Increasing Protein Intake to Help Older Adults Increase Muscle Strength and Function: A Pilot, Single-Arm Investigation Using Coaching and a Per-Meal Protein Prescription.

Objective: To evaluate the effects of nutrition education, diet coaching, and a protein prescription (PP) on protein intake, and associations with muscle strength and function. Design: Prospective pretest posttest single-arm study. Setting: Urban area, East coast of South Florida. Participants: 20 white, non-Hispanic adults, aged 73.3 + 10.4 years. Intervention: 10-week telephone-based diet coaching, nutrition education and a per-meal PP. Measurements: Protein and energy intakes, weight, grip strength (GS), and 5-chair-rise (5CR), timed up and go (TUG), 3-meter walk (3mW) tests at baseline and 10 weeks. Results: Pre to 10-week post values significantly improved (p<0.05) for protein intake/kg body weight (0.8 + 0.3 to 1.2 + 0.3g), protein intake/meal (17.2 ± 4.8g to 26.4 ± 6.g), protein intake/100 kcal (3.74 + 1.16 to 5.97 + 0.98g), GS (22.4 to 23.4kg), and times for TUG (10 to 8sec), 3mW (4 to 3sec), and 5CR (13 to 11sec). Conclusions: Given the positive findings of this unique pilot investigation, additional studies, which include a larger more diverse group of participants and provide for control group(s), are needed to better investigate the effectiveness of this approach and its effects on muscle strength and function.

Preservation of forelimb function by UPF1 gene therapy in a rat model of TDP-43-induced motor paralysis.

Nonsense-mediated mRNA decay (NMD) is an RNA surveillance mechanism that requires upframeshift protein 1 (UPF1). This study demonstrates that human UPF1 exerts protective effects in a rat paralysis model based on the amyotrophic lateral sclerosis (ALS)-associated protein, TDP-43 (transactive response DNA-binding protein 43 kDa). An adeno-associated virus vector (AAV9) was used to express TDP-43 throughout the spinal cord of rats, inducing reproducible limb paralysis, to recapitulate the paralysis in ALS. We selected UPF1 for therapeutic testing based on a genetic screen in yeast. The expression of human TDP-43 or human UPF1 in the spinal cord was titrated to less than twofold over the respective endogenous level. AAV9 human mycUPF1 clearly improved overall motor scores in rats also expressing TDP-43. The gene therapy effect of mycUPF1 was specific and reproducible compared with groups receiving either empty vector or green fluorescent protein vector controls. The gene therapy maintained forelimb motor function in rats that would otherwise become quadriplegic. This work helps validate UPF1 as a novel therapeutic for ALS and other TDP-43-related diseases and may implicate UPF1 and NMD involvement in the underlying disease mechanisms.

Sensitivity of Phytophthora capsici on Vegetable Crops in Georgia to Mandipropamid, Dimethomorph, and Cyazofamid.

Phytophthora blight, caused by Phytophthora capsici, is a serious disease in vegetable production, and selective use of fungicides continues to be a significant component of disease management programs. The effect of three chemical compounds-mandipropamid, dimethomorph, and cyazofamid-on asexual stages of P. capsici collected from bell pepper and cucurbits in Georgia was assessed in this study. Forty isolates of P. capsici were determined to be sensitive to mandipropamid and dimethomorph based on mycelial growth, zoospore germination, and sporangial production. Concentrations that were 50% effective (EC50 values) of mandipropamid that inhibited mycelial growth, zoospore germination, and sporangial production of the isolates averaged 0.03, 5.70, and 0.02 µg/ml, respectively. EC50 values of dimethomorph in inhibiting mycelial growth, zoospore germination, and sporangial production averaged 0.24, 0.10, and 0.46 µg/ml, respectively. The majority of isolates were either resistant or intermediately sensitive to cyazofamid at 500 µg/ml or lower concentrations based on mycelial growth or sporangial production, although all the isolates were sensitive to this compound based on zoospore germination, with an average EC50 of 0.04 µg/ml. The results indicated that P. capsici populations in Georgia have not developed resistance to mandipropamid and dimethomorph whereas, for the majority of the isolates, certain asexual stages were resistant to cyazofamid.

First Report of Root Rot Caused by Fusarium solani on Benincasa hispida in the United States.

Root rot was observed on wax gourd (Benincasa hispida (Thunb.) Cogn.) cv. Black Giant in August 2010 in a commercial vegetable farm in southern Georgia. Approximately 5% of the plants were affected and infected roots turned light to dark brown with partial or entire roots affected and the lower leaves became wilted. Symptomatic roots from six plants were surface sterilized with 0.6% sodium hypochlorite and plated on potato dextrose agar (PDA) medium. Pure cultures had white mycelia and spore masses and were obtained from all six plants by subculturing hyphal tips onto PDA. One- to two-celled, oval- to kidney-shaped microconidia and cylindrical macroconidia with two or three cells plus apical and basal cell were produced, which averaged 12.5 × 4 µm and 28 × 4.5 µm, respectively. Microconidia were abundant and macroconidia were sparse on PDA. Single-spore isolates were obtained and identified as a Fusarium sp. by PCR analysis with primers ITS-Fu-f and ITS-Fu-r (1). Genomic DNA of two isolates obtained from different plants was extracted and a portion of the translation elongation factor 1-α (TEF) gene of the isolates was amplified and sequenced (3). When compared with sequences available in the GenBank database, DNA sequences of the two isolates (GenBank Accession No. JF928376) shared 100% sequence identity with F. solani strain FRC S1734 (GenBank Accession No. DQ247527). The fungus was identified as F. solani (Mart.) Sacc. based on molecular analysis and morphological characteristics (2). Oat grains were separately infected with two isolates, BG2a and BG6, and used to inoculate healthy, 3-week-old wax gourd seedlings (cv. Black Giant) under greenhouse conditions (14-h photoperiod, 24 to 30°C). Each seedling was grown in a 10-cm pot containing a commercial potting mix, and five healthy plants were inoculated with each isolate by placing 15 infected oat grains around each plant at a depth of 5 cm in the soil. Five plants treated with noninfected oat grains served as controls. Symptoms identical to those on field samples developed on all inoculated plants 3 weeks after inoculation but not on the control plants. F. solani was reisolated from inoculated symptomatic plants and the identity was confirmed, which completed Koch's postulates. The experiment was repeated one more time under similar conditions. To our knowledge, this is the first report of root rot caused by F. solani on wax gourd in the United States. Wax gourd is an important specialty crop in the southeastern United States and the occurrence of this disease needs to be taken into account in wax gourd production. References: (1) K. A. Abd-Elsalam et al. Afr. J. Biotechnol. 2:82, 2003. (2) C. Booth. Fusarium Laboratory Guide to the Identification of the Major Species. CMI, Kew, England, 1977. (3) D. M. Geiser et al. Eur. J. Plant Pathol. 110:473, 2004.

Cardiovascular reactivity and neuronal activation to stress in Schlager genetically hypertensive mice.

Schlager inbred hypertensive mice (BPH/2J) have been suggested to have high blood pressure (BP) due to an overactive sympathetic nervous system (SNS). The brain nuclei associated with the hypertension are also those involved in the integration of the cardiovascular responses to stress. Therefore, in the present study, we hypothesize that BPH/2J mice likely have a greater response to stress that is associated with greater neuronal activation in the limbic system, hypothalamus and medulla in regions known to regulate sympathetic activity. Male hypertensive BPH/2J and normotensive BPN/3J mice were implanted with telemetry devices and exposed to dirty cage-switch, an acute model of aversive stress. Stress exposure caused a 60% greater pressor response in BPH/2J compared with BPN/3J mice and an increase in activity, by contrast the level of tachycardia was less in BPH/2J mice. Stress-induced cardiovascular responses were also associated with greater neuronal activation, as detected by c-Fos expression, in BPH/2J compared with BPN/3J mice in the medial nucleus of the amygdala (MeAm), dorsomedial hypothalamus (DMH) (P<0.001) and marginally in the rostral ventrolateral medulla (RVLM; P=0.7). These findings suggest that hypertension in the BPH/2J mice is associated with greater sympathetic vasomotor responses to central pathways mediating the arousal responses to acute aversive stress in particular the amygdala, hypothalamus and rostral ventrolateral medulla.

Prevalence of attention-deficit/hyperactivity disorder in a community sample of older adolescents.

OBJECTIVE: To study the prevalence and correlates of attention-deficit/hyperactivity disorder (ADHD) in a community sample of older adolescents. METHOD: From 1986 to 1988, 3,419 seventh, eighth, and ninth graders were screened with the Center for Epidemiologic Studies-Depression Scale. The top decile scorers and a random sample of the remainder were interviewed with the Schedule for Affective Disorders and Schizophrenia for School-Age Children. These data are from the second wave of interviews (N = 490, mean age = 18.65). RESULTS: The weighted prevalence of DSM-III-R ADHD was 1.51% (males: 2.62%, females: 0.54%). Significant associations (p < .05) were found for gender (male), comorbid affective disorders, baseline undesirable life events, and fewer than two biological parents at baseline. Family cohesion (p = .058) is inversely associated with ADHD. For subjects not meeting the age-at-onset criterion, 1.94% met the eight symptom criteria, and females (3.2%) were more prevalent than males (0.3%). CONCLUSIONS: ADHD remains a problem in this sample of older adolescents and is often comorbid with affective disorders. A significant number report eight ADHD symptoms but do not meet the age-at-onset criterion. This group deserves research attention.

A longitudinal study of adolescent mental health service use.

This study examines longitudinal mental health service use patterns of a school-based sample of adolescents. Based on the Center for Epidemiologic Studies Depression Scale scores, a stratified sample of middle-school students was interviewed using the Schedule for Affective Disorders and Schizophrenia for School-Aged Children: cycle one (n = 579; mean age 12.83) and cycle two (n = 490; mean age 18.65). Service use also was assessed by mailed questionnaire: cycle three (n = 330; mean age 20.60). Service use decreased over time. Whites and males received significantly more treatment in the first cycle. In the second cycle, service use by race and gender was equal; in the third cycle, females received more treatment. Those with a psychiatric diagnosis (first cycle, 54%; second cycle, 33%) received treatment in the prior year. Under-treatment of youth with psychiatric diagnoses is a significant problem, with differences in service use by race and gender over time.

High-risk HPVs and risk of cervical neoplasia: a nested case-control study.

The purpose of this nested case-control study was to estimate the risk of SIL development among a cohort of women providing cervical samples as part of their family planning visit at baseline in 1991-1992. All women had normal cervical cytology (N = 2905) at baseline and provided a cervical sample for subsequent HPV typing. Among this cohort, 426 women developed SIL (22 HSIL and 404 LSIL), 619 developed atypia, and 1860 remained cytologically normal. Two controls per case were sampled from those who remained normal. PCR-based methods with L1 consensus primers were used to assess high-risk HPV positivity. Having an oncogenic HPV type at baseline was associated with an almost fourfold increased risk of HSIL development (relative risk (RR) = 3.8; 95% CI, 1.5--9.0) and a 70% increased risk of LSIL development (RR = 1.7; 95% CI, 1.2--2.3%). The association between HPV positivity and SIL development was strongest in the first year of follow-up (RR = 9.2 for HSIL and 2.5 for LSIL development). The decline in HPV-associated SIL risk may be a function of having only one measure of HPV positivity (at baseline).

C-terminal epitope tagging facilitates comparative ligand mapping from MHC class I positive cells.

Purification of specific class I molecules prior to peptide ligand characterization is complicated by the presence of multiple class I proteins in most cell lines. Immortalized B, T, and tumor cell lines typically express endogenous HLA-A, -B, and -C; and most individuals from which the cell lines are derived are heterozygous at these loci. Antibodies specific for a particular HLA molecule may be used for purification, but allele-specific antibodies can be biased by ligands occupying the peptide-binding groove. Through the use of C-terminal tagging, we have developed a method of soluble HLA production such that downstream purification does not skew the peptide analysis of the examined molecule. Comparison of peptides eluted from HLA class I molecules with and without C-terminal tags demonstrates that addition of a tag does not abrogate the peptide binding specificity of the original molecule. Both pooled Edman sequencing and mass spectrometric sequencing identified no substantial differences in peptides bound by untailed, 6-HIS-tailed, and FLAG-tailed class I molecules, demonstrating that the peptide specificity of a given molecule is not distorted by either tag. This production methodology bypasses problems with isolation of specific molecules and permits ligand mapping and epitope discovery in a variety of pathogen-infected and tumor cell lines.

Association between employment and substance abuse behaviors among public high school adolescents.

PURPOSE: To examine the relationship between adolescents' after-school and weekend employment and substance abuse behaviors in a cross-sectional sample of public high school students in South Carolina. METHODS: The Centers for Disease Control and Prevention Youth Risk Behavior Survey (YRBS) was used to secure usable data from 4800 subjects. Logistic regression adjusting for age and using SUDAAN were performed. Odds ratios and 95% confidence intervals were calculated from the regression analyses. RESULTS: Thirty percent of white males, 29% of white females, and 20% of black males and females worked at a job for pay during the academic year. For white males employment, ranging from 11 to 15 h and 26 to > or =31 h was associated with cigarette smoking, working from 11 to > or =31 h was associated with alcohol use, working > or =31 h was associated with binge drinking, working from 26 to > or =31 h was associated with marijuana use, and working from 26 to 30 h was associated with cocaine use. For white females, working from 16 to 20 h was associated with alcohol use, working from 21 to 30 h was associated with binge drinking, and working from 26 to 30 h was associated with marijuana and cocaine use. CONCLUSION: Youth who work above 15 h/week at a job for pay during high school appear to have an increased risk for substance abuse and its consequences.

Association between exercise and HIV disease progression in a cohort of homosexual men.

PURPOSE: To study the relationship between exercise and human immunodeficiency virus (HIV) disease progression. METHODS: 415 individuals (156 HIV positive, 259 HIV negative), from a cohort study of 851 homosexual men from New York City, 1985-1991. By 1991, 68 of the 156 persons developed Acquired Immune Deficiency Syndrome (AIDS) and 49 died with AIDS. Exercise was defined as self-report of exercising 3-4 times/week or daily at entry; less was considered nonexercise. CD4 lymphocyte decline was constructed for each subject by modeling log CD4 count against time in days. The association between exercise and progression to AIDS and death with AIDS, adjusting for baseline CD4 count, was determined using Cox model. Linear regression was used to model CD4 decline with exercise for HIV positive and HIV negative groups separately, adjusting for initial CD4 count. RESULTS: Having exercised was associated with slower progression to AIDS at 1 year (HR = 0.68, 90% confidence interval (CI): 0.4-1.17); hazard ratios (HR) at 2, 3, and 4 years were 0.96, 1.18, and 1.36, respectively. Having exercised was also associated with slower progression to death with AIDS at 1 year (HR = 0.37, 90% CI: 0.14-0.94) with hazard ratios at 2, 3, and 4 years of 0.68, 0.98, and 1.27, respectively, suggesting a protective effect close to the time exercise was assessed, but an increased risk after 2 years. Exercising 3-4 times/week had a more protective effect than daily exercise. Exercisers in the HIV positive group showed an increase in CD4 count during a year by a factor of 1.07. CONCLUSION: Moderate physical activity may slow HIV disease progression.

Incidence and predictors of suicidal behaviors in a longitudinal sample of young adolescents.

OBJECTIVE: This analysis examines 1-year transition probabilities and baseline predictors for suicidal behaviors in young adolescents. METHOD: Adolescents from a two-stage, community-based longitudinal study were classified into suicidal behavior categories (attempt, plan, ideation, and none) for baseline and follow-up years. Transition probabilities for movement among categories were calculated, and polytomous logistic regression analysis was used to examine predictors of suicidal behaviors. RESULTS: Among those with no suicidal behaviors at baseline, 1-year incidence rates were 1.3% for attempts and 1.7% each for plans and ideation. Increasing family cohesion was protective for suicide attempts (odds ratio [OR] = 0.9). Female subjects were more likely than males to report plans (OR = 8.9) and ideation (OR = 4.1). Increasing impulsivity (OR = 2.3), prior suicidal behavior (OR = 10.6), and undesirable life events (OR = 1.1) were significant predictors of plans. CONCLUSIONS: While there are a number of predictors of suicidal behaviors, the false-positive rate is high. Focusing on proximal risk factors, particularly stressors in adolescent development, may overlook the fundamental role of underlying mental disorder and familial factors--both biological and environmental. Suicide and suicidal behaviors are the result of a constellation of adverse factors requiring a range of interventions for prevention.

Risk factors for congenital syphilis in infants of women with syphilis in South Carolina.

OBJECTIVES: This study examined risk factors for congenital syphilis in South Carolina. METHODS: Case infants with presumptive and confirmed congenital syphilis were compared with control infants born to women with reactive serologies during pregnancy, allowing investigation of risk factors for congenital rather than acquired transmission of syphilis. Data were collected from congenital syphilis report forms and birth certificates for 186 case infants and 487 controls born from 1991 to 1993. Odds ratios were calculated for maternal risk factors. RESULTS: Significant statistical trends were found for timing of first prenatal visit and number of visits. Other significant factors included rural residence (odds ratio [OR] = 2.0, 95% confidence interval [CI] = 1.4, 2.9) and previous pregnancy loss (OR = 0.3, 95% CI = 0.2, 0.6). CONCLUSIONS: Prevention of congenital syphilis may be less effective among pregnant women with syphilis in South Carolina who have fewer prenatal care visits. Health care providers need further education on maternal/child syphilis management and techniques for motivating and educating patients.

Exaggerated blood pressure response to dynamic exercise and risk of future hypertension.

This study examined the association between an exaggerated blood pressure response to treadmill exercise and the risk of developing hypertension. Subjects were healthy normotensive men (n = 5386) who had a baseline graded maximal exercise test between 1971 and 1982, and completed a mailed follow-up questionnaire. At follow-up in 1986, cases (n = 151) reported physician diagnosed hypertension and controls (n = 201) reported normotension. Those who had developed hypertension at follow-up were more likely to have had an exaggerated blood pressure response to exercise (OR = 2.4, 1.4-4.3). In multiple logistic regression analysis an exaggerated response was significantly associated (OR = 3.0, 1.5-6.1) with future hypertension after controlling for sitting systolic and diastolic blood pressure, weight change from age 21 to follow-up, entry age, family history of hypertension, body mass index, treadmill time, alcohol consumption, and years of follow-up. These results suggest that an exaggerated blood pressure response to exercise is independently associated with increased risk of future hypertension, and therefore, may be an important factor in determining hypertension risk.

Prevalence of PTSD in a community sample of older adolescents.

OBJECTIVE: To examine prevalence and correlates of trauma and posttraumatic stress disorder (PTSD) symptoms and diagnosis in older adolescents aged 16 through 22 years. METHOD: The second cycle of a longitudinal epidemiological study in the Southeast included a semistructured interview assessing PTSD symptomatology administered to 490 adolescents. RESULTS: Approximately 3% of female subjects and 1% of male subjects satisfied the DSM-IV criteria for PTSD. Females reported more traumatic events than males, and black subjects reported more events than white subjects. Being female (odds ratio = 12.32), experiencing rape or child sexual abuse (odds ratio = 49.37), and witnessing an accident or medical emergency (odds ratio = 85.02) were associated with increased risk of PTSD. CONCLUSIONS: While relatively few adolescents satisfy the criteria for PTSD, most subjects who experienced a traumatic event reported some PTSD symptoms. Specific types of traumatic events were associated with occurrence of PTSD.

Effect of body mass index on activity limitation and mortality among older women: the National Health Interview Survey, 1986-1990.

We assessed the impact of body mass on the association between activity limitations due to chronic conditions and mortality among 24,612 noninstitutionalized white or African American women aged > or = 65 years who participated in a National Health Interview Survey between 1986 and 1990. We found that more African American women had activity limitations than white women (59% vs 46%, respectively). The difference by race was greatest (19% vs 10%) for the most severe limitation (unable to perform the major activity). For women aged 65-69, the major activity was working or keeping house; for those aged > or = 70, it was the ability to live independently. For white women in all three categories of body mass index (BMI) and for African American women with BMI 15%-85%, the risk of dying was significantly higher for those unable to perform the major activity than for those with no limitations, controlling for the effects of education, marital status, and perceived health. The findings confirm the established link between low BMI and mortality and between activity limitations and mortality. Additionally, the findings further suggest that activity limitations linked to chronic conditions increase the risk of death within each stratum of BMI after adjusting for potential confounders.

Black-white differences in body size perceptions and weight management practices among adolescent females.

OBJECTIVE: This study compares body size perceptions and weight management practices of black and white adolescent females. DESIGN: Subjects were selected through a statewide, three-stage sampling procedure designed to provide a sample statistically representative of high school students in South Carolina. SUBJECTS: Participants included black (n = 1824) and white (n = 2256) females, 14-18 years of age, enrolled in South Carolina public high schools. METHODS: Respondents were asked to assess their perceived body size as overweight, underweight, or about right. Self-reported weight management practices included dieting (reducing caloric intake), exercise, and other methods (including diet pills and vomiting). Chisquare analysis was used to assess the differences in body size perception and weight management behaviors. Polychotomous logistic regression was performed to examine association while controlling for socioeconomic status. RESULTS: Forty-one percent of the white adolescents and 29% of the black adolescents perceive themselves as overweight (p < 0.005). In the week prior to the survey, 28% of the white adolescents and 13% of the black adolescents reported dieting 34% of the while versus 23% of the black adolescents reported exercising to lose weight; and 45% of the white and 16% of the black students reported both dieting and exercising. Polychotomous logistic regression analysis showed that white adolescent girls were almost twice as likely to perceive themselves as overweight as black adolescent girls. The white students had 6.04 [95% confidence interval (CI), 1.77, 20.67] times the odds of using pills and vomiting and 3.76 (95% CI, 2.99, 4.72) times the odds of engaging in dieting and exercising as methods of weight management compared to the black students. CONCLUSIONS: These findings suggest that white adolescents are more likely to perceive themselves as overweight than black adolescents and are more likely to engage in unhealthy weight management practices than black adolescents.