hypertension, with a threshold effect above 5 cumulative pack-years of smoking (vs. never smokers, hazard ratio for hypertension [95% confidence interval] of 0.95 [0.67, 1.35] for 0-5 pack-years, 1.47 [1.05, 2.06] for 5-10 pack-years, 1.40 [1.00, 1.96] for 10-20 pack-years, and 1.34 [1.09, 1.66] for ≥20 pack-years, P = 0.037). In contrast to current smokers, former smokers did not appear to have increased risk of hypertension, even at the highest cumulative pack-years of past exposure.

Conclusions: The results confirm that smoking constitutes a hypertension risk factor in Hispanic adults. A relatively modest cumulative dose of smoking, above 5 pack-years of exposure, raises risk of hypertension by over 30%. The increased hypertension risk was confined to current smokers, and did not increase further with higher pack-year levels. The lack of a smoking-hypertension association in former smokers underscores the value of smoking cessation.
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http://dx.doi.org/10.1093/ajh/hpaa152DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7951044PMC
March 2021

Fire Service Organizational-Level Characteristics Are Associated With Adherence to Contamination Control Practices in Florida Fire Departments: Evidence From the Firefighter Cancer Initiative.

J Occup Environ Med 2020 09;62(9):e508-e514

Department of Public Health Sciences (Ms Louzado-Feliciano, Mr Griffin, Ms Santiago, Dr Koru-Sengul, Dr Lee, Dr Kobetz, Dr Caban-Martinez); Department of Medicine (Dr Solle, Dr Kobetz); Sylvester Comprehensive Cancer Center (Dr Solle, Dr Koru-Sengul, Dr Lee, Dr Kobetz, Dr Caban-Martinez), Miller School of Medicine, University of Miami, Miami; National Fire Protection Association (NFPA), Boston, Massachusetts (Mr Grant); Palm Beach County Fire Rescue (PBCFR), West Palm Beach (Mr Niemczyk), Florida.

Objectives: To characterize the types of contamination control practices followed by Florida fire departments and examine the association between fire department organizational-level characteristics and adherence to contamination control practices.

Methods: Using a cross-sectional study design, a survey was administered to 142 Florida firefighters. Validated survey measures assessed organizational level characteristics and 32 recommended national contamination control practices.

Results: An average of 18.9 contamination control practices (standard deviation = 5.54; min = 3; max = 30) were reported by fire departments of which, wearing personal protective equipment (PPE) according to manufacturer instructions (98.9%) and access to special machine for cleaning (91%) were most cited. Fire departments with one or more health and safety officers had significantly higher implementation of contamination control practices (P = 0.032).

Conclusion: Health and safety officers may have a positive impact on the number of contamination control practices followed in Florida fire departments.
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http://dx.doi.org/10.1097/JOM.0000000000001953DOI Listing
September 2020

Associations between Perceived Racial Discrimination and Tobacco Cessation among Diverse Treatment Seekers.

Ethn Dis 2020 9;30(3):411-420. Epub 2020 Jul 9.

Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL.

Objectives: This study investigated a) racial/ethnic differences in past-year discrimination experiences and b) associations between discrimination and smoking abstinence.

Design: Prospective, longitudinal analysis of smoking status. Perceived past-year discrimination was assessed at baseline. ANCOVAs and intent-to-treat hierarchical logistic regressions were conducted.

Setting: Dual-site (Tampa, FL and Miami, FL) randomized controlled trial testing the effects of a group cessation intervention plus pharmacotherapy.

Participants: Treatment-seeking adult smokers (N=347; non-Hispanic White, non-Hispanic African American/Black, or Hispanic).

Main Outcome Measures: Biochemically verified 7-day point prevalence abstinence (7-day ppa) was assessed immediately post-intervention and at 6-month follow-up.

Results: After controlling for covariates, African Americans/Blacks reported greater perceived discrimination compared with non-Hispanic Whites (P=.02), and Hispanics (P=.06). Non-Hispanic Whites and Hispanics did not differ in perceived racial/ethnic discrimination experiences over the past year. Irrespective of race/ethnicity, past-year perceived discrimination was inversely associated with 7-day ppa, both post-intervention (AOR=.97, CI: .95-.99) and at 6-months (AOR=.98, CI: .96-.99). Among African Americans/Blacks, past-year perceived discrimination was inversely associated with 7-day ppa, both post-intervention (AOR=.95, CI: .92-.97) and at 6-months (AOR=.97, CI: .94-.99). Perceived discrimination was unrelated to 7-day ppa among Hispanics. Among non-Hispanic Whites, past-year perceived discrimination was inversely associated with post-intervention 7-day ppa (AOR=.95, CI: .91-.99), but not 6-months.

Conclusions: Perceived racial/ethnic discrimination was greater among African American/Black smokers compared with non-Hispanic Whites. Perceived discrimination was negatively associated with tobacco cessation in the full sample, and for African Americans at 6-months post-intervention. These data have implications for intervention delivery and health disparities.
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http://dx.doi.org/10.18865/ed.30.3.411DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7360180PMC
April 2021

Activation by NarL at the Escherichia coli ogt promoter.

Biochem J 2020 08;477(15):2807-2820

Institute of Microbiology and Infection and School of Biosciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, U.K.

The Escherichia coli NarX/NarL two-component response-regulator system regulates gene expression in response to nitrate ions and the NarL protein is a global transcription factor, which activates transcript initiation at many target promoters. One such target, the E. coli ogt promoter, which controls the expression of an O6-alkylguanine-DNA-alkyltransferase, is dependent on NarL binding to two DNA targets centred at positions -44.5 and -77.5 upstream from the transcript start. Here, we describe ogt promoter derivatives that can be activated solely by NarL binding either at position -44.5 or position -77.5. We show that NarL can also activate the ogt promoter when located at position -67.5. We present data to argue that NarL-dependent activation of transcript initiation at the ogt promoter results from a direct interaction between NarL and a determinant in the C-terminal domain of the RNA polymerase α subunit. Footprinting experiments show that, at the -44.5 promoter, NarL and the C-terminal domain of the RNA polymerase α subunit bind to opposite faces of promoter DNA, suggesting an unusual mechanism of transcription activation. Our work suggests new organisations for activator-dependent transcription at promoters and future applications for biotechnology.
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http://dx.doi.org/10.1042/BCJ20200408DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7419079PMC
August 2020

Impact of Mindfulness Training on the Well-Being of Educators.

J Altern Complement Med 2020 Jul 21;26(7):645-651. Epub 2020 May 21.

Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.

As awareness of educator stress and burnout is at the forefront of issues faced in the education system, programs are being implemented to focus on the well-being and betterment of educators. Mindfulness is one such practice that has been found to increase wellness and, in many cases, decrease negative outcomes. In this study, the effects of a Mindfulness-Based Stress Reduction Program were measured in grade-school (K-12) educators. A longitudinal noncontrolled trial of educators who completed baseline and short- and long-term postintervention surveys. Miami-Dade County. Two hundred thirty-six educators who worked in K-12 public and private schools. An 8-week Mindfulness-Based Stress Reduction Program. Five Facet Mindfulness Questionnaire, Self-Compassion Scale, Maslach Burnout Inventory-Educators, Patient-Reported Outcome Measurement Information System (PROMIS-29) for measuring physical and mental health functionality. The multiple linear regression analysis of the short-term cohort data yielded statistically significant improvements in mindfulness, self-compassion, and personal accomplishment and decreases in isolation, anxiety, fatigue, and emotional exhaustion. In the long-term cohort, repeated measures regression showed self-compassion and mindfulness continued to improve significantly, whereas negative outcomes of fatigue and sleep disturbance showed statistically significant decreases. Effect sizes were calculated for all the measures, many of which were medium sized, total mindfulness (0.69), self-compassion (0.051), and sleep disturbance (0.49). Findings are consistent with previous literature and support the need for such programs that impact the educator's personal and professional experience.
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http://dx.doi.org/10.1089/acm.2019.0451DOI Listing
July 2020

Impact of Clinical Factors on the Intestinal Microbiome in Infants With Gastroschisis.

JPEN J Parenter Enteral Nutr 2021 May 26;45(4):818-825. Epub 2020 Jun 26.

Department of Pediatrics, Neonatal Research Center of the UCLA of Children's Discovery and Innovation Institute, David Geffen School of Medicine UCLA and UCLA Mattel Children's Hospital, Los Angeles, California, USA.

Background: Infants with gastroschisis require operations and lengthy hospitalizations due to intestinal dysmotility. Dysbiosis may contribute to these problems. Little is known on the microbiome of gastroschisis infants.

Methods: The purpose of this study was to investigate the fecal microbiome in gastroschisis infants. Microbiome profiling was performed by sequencing the V4 region of the 16S rRNA gene. The microbiome of gastroschisis infants was compared with the microbiome of healthy controls, and the effects of mode of birth delivery, gestational age, antibiotic duration, and nutrition type on microbial composition and diversity were investigated.

Results: The microbiome of gastroschisis infants (n = 13) was less diverse (Chao1, P < .001), lacked Bifidobacterium (P = .001), and had increased Staphylococcus (P = .007) compared with controls (n = 83). Mode of delivery (R = 0.04, P = .001), antibiotics duration ≥7 days (R = 0.03, P = .003), age at sample collection (R = 0.03, P = .009), and gestational age (R = 0.02, P = .035) explained a small portion of microbiome variation. In gastroschisis infants, Escherichia-Shigella was the predominate genus, and those delivered via cesarean section had different microbial communities, predominantly Staphylococcus and Streptococcus, from those delivered vaginally. Although antibiotic duration contributed to the variation in microbiome composition, there were no significant differences in taxa distribution or α diversity by antibiotic duration or nutrition type.

Conclusion: The microbiome of gastroschisis infants is dysbiotic, and mode of birth delivery, antibiotic duration, and gestational age appear to contribute to microbial variation.
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http://dx.doi.org/10.1002/jpen.1926DOI Listing
May 2021

Chronic condition patterns in the US population and their association with health related quality of life.

Prev Med 2020 07 29;136:106102. Epub 2020 Apr 29.

Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States of America.

This study aims to identify chronic disease patterns and their relationship to health-related quality of life (HRQL) in the US population. This cross-sectional study used data from 86,745 participants aged 18 years and older of the Medical Expenditure Panel Survey (MEPS) 2010-2015, we employed latent class analysis (LCA) to identify subgroups of participants with different combinations of 23 chronic conditions which had medical utilization during the past 12 months. Derived chronic condition latent classes were used to predict the 12-Item Short Form Survey physical component score (PCS), mental component score (MCS) in addition to overall HRQL (SF-6D) while controlling for covariates. LCA identified five unique multi-morbidity groups: "healthy" (62.5%), "vascular risk" (18.9%), "anxiety" (12.2%), "heart disease" (2.9%), and "severely-impaired" (3.5%). Covariate-adjusted mean SF-6D scores varied significantly among classes: healthy (0.85), vascular risk (0.77), anxiety (0.67), heart disease group (0.65), and severely-impaired (0.56). The anxiety group, proportionately younger and female, had high PCS (46.3) but low MCS (41.9). The heart disease group, although older and in poor physical health (PCS = 33.2), had higher MCS scores (46.9). Our results demonstrate multi-morbidity significantly impacts HRQL. The relationship between physical and mental health functioning varied across different multi-morbidity groups, and the discordance was more pronounced in younger ages and females. Our research also identified an older age group that was mentally robust and maintained a strong HRQL. Findings can inform the development of targeted interventions to improve physical and mental health functioning in vulnerable populations.
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http://dx.doi.org/10.1016/j.ypmed.2020.106102DOI Listing
July 2020

Effects of Food on Bioavailability of Analgesics; Resulting Dosage and Administration Recommendations.

Pain Med 2020 11;21(11):2877-2892

Division of Clinical Pharmacology 2, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland.

Objectives: To evaluate currently approved analgesics, that is, opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), anticonvulsants, and serotonin and norepinephrine reuptake inhibitors (SNRIs) used as analgesics, for 1) differences in pharmacokinetic parameters under fed vs fasting conditions and 2) factors involved in dosage recommendations in relation to food.

Design: Systematic review.

Results: Food effect on the rate, extent of absorption, or shape of concentration-time profile can alter the onset of action, duration of action, or tolerability of a medication. Based on 79 analgesic products reviewed, food effect dosage recommendations depend on whether an analgesic will be dosed on a regular interval around-the-clock vs on an as-needed basis, the shape of concentration-time profile, steady-state concentrations, the type of meals used in the pharmacokinetic study, and drug administration with regard to food in clinical trials. Overall, most opioids do not have food restriction and are taken without regard to food, with the exception of OPANA products and XTAMPZA ER. For many NSAIDs, food does not affect absorption characteristics, with the exception of ZORVOLEX and CELEBREX. Although NSAIDs are commonly to be taken without regard to food, prescribers recommend administering them with food to reduce their propensity for gastrointestinal adverse events. A larger percentage of anticonvulsants and SNRIs used as analgesics are taken with food to improve their tolerability. Of all analgesic products, seven NSAIDs and six opioids lack food effect information, maybe due to their approval before Food and Drug Administration food effect guidance.

Conclusions: Overall, because food effects could alter the onset and/or duration of pain relief, analgesic medication should be used as per labeled recommendations for proper pain management.
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http://dx.doi.org/10.1093/pm/pnaa046DOI Listing
November 2020

Resistance of New Zealand Provenance , and to .

Plant Dis 2020 Jun 9;104(6):1771-1780. Epub 2020 Apr 9.

The Queensland Department of Agriculture and Fisheries, Brisbane, Queensland 4001, Australia.

Resistance to the pandemic strain of was identified in New Zealand provenance , , and plants. Only 1 -resistant plant was found (of the 570 tested) and no resistant plants of either or were found. Three types of resistance were identified in . The first two, a putative immune response and a hypersensitive response, are leaf resistance mechanisms found in other myrtaceous species while on the lateral and main stems a putative immune stem resistance was also observed. Both leaf and stem infection were found on and plants as well as branch tip dieback that developed on almost 50% of the plants. , and are the first myrtaceous species where consistent infection of stems has been observed in artificial inoculation trials. This new finding and the first observation of significant branch tip dieback of plants of the two spp. resulted in the development of two new myrtle rust disease severity assessment scales. Significant seed family and provenance effects were found in , and : some families produced significantly more plants with leaf, stem, and (in spp.) branch tip dieback resistance, and provenances provided different percentages of resistant families and plants. The distribution of the disease symptoms on plants from the same seed family, and between plants from different seed families, suggested that the leaf, stem, and branch tip dieback resistances were the result of independent disease resistance mechanisms.
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http://dx.doi.org/10.1094/PDIS-11-19-2302-REDOI Listing
June 2020

Analysis of musculoskeletal radiology fellowship websites.

Skeletal Radiol 2020 Jul 2;49(7):1149-1153. Epub 2020 Mar 2.

Warren Alpert Medical School of Brown University, 222 Richmond Street, Providence, RI, 02906, USA.

Objective: Due to the relative lack of standardization in the fellowship application processes for musculoskeletal radiology, program websites are of paramount importance as application resources. This study evaluates the comprehensiveness of these websites and the potential effects of program ACGME accreditation, region, and size on website comprehensiveness.

Materials And Methods: The websites of musculoskeletal fellowship programs listed on the Society of Skeletal Radiology website were assigned a validated comprehensiveness score based on the presence of 19 specific informative components pertaining to the program's characteristics. The correlations of comprehensiveness scores with program ACGME accreditation, region, and size were evaluated.

Results: A total of 90 musculoskeletal radiology fellowship program websites were reviewed, yielding a mean comprehensiveness score of 55.1% (10.5 out of 19 criteria). Only 3 of the 19 criteria-application information (88.9%), stand-alone webpage (87.8%), and affiliated hospital information (84.4%)-were present in more than 80% of all websites. Eleven criteria, most notably away rotation information (6.7% presence) and case log (0.0% presence), were absent from at least 50% of all websites. Program ACGME accreditation was correlated with significantly higher website comprehensiveness scores compared with non-accreditation (p = 0.087).

Conclusion: There is lack of sufficient, useful information and standardization on the websites of MSK fellowship programs throughout the country. According to our review and analysis, addition of specific information regarding each fellowship program and implementing some type of standardization may optimize fellowship matching for both applicants and the programs.
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http://dx.doi.org/10.1007/s00256-020-03401-3DOI Listing
July 2020

Patterns of Chronic Conditions and Their Association With Visual Impairment and Health Care Use.

JAMA Ophthalmol 2020 04;138(4):387-394

Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida.

Importance: Visual impairment and visual disorders often co-occur with other chronic conditions. Understanding patterns of multimorbidity is important for reducing health care use and improving health outcomes.

Objective: To identify chronic condition patterns and their association with visual impairment and health care use in a nationally representative sample.

Design, Setting, And Participants: This cross-sectional study used National Health Interview Survey data for 387 780 individuals aged 18 years and older, representative of the civilian noninstitutionalized US population, from January 1, 2002, to December 31, 2014. Statistical analysis was performed from June to November 2018.

Exposures: Participants were classified in subgroups with different combinations of self-reported chronic conditions using latent class analysis.

Main Outcomes And Measures: Self-reported visual impairment, emergency department visit, and hospitalization use in the previous 12 months.

Results: Among the 387 780 individuals included in the study, 51.8% were female, 77.6% were white, and the mean (SD) age was 46.2 (18.0) years. Latent class analysis identified 5 different classes, with 70.5% of the participants belonging to the healthy group. The other 4 groups represented various degrees and patterns of multimorbidity. The hypertensive group (19.6%) had a high prevalence of hypertension (62.6%), the respiratory conditions group (4.4%) had a high prevalence of emphysema (47.7%) and asthma (45.6%), the heart disease group (3.6%) had high prevalence of coronary heart disease (69.8%), and the severely impaired group (1.8%) had higher prevalence of most conditions compared with the other groups. In the adjusted analysis, compared with the healthy group, participants in all 4 disease groups had elevated risk of visual impairment: heart condition group (odds ratio [OR], 3.19; 95% CI, 2.92-3.48), hypertensive group (OR, 3.28; 95% CI, 3.10-3.48), respiratory condition group (OR, 3.87; 95% CI, 3.56-4.20), and severely impaired group (OR, 10.19; 95% CI, 9.20-11.28). All 4 disease groups had elevated risk of reporting emergency department use and hospitalization. For the severely impaired group, the OR for emergency department use was 9.39 (95% CI, 8.53-10.34), and the OR for hospitalization was 10.80 (95% CI, 9.80-11.92).

Conclusions And Relevance: In this study, individuals in all 4 multimorbidity groups had an elevated risk of visual impairment and health care use compared with the healthy group. Characteristics of high-risk groups identified by this study may help in the development and implementation of interventions to avert the more serious consequences of having multiple chronic conditions.
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http://dx.doi.org/10.1001/jamaophthalmol.2020.0052DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7047855PMC
April 2020

Contributions to human breast milk microbiome and enteromammary transfer of Bifidobacterium breve.

PLoS One 2020 28;15(1):e0219633. Epub 2020 Jan 28.

Department of Pediatrics, University of California Los Angeles, Los Angeles, CA, United States of America.

Increasing evidence supports the importance of the breast milk microbiome in seeding the infant gut. However, the origin of bacteria in milk and the process of milk microbe-mediated seeding of infant intestine need further elucidation. Presumed sources of bacteria in milk include locations of mother-infant and mother-environment interactions. We investigate the role of mother-infant interaction on breast milk microbes. Shotgun metagenomics and 16S rRNA gene sequencing identified milk microbes of mother-infant pairs in breastfed infants and in infants that have never latched. Although breast milk has low overall biomass, milk microbes play an important role in seeding the infant gut. Breast milk bacteria were largely comprised of Staphylococcus, Streptococcus, Acinetobacter, and Enterobacter primarily derived from maternal areolar skin and infant oral sites in breastfeeding pairs. This suggests that the process of breastfeeding is a potentially important mechanism for propagation of breast milk microbes through retrograde flux via infant oral and areolar skin contact. In one infant delivered via Caesarian section, a distinct strain of Bifidobacteria breve was identified in maternal rectum, breast milk and the infant's stool potentially suggesting direct transmission. This may support the existence of microbial translocation of this anaerobic bacteria via the enteromammary pathway in humans, where maternal bacteria translocate across the maternal gut and are transferred to the mammary glands. Modulating sources of human milk microbiome seeding potentially imply opportunities to ultimately influence the development of the infant microbiome and health.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0219633PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6986747PMC
March 2020

Cancer risk among career male and female Florida firefighters: Evidence from the Florida Firefighter Cancer Registry (1981-2014).

Am J Ind Med 2020 04 12;63(4):285-299. Epub 2020 Jan 12.

Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida.

Background: Firefighters are at increased risk for select cancers. However, many studies are limited by relatively small samples, with virtually no data on the cancer experience of female firefighters. This study examines cancer risk in over 100,000 career Florida firefighters including 5000 + females assessed over a 34-year period.

Methods: Florida firefighter employment records (n = 109 009) were linked with Florida Cancer Data System registry data (1981-2014; ~3.3 million records), identifying 3760 male and 168 female-linked primary cancers. Gender-specific age and calendar year-adjusted odds ratios (aOR) and 95% confidence intervals for firefighters vs non-firefighters were calculated.

Results: Male firefighters were at increased risk of melanoma (aOR = 1.56; 1.39-1.76), prostate (1.36; 1.27-1.46), testicular (1.66; 1.34-2.06), thyroid (2.17; 1.78-2.66) and late-stage colon cancer (1.19;1.00-1.41). Female firefighters showed significantly elevated risk of brain (2.54; 1.19-5.42) and thyroid (2.42; 1.56-3.74) cancers and an elevated risk of melanoma that approached statistical significance (1.68; 0.97-2.90). Among male firefighters there was additional evidence of increased cancer risk younger than the age of 50 vs 50 years and older for thyroid (2.55; 1.96-3.31 vs 1.69; 1.22-2.34), prostate (1.88; 1.49-2.36 vs 1.36; 1.26-1.47), testicular (1.60; 1.28-2.01 vs 1.47; 0.73-2.94), and melanoma (1.87; 1.55-2.26 vs 1.42; 1.22-1.66) cancers.

Conclusion: Male career firefighters in Florida are at increased risk for five cancers with typically stronger associations in those diagnosed younger than the age of 50, while there was evidence for increased thyroid and brain cancer, and possibly melanoma risk in female firefighters. Larger cohorts with adequate female representation, along with the collection of well-characterized exposure histories, are needed to more precisely examine cancer risk in this occupational group.
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http://dx.doi.org/10.1002/ajim.23086DOI Listing
April 2020

Alterations to the Gastrointestinal Microbiome Associated with Methamphetamine Use among Young Men who have Sex with Men.

Sci Rep 2019 10 16;9(1):14840. Epub 2019 Oct 16.

Department of Epidemiology, Fielding School of Public Health at the University of California, Los Angeles, USA.

Methamphetamine (MA) use is a major public health problem in the United States, especially among people living with HIV (PLWH). Many MA-induced neurotoxic effects are mediated by inflammation and gut microbiota may play a role in this process, yet the effects of MA on the microbiome have not been adequately explored. Therefore, we performed 16S rRNA gene sequencing on rectal swab samples from 381 men who have sex with men, 48% of whom were PLWH and 41% of whom used MA. We compared microbiome composition between MA users and non-users while testing for potential interactions with HIV and controlling for numerous confounders using inverse probability of treatment weighting. We found that MA use explained significant variation in overall composition (R = 0.005, p = 0.008) and was associated with elevated Finegoldia, Parvimonas, Peptoniphilus, and Porphyromonas and reduced Butyricicoccus and Faecalibacterium, among others. Genera including Actinomyces and Streptobacillus interacted with HIV status, such that they were increased in HIV+ MA users. Finegoldia and Peptoniphilus increased with increasing frequency of MA use, among others. In summary, MA use was associated with a microbial imbalance favoring pro-inflammatory bacteria, including some with neuroactive potential and others that have previously been associated with poor HIV outcomes.
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http://dx.doi.org/10.1038/s41598-019-51142-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6795845PMC
October 2019

Persistent Hearing Loss among World Trade Center Health Registry Residents, Passersby and Area Workers, 2006-2007.

Int J Environ Res Public Health 2019 10 12;16(20). Epub 2019 Oct 12.

New York City Department of Health and Mental Hygiene, World Trade Center Health Registry, New York City, NY 10013, USA.

Background: Prior studies have found that rescue and recovery workers exposed to the 9/11 World Trade Center (WTC) disaster have evidence of increased persistent hearing and other ear-related problems. The potential association between WTC disaster exposures and post-9/11 persistent self-reported hearing problems or loss among non-rescue and recovery survivors has not been well studied.

Methods: We used responses to the World Trade Center Health Registry (Registry) enrollment survey (2003-2004) and first follow-up survey (2006-2007) to model the association between exposure to the dust cloud and persistent hearing loss (n = 22,741).

Results: The prevalence of post-9/11 persistent hearing loss among survivors was 2.2%. The adjusted odds ratio (aOR) of hearing loss for those who were in the dust cloud and unable to hear was 3.0 (95% CI: 2.2, 4.0). Survivors with persistent sinus problems, headaches, PTSD and chronic disease histories had an increased prevalence of reported hearing problems compared to those without symptoms or chronic problems.

Conclusions: In a longitudinal study, we observed an association between WTC-related exposures and post-9/11 self-reported hearing loss among disaster survivors.
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http://dx.doi.org/10.3390/ijerph16203864DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6848920PMC
October 2019

Yap/Taz are required for establishing the cerebellar radial glia scaffold and proper foliation.

Dev Biol 2020 01 3;457(1):150-162. Epub 2019 Oct 3.

Shriners Hospitals Pediatrics Research Center, Department of Anatomy and Cell Biology, Temple University Lewis Katz School of Medicine, Philadelphia, PA, 19140, USA. Electronic address:

Yap/Taz are well-established downstream effectors of the Hippo pathway, known to regulate organ size by directing proliferation and apoptosis. Although the functions of Yap/Taz have been extensively studied, little is known about their role in brain development. Here, through genetic ablation, we show that Yap/Taz are required for cerebellar morphogenesis. Yap/Taz deletion in neural progenitors causes defects in secondary fissure formation, leading to abnormal folia development. Although they seemed very likely to serve an important function in the development of cerebellar granule cell precursors, Yap/Taz are dispensable for their proliferation. Furthermore, Yap/Taz loss does not rescue the medulloblastoma phenotype caused by constitutively active Smoothened. Importantly, Yap/Taz are highly expressed in radial glia and play a crucial role in establishing the radial scaffold and cellular polarity of neural progenitors during embryogenesis. We found that Yap/Taz are necessary to establish and maintain junctional integrity of cerebellar neuroepithelium as prominent junction proteins are not maintained at the apical junction in the absence of Yap/Taz. Our study identifies a novel function of Yap/Taz in cerebellar foliation and finds that they are required to establish the radial glia scaffold and junctional stability.
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http://dx.doi.org/10.1016/j.ydbio.2019.10.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910221PMC
January 2020

Integrating Worksite Smoking Cessation Services Into the Construction Sector: Opportunities and Challenges.

Health Educ Behav 2019 12 19;46(6):1024-1034. Epub 2019 Aug 19.

University of Miami, Miami, FL, USA.

. Smoking prevalence among Hispanic/Latino construction workers in the United States is very high (31%). To investigate tobacco use profiles in these minority workers and explore their management's views about implementing sustainable worksite smoking cessation services. Analysis of baseline data from a smoking cessation trial among Hispanic/Latino construction workers ( = 134; adult men ≥18 years), and semistructured, 45-minute interviews with 24 key personnel at six construction companies in south Florida were conducted. Interviews were recorded, transcribed, and analyzed thematically. . Overall, 43.3% of workers were Cuban, and 81.3% had low acculturation level. Nicotine dependence levels were "high" in 61.8% of workers. Half of the workers had a successful quit attempt but only 9.9% received advice from a physician to quit smoking, 16.7% used medication to quit, and 79.2% did not receive assistance. Participants in the interviews stated that nothing was provided to help smokers quit smoking and considered distributing self-help materials with free medications as the most appropriate service. Challenges to integrating the service were time restriction and cost. Recommendations for implementing the service were local/state government mandate. Tailoring tobacco treatment to Hispanic/Latino construction workers' job circumstances and culture is essential to support their cessation efforts. Integrating worksite tobacco treatment services into other available health promotion programs (e.g., safety) and enforcing smoke-free legislation in the construction sector can facilitate its adoption. . Involving key stakeholders and mandating the service by the State and local government are necessary to integrate sustainable worksite smoking cessation services in the construction sector.
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http://dx.doi.org/10.1177/1090198119866900DOI Listing
December 2019

Rapid, point-of-care diagnosis of tuberculosis with novel Truenat assay: Cost-effectiveness analysis for India's public sector.

PLoS One 2019 2;14(7):e0218890. Epub 2019 Jul 2.

Harvard Medical School, Boston, Massachusetts, United States of America.

Background: Truenat is a novel molecular assay that rapidly detects tuberculosis (TB) and rifampicin-resistance. Due to the portability of its battery-powered testing platform, it may be valuable in peripheral healthcare settings in India.

Methods: Using a microsimulation model, we compared four TB diagnostic strategies for HIV-negative adults with presumptive TB: (1) sputum smear microscopy in designated microscopy centers (DMCs) (SSM); (2) Xpert MTB/RIF in DMCs (Xpert); (3) Truenat in DMCs (Truenat DMC); and (4) Truenat for point-of-care testing in primary healthcare facilities (Truenat POC). We projected life expectancy, costs, incremental cost-effectiveness ratios (ICERs), and 5-year budget impact of deploying Truenat POC in India's public sector. We defined a strategy "cost-effective" if its ICER was
Results: Compared to SSM, Truenat POC increased life expectancy by 0.39 years and was cost-effective (ICER $210/YLS). Compared to Xpert, Truenat POC increased life expectancy by 0.08 years due to improved linkage-to-care and was cost-effective (ICER $120/YLS). In sensitivity analysis, the cost-effectiveness of Truenat POC, relative to Xpert, depended on the diagnostic sensitivity of Truenat and linkage-to-care with Truenat. Deploying Truenat POC instead of Xpert increased 5-year expenditures by $270 million, due mostly to treatment costs. Limitations of our study include uncertainty in Truenat's sensitivity for TB and not accounting for the "start-up" costs of implementing Truenat in the field.

Conclusions: Used at the point-of-care in India, Truenat for TB diagnosis should improve linkage-to-care, increase life expectancy, and be cost-effective compared with smear microscopy or Xpert.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0218890PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6605662PMC
February 2020

Position effects on promoter activity in and their consequences for antibiotic-resistance determinants.

Biochem Soc Trans 2019 06 12;47(3):839-845. Epub 2019 Jun 12.

Institute of Microbiology and Infection, School of Biosciences, University of Birmingham, Birmingham B15 2TT, U.K.

The activity of any bacterial promoter is generally supposed to be set by its base sequence and the different transcription factors that bind in the local vicinity. Here, we review recent data indicating that the activity of the operon promoter also depends upon its chromosomal location. Factors that affect promoter activity include the binding of nucleoid-associated proteins to neighbouring sequences, supercoiling and the activity of neighbouring promoters. We suggest that many bacterial promoters might be susceptible to similar position-dependent effects and we review recent data showing that the expression of mobile genes encoding antibiotic-resistance determinants is also location-dependent, both when carried on a bacterial chromosome or a conjugative plasmid.
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http://dx.doi.org/10.1042/BST20180503DOI Listing
June 2019

Developing a Worksite-based Culturally Adapted Smoking Cessation Intervention for Male Hispanic/Latino Construction Workers.

J Smok Cessat 2019 Jun 11;14(2):73-82. Epub 2018 May 11.

Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine.

Introduction: Over 2.6 million Hispanic/Latino construction workers (CWs) live in the US; 91% of South Florida CWs are Hispanic/Latino. CWs have higher smoking and lower cessation rates than other workers. Limited access to cessation services, worksite turnover, and lack of interventions tailored to culture/occupation hinder cessation. Partnering with worksite food trucks to deliver unique cessation interventions may improve these efforts.

Aims: To explore a novel cessation approach, assess worker/worksite acceptability, and seek input into intervention development.

Methods: In 2016, we conducted five semi-structured focus groups with 37 daily smoking Hispanic/Latino CWs. Constant comparative analysis was used to examine themes regarding smoking behaviors, cessation treatments, intervention delivery, cultural adaptation, and quit interest.

Results: CWs reported tremendous job stress. Most smoking occurred during the workday and most CWs did not use Nicotine Replacement Therapy with past quit attempts. Most CWs were open to a worksite face-to-face group cessation intervention before work (many underutilize breaks and feel pressure to keep working). CWs felt it unnecessary to tailor the intervention to Hispanics/Latinos indicating smokers are the same regardless of race/ethnicity.

Conclusions: Findings demonstrate the need to consider work environments, job demands/stress, and worker preferences when developing accessible and acceptable cessation interventions.
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http://dx.doi.org/10.1017/jsc.2018.16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6502474PMC
June 2019