Partnering with Local Schools of Traditional Chinese Medicine to Provide Accessible Acupuncture Services for Pain Management in a Group of Low-Income Hispanics/Latinos.

This field report describes the accessibility and perceived effectiveness of a free acupuncture program among a group of predominantly low-income Hispanic/Latino adults. Surveys, developed based on the Levesque Conceptual Framework of Access to Health Care, were administered to clients. Baseline (n = 245) and 6-week follow-up (n = 79) surveys were analyzed to document early program findings. A majority of clients were Hispanic/Latino (72.7%) and female (73.1%). Most reported their original pain complaint was treated very well/well (98.7%). Clients reported an average 1.2 points pain level decrease (scale 1-10) at follow-up (p < 0.0001). Early program results suggest this acupuncture program was accessible and well received by low-income Hispanics/Latinos.

3D organoid modeling of extramedullary hematopoiesis.

BACKGROUND: Under certain clinical and experimental conditions hematopoiesis occurs in other site than bone marrow (BM), such as the liver. Here, we develop a 3D organoid that mimics several components of the hematopoietic niche present during liver extramedullary hematopoiesis. AIM: To evaluate the capacity of a 3D hematopoietic organoid (3D-HO) to function as a hematopoietic like-niche allowing for blood cell production outside of the BM. METHODS: The 3D-HO is constituted by liver sinusoidal endothelial cells (LSEC) as the stromal component, BM isolated from 5-FU treated mice (FU-BMCs), collagen microspheres and plasma clot as scaffolds. The ability of the 3D-HO to support the survival and functionality of FU-BMCs was investigated by using confocal microscopy, histology analysis, flow cytometry, and clonogenic assays. RESULTS: After 15 and 30 days, post-ectopic implantation, histological studies of the 3D-HO showed the presence of cells with myeloid and lymphoid lineage morphology. Flow cytometry analysis of these cells showed the presence of cells expressing hematopoietic stem progenitor cells (HSPC) (Sca-1+/c-Kit+), myeloid (Gr-1+) and lymphoid (B220+ and CD19+) markers. Clonogenic assays showed that cells from the 3D-HO formed hematopoietic colonies. Expression of the Sry gene by cells from the 3D-HO, implanted for 30 days in female mice, indicated that male donor cells persist in this model of extramedullary hematopoiesis. CONCLUSIONS: The 3D-HO constitutes an extramedullary hematopoietic-like niche which supports the survival and functionality of FU-BMCs. It may constitute an efficient model for investigating, in vitro and in vivo, those factors that control hematopoiesis outside BM.

Prognostic and Clinicopathological Significance of Telomerase Reverse Transcriptase Upregulation in Oral Cancer: A Systematic Review and Meta-Analysis.

The aim of this systematic review and meta-analysis was to evaluate the current evidence on the prognostic and clinicopathological significance value of telomerase reverse transcriptase (TERT) upregulation in patients with oral squamous cell carcinoma (OSCC). PubMed, Embase, Web of Science, and Scopus were searched for studies published before April 2022, not restricted by date or publication language. The methodological quality of primary-level studies was critically assessed using the Quality in Prognosis Studies (QUIPS) tool. We carried out meta-analyses, explored heterogeneity and its sources, and performed subgroup, meta-regression, sensitivity, and small-study effects analyses. Twenty-one studies (1698 patients) met inclusion criteria. TERT protein overexpression was significantly associated with worse overall survival (hazard ratio [HR] = 3.01, 95% CI = 1.70−5.35, p < 0.001), disease-free survival (HR = 4.03, 95% CI = 1.80−9.05, p = 0.001), and higher histological grade OSCC (odds ratio [OR] = 3.20, 95% CI = 1.83−5.62, p < 0.001). These large effect sizes were consistently obtained by homogeneous subgroups (p > 0.10, I2 = 0.0, respectively), which reflects a high quality of evidence. On the other hand, TERT gene mutations obtained constantly nonsignificant null effect sizes for all outcomes investigated, evidencing no prognostic or clinicopathological value. In conclusion, our findings indicate that TERT upregulation is a prognostic indicator of poor survival in oral cancer. Our findings support the immunohistochemical assessment of TERT overexpression, which could probably be incorporated into the prognostic evaluation of OSCC.

Access to and Use of Schools for Physical Activity Among Adults in Los Angeles County.

Formal agreements that outline conditions for community use of school facilities represent a potentially attractive approach to increasing access to places for physical activity in underresourced areas. Despite growing interest in these shared use agreements, limited data are available on their population-level impacts. This study used data collected via an Internet panel survey in spring 2014 (n = 1,006) to examine the extent of public awareness and use of school-based physical activity resources in Los Angeles County. Weighted data were analyzed using logistic regression to examine associations among access to and use of schools, demographics, and behavioral and environmental factors. Negative binomial regression was performed to test the association between access to school-based physical activity resources and physical activity. Results suggest that a large percentage (57.7%) of people have access to school-based physical activity resources; however, only a portion (30.3%) use them. Safety of school grounds and whether onsite programming was offered were positively associated with use. In light of these findings, additional efforts may be needed to help optimize community use of schools for physical activity. These results can help inform program planning and implementation in communities considering shared use policies.

Building mutually beneficial partnerships to improve physical activity opportunities through shared-use efforts in under-resourced communities in Los Angeles County.

OBJECTIVE: To evaluate 18 shared-use agreements (SUAs) implemented in Los Angeles County during 2010-2012. SUAs opened school grounds and/or facilities in seven school districts to increase physical activity opportunities for under-resourced communities with high prevalence of obesity. METHODS: We reviewed the extent to which SUAs addressed school district concerns about cost responsibility, sustainability, and scope. A school site and community partner survey was conducted to inform planning and to facilitate comparisons of the types and range of legal clauses (up to 16) contained in the agreements. We used geographic information systems and 2010 United States Census data to estimate the population reached and the potential benefits of the SUAs. RESULTS: SUAs varied in the degree to which they addressed the three categories of concerns. Eight of the 18 agreements included 13 of the 16 legal clauses. We estimate that these SUAs have the potential to reach nearly 165,000 children (ages 5-19) and more than 500,000 adults (ages 20-64) at a cost of about $0.38 per community member reached. CONCLUSION: SUAs that include legal clauses to address school concerns about factors such as vandalism, staffing and funding represent a promising strategy for increasing physical activity opportunities in under-resourced neighborhoods where the prevalence of obesity is high.

Increasing physical activity in under-resourced communities through school-based, joint-use agreements, Los Angeles County, 2010-2012.

INTRODUCTION: Few studies have examined how joint-use agreements between schools and communities affect use of school facilities after hours for physical activity in under-resourced communities. The objective of this study was to assess whether these agreements can increase community member use of these opened spaces outside of school hours. METHODS: Trained observers conducted school site observations after joint-use agreements were implemented in 7 Los Angeles County school districts. All 7 districts had disproportionately high adult and child obesity rates, and all had executed a joint-use agreement between schools and community or government entities from January 2010 through December 2012. To assess use, we adapted the System for Observing Play and Recreation in Communities (SOPARC) instrument to record the number, demographic characteristics, and physical activity levels of community members who used the joint-use school sites. To supplement observations, we collected contextual information for each location, including the existence of physical activity programs at the site and the condition of exercise equipment. RESULTS: We completed 172 SOPARC observations and related environmental assessments for 12 school sites. Observations made on 1,669 site users showed that most of them were Hispanic and nearly half were adults; three-quarters engaged in moderate to vigorous physical activity. Community member use of school sites was 16 times higher in joint-use schools that had physical activity programs than in schools without such programs. CONCLUSION: Joint-use agreements are a promising strategy for increasing moderate to vigorous physical activity among adults and children in under-resourced communities. Providing physical activity programs may substantially increase after-hours use of school facilities by community members.

Physical activity promotion: a local and state health department perspective.

Local and state health departments are well-positioned to serve as catalysts for the institutional and community changes needed to increase physical activity across the population. Efforts should focus on evidence-based strategies, including promotion of high-quality physical education in schools, social support networks and structured programs for physical activity in communities, and organizational practices, policies, and programs that promote physical activity in the workplace. Health departments must also focus on land use and transportation practices and policies in communities where the built environment creates major impediments to physical activity, particularly in economically disadvantaged communities disproportionately burdened by chronic disease.

Correlation of obesity with elevated blood pressure among racial/ethnic minority children in two Los Angeles middle schools.

INTRODUCTION: To identify anthropometric and fitness correlates of elevated blood pressure, serum cholesterol, and glycated hemoglobin, we examined anthropometric and physiologic biomarkers among racial/ethnic minority children aged 11 to 13 years in two urban Los Angeles middle schools. We explored the potential for using obesity or fitness level as screening variables for cardiovascular disease risk factors in these students. METHODS: During regularly scheduled physical education classes, we collected data on demographic characteristics, height, weight, blood pressure, nonfasting total serum cholesterol, glycated hemoglobin, time to run/walk 1 mile, and a range of self-reported behaviors. A total of 199 sixth-graders (121 Latinos, 78 African Americans) participated in the study. RESULTS: Bivariate analyses indicated that 48.6% of sixth-graders were of desirable weight, 17.5% were overweight, 29.9% were at risk for overweight, and 4.0% were underweight. Higher weight was associated with higher levels of serum cholesterol, systolic blood pressure, and diastolic blood pressure (P values for all associations <.02) but not with glycated hemoglobin. Multivariate analyses maintained the findings with regard to blood pressure but not serum cholesterol. CONCLUSION: Overweight status could be a screening variable for identifying youth at risk for high blood pressure. Obesity prevention and intervention programs and policies need to target low-income racial/ethnic minority children. Assessment of hypertension status also seems warranted in low-income racial/ethnic minority sixth-graders, as does early intervention for children at high risk.