Clinico-Demographic Parameters of Oral Fungal Infections: An Institutional Retrospective Study.

Introduction Most fungal infections are responsive to antifungal therapy. However, failure to diagnose the same can significantly affect the quality of lives of patients. Timely identification of fungal infections and their association with varied demographic and clinical parameters will help in improving the prognosis of the patient. The present study aims to evaluate the prevalence of fungal infections among various age groups and genders and also to evaluate the association of fungal infections with demographic parameters. Methods This study included a sample size of n = 600. The demographic and clinical details were compiled and transferred to IBM SPSS Version 23 software (IBM Corp., Armonk, NY) for statistical analysis. Descriptive and Pearson chi-square tests were used to analyze the association of the type of fungal infection with gender, age, and comorbidities. A p-value of less than 0.05 is considered statistically significant. Results Angular cheilitis (40%, 240), followed by denture stomatitis (37.5%, 225), were the most common type of fungal infection among the sample population, and the elderly age group (51-72 years) was the most affected. Angular cheilitis was the most common infection among both males (21.4%, 128) and females (18.6%, 112), but candidiasis was reported more in females (18%, 108) than males (3%, 18) (p = 0.00). Angular cheilitis (32%, 192) and candidiasis (18%, 108) were more observed in association with anemia; however, denture stomatitis (34%, 204) was significantly higher among diabetics (p = 0.00). Conclusion The identification of associated systemic and demographic factors is as important as the treatment of fungal infection itself. The recognition of fungal infections and the role of parameters like age, gender, and systemic comorbidities in the development of fungal infections will have valuable implications for public health. Future research is required for a clear understanding of the same.

Traditional Newborn Care Practices in a Tribal Community of Tamilnadu, South India: A Mixed Methods Study.

Background and Objectives: Traditional newborn rearing practices play a vital role in neonatal morbidity and mortality. In this context, a concurrent mixed method study was conducted to identify the traditional practices in newborn care in tribal villages of Sittilingi Panchayat of Tamil Nadu, South India. Methods: The quantitative data were collected by a community-based cross-sectional study among 59 mothers of infants. Qualitative component included two focus group discussions (FGD) each with seven mothers and one traditional dai. Results: About 38.9% of newborns received colostrum, and 61.1% had prelacteal feeds. Majority (84.7%) of newborns had received appropriate thermal care. More than two-thirds (71.2%) of newborns were given bath before umbilical cord dropped off. During bathing, 83.1% were massaged and 67.8% had their vernix removed. Practice of blowing into nostrils (45.7%), substance application on the cord (94.9%), tepid sponging during fever (28.8%), sweet flag application over umbilicus for colic (8.5%), herbal medications during diarrhea (40.6%) and cold (25.4%), exposure to sunlight (67.8%) during jaundice, oil instillation in nostrils (76.3%), and ears (32.2%) to protect against infection were reported. Majority reported approaching traditional health practitioners during illness. Similar practices were reported in the FGDs. The beliefs related to these practices were explored. Conclusion: Both beneficial and harmful practices in newborn care were identified. Primary health care workers like ASHAs could be trained to recognize traditional newborn practices in their field areas to deliver appropriate behavior change communication to preserve safe practices and avoid harmful practices to improve newborn health.

Clinico-epidemiological profile and outcomes of adults with COVID-19: A hospital-based retrospective study in Kerala, India.

Introduction: The clinical and epidemiological presentations of patients with coronavirus disease 2019 (COVID-19) in India is still not well explored. We studied the epidemiological and clinical profile and outcomes of COVID-19 patients admitted to a tertiary care private hospital in Kerala, India. Methods: In this retrospective study, we analyzed data of 476 adult (≥18 years) COVID-19 patients admitted to a tertiary care hospital in Kerala from September 1, 2020 to March 31, 2021. The patients were categorized into mild, moderate, and severe cases and followed till discharge or death. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 23.0 with a significance set at P < 0.05. Results: The median age was 57 years (56% men). Mild, moderate, and severe cases accounted for 17%, 65%, and 18%, respectively. Around 75% had at least one comorbidity, and 51% had multiple comorbidities. The most common comorbidities were diabetes (45%), hypertension (44%), dyslipidemia (15%), and cardiac problems (12%). The elevated D-dimer values among patients in different categories were significantly different, with 74% in severe, 46% in moderate, and 19% in mild category patients. Serum ferritin, C-reactive protein, lactic acid dehydrogenase, and neutrophil to lymphocyte ratio values were significantly higher for severely ill patients. Thirty deaths (67% men) occurred during the study period, with a case fatality rate of 6.3%. Mortality mainly happened in the older age group (80%) and those with multimorbidity (90%). Conclusion: Age and multimorbidity are the major contributing factors for death in hospitalized COVID-19 patients. Generalization of the findings necessitates well-designed large-scale studies.

Optimization of parameters to improve transformation efficiency of elephant foot yam (Amorphophallus paeoniifolius (Dennst.) Nicolson.

Elephant foot yam (Amorphophallus paeoniifolius (Dennst.) Nicolson), is an important edible tropical tuber crop, belonging to the family Araceae. Corms produced by this plant is very big and they are rich in starch, protein, mineral, vitamins, and dietary fiber but has acridity problem. This crop is susceptible to virus and phytoplasma diseases which affects crop growth and corm yield. Even though this crop has high commercial value, the problems like susceptibility to viral diseases, acridity problems, and lack of genetic diversity made hindrance in their exploitation. These issues can be resolved only by improving the characters through genetic transformation. To achieve genetic transformation in this important crop, a study was conducted to optimize various parameters for efficient Agrobacterium-mediated genetic transformation using embryogenic calli with vectors having gus reporter gene. Calli were developed using petiole and leaves of in vitro plantlets of elephant foot yam cultivar Gajendra and experiments were conducted to evaluate the sensitivity of calli to different doses of antibiotics viz. geneticin, hygromycin, ticarcillin. It was observed that complete death and discoloration of the calli were obtained with 25 mgl-1 geneticin and 10 mgl-1 hygromycin. The lowest lethal concentration of ticarcillin against Agrobacterium growth was found to be 500 mgl-1 which did not affect calli growth. Optimized parameters for efficient transformation in elephant foot yam include 100 µM acetosyringone concentration with 2 days of co-cultivation at temperature 22 °C using LBA4404 strain. The putative transformants were characterized for the integration of the gus gene using PCR and nucleic acid spot hybridization. The optimized protocol is simple and reproducible and may be adapted for other cultivars also. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13205-021-02824-6.

Adiposity, Depression Symptoms and Inflammation in Hispanic/Latino Youth: Results From HCHS/SOL Youth.

BACKGROUND: Inflammation is implicated as one of many factors related to the development of chronic disease; thus, identifying its modifiable risk factors offers potential intervention targets to reduce risk. PURPOSE: To investigate whether depression and anxiety symptoms may indirectly affect high-sensitivity C-reactive protein (hs-CRP) and plasminogen activator inhibitor-1 (PAI-1) through sleep duration and adiposity (i.e., percentage body fat and waist circumference). METHODS: Multiple regression analyses were performed on Hispanic Community Health Study/Study of Latinos Youth (ages 8-16 years) cross-sectional baseline data, which were weighted to adjust for sampling design. Data were collected at a clinical assessment, including fasting blood samples, self-report surveys, and objectively measured anthropometrics. RESULTS: Adjusting for sociodemographic covariates, depression symptoms were associated with log hs-CRP (ß = .011, p = .047) but not PAI-1 (p = .285). Percentage body fat and waist circumference were positively related to depression symptoms (p = .026 and p = .028, respectively) and log hs-CRP (p < .001 for both). When including adiposity in the hs-CRP model, the associations of depression symptoms with hs-CRP were attenuated and became nonsignificant. Monte Carlo confidence intervals (CIs) showed that the indirect effects from depression symptoms to CRP through percentage body fat (95% CI: .0006, .0119) and waist circumference (95% CI: .0004, .0109) were statistically significant. CONCLUSIONS: Results indicate that the association between psychological distress and inflammation may occur indirectly through adiposity in Hispanic/Latino children. If findings are replicated in causal designs, reducing depression symptoms and adiposity among Hispanic/Latino children may be avenues for primary prevention of inflammation in later years.

Predicting the molecular subtype of breast cancer based on mammography and ultrasound findings.

AIM: To determine the correlation between mammography and ultrasound features of breast cancer with molecular subtypes and to calculate the predictive value of these features. MATERIALS AND METHOD: This is a prospective study of consecutive patients with breast cancer presenting between January 2016 and July 2017, who underwent mammography and/or ultrasound of breast and excision of the breast mass. Patients with contralateral breast mass, metastases, h/o prior cancer treatment, and other malignancies were excluded. On mammography, the presence or absence of microcalcification was noted. On ultrasound examination size, margins, microcalcification, posterior acoustic features, vascularity, and axillary nodes were assessed. Margins were categorized into circumscribed and non-circumscribed. Posterior acoustic features were classified into four categories: shadowing, enhancement, mixed, and no changes. Vascularity was assessed based on Adler's index into grades 0, 1, 2, and 3. Grades 0 and 1 were considered low and 2 and 3 were high. RESULTS: Tumors with non-circumscribed margins and posterior acoustic shadowing were likely to be luminal A or B subtype of breast cancer [odds ratio (OR) 5.78; 95% confidence interval (CI) 3.68-9.80; P < 0.0001]. Tumors with non-circumscribed margins, posterior acoustic shadowing, and high vascularity were more likely to be luminal B subtype (OR 2.88; 95% CI 2-4.14; P- <0.0001). Tumors with microcalcification and posterior mixed acoustic pattern were strongly associated to be HER2-positive (OR 5.48; 95% CI 3.06-9.80; P < 0.0001). Tumors with circumscribed margins and posterior acoustic enhancement were highly suggestive of triple-negative breast cancer (OR 7.06; 95% CI 4.64-10.73; P < 0.0001). CONCLUSION: Microcalcification detected on mammography and certain ultrasound features such as circumscribed or non-circumscribed margins, posterior acoustic features, and vascularity are strongly correlated in predicting the molecular subtypes of breast cancer, and thus may further expand the role of conventional breast imaging.

Effects of Social Exclusion on Cardiovascular and Affective Reactivity to a Socially Evaluative Stressor.

PURPOSE: Socially disconnected individuals have worse health than those who feel socially connected. The mechanisms through which social disconnection influences physiological and psychological outcomes warrant study. The current study tested whether experimental manipulations of social exclusion, relative to inclusion, influenced subsequent cardiovascular (CV) and affective reactivity to socially evaluative stress. METHODS: Young adults (N = 81) were assigned through block randomization to experience either social exclusion or inclusion, using a standardized computer-based task (Cyberball). Immediately after exposure to Cyberball, participants either underwent a socially evaluative stressor or an active control task, based on block randomization. Physiological activity (systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR)) and state anxiety were assessed throughout the experiment. RESULTS: Excluded participants evidenced a significant increase in cardiovascular and affective responses to a socially evaluative stressor. Included participants who underwent the stressor evidenced similar increases in anxiety, but systolic blood pressure, diastolic blood pressure, and heart rate did not change significantly in response to the stressor. CONCLUSIONS: Results contribute to the understanding of physiological consequences of social exclusion. Further investigation is needed to test whether social inclusion can buffer CV stress reactivity, which would carry implications for how positive social factors may protect against the harmful effects of stress.

Rapid and sensitive detection of Dasheen mosaic virus infecting elephant foot yam by reverse transcription loop mediated isothermal amplification of coat protein gene.

Dasheen mosaic virus (DsMV), the pathogen causing mosaic disease of elephant foot yam (Amorphophallus paeoniifoilius) is disseminated mainly through vegetative propagation of the tubers. For the rapid and sensitive detection of the virus, a reverse transcription loop-mediated isothermal amplification (RT-LAMP) assay based on the coat protein gene has been developed. A final concentration of 5.4 mM magnesium sulphate and 0.7 M betaine in the reaction mixture was found to be optimum for getting characteristic ladder like bands of the amplified product after gel electrophoresis. The reaction was set at 65°C for 50 min followed by reaction termination at 86°C for 5 min in a water bath. The sensitivity of the assay was found to be 100 times higher than that of RT-PCR. The virus was indexed successfully from tubers of elephant foot yam. In tube detection of the DsMV was carried out using fluorescence detection reagents. The assay was validated with field samples from various regions of Kerala state, India.

Approach and avoidance coping: diurnal cortisol rhythm in prostate cancer survivors.

Psychological coping responses likely modulate the negative physiological consequences of cancer-related demands. This longitudinal, observational study examined how approach- and avoidance-oriented strategies for coping with cancer are associated with diurnal cortisol rhythm in prostate cancer (PC) survivors. Sixty-six men (M age=65.76; SD=9.04) who had undergone radical prostatectomy or radiation therapy for localized PC within the prior two years reported their use of approach and avoidance coping via questionnaire at study entry (T1). Participants provided saliva samples (3 times per day over 3 days) for diurnal cortisol assessment at T1 and again 4 months later (T2). When controlling for relevant biobehavioral covariates, cancer-related avoidance-oriented coping was associated with flatter cortisol slopes at T1 (B=.34, p=.03) and at T2 (B=.30, p=.02). Approach-oriented coping was not associated with cortisol slopes. Post-hoc analyses revealed a significant interaction between avoidant coping and time since completion of cancer treatment on T2 cortisol slope (B=-.05, p=.04). Men who used relatively more avoidance-oriented coping who were further in time from treatment demonstrated a flatter cortisol slope. High avoidance-oriented coping is associated with dysregulation of cortisol responses, which may be an important target for reducing stress during PC survivorship.

Inflammatory biomarkers and emotional approach coping in men with prostate cancer.

OBJECTIVE: Emotion-regulating coping is associated with improvements in psychological and physical health outcomes. Yet in the context of prostate cancer-related stressors, limited research has characterized associations of emotion-regulating coping processes (emotional expression, emotional processing) and inflammatory processes that are related to disease risk. This investigation examined the relation of Emotional Approach Coping (EAC) with markers of inflammation to test the hypothesis that higher EAC scores at study entry (T1) would be associated with lower proinflammatory markers four months later (T2), specifically sTNF-RII, CRP, and IL-6. METHODS: Forty-one men (M age=66.62 years; SD=9.62) who had undergone radical prostatectomy or radiation therapy for localized prostate cancer within two years completed questionnaires, including assessments of EAC, at T1, and provided blood samples for immune assessments at T2. RESULTS: When controlling for relevant biobehavioral controls, emotional processing predicted lower IL-6 (B=-.66, p<.01), sTNF-RII (B=-.43, p<.05), and CRP (B=-.43, p<.10), whereas emotional expression was significantly associated with higher levels of sTNF-RII (B=.55, p<.05). Associations of emotional expression and IL-6 (B=.38, p<.10), and CRP (B=.44, p<.10) approached significance. Probing interactions of emotional processing and expression (though only approaching significance) suggested that expression of emotion is associated with higher inflammation (CRP and sTNF-RII) only in the context of low emotional processing. CONCLUSIONS: Attempts at emotion regulation via emotional processing appear to modulate inflammatory processes. Understanding, making meaning of, and working through emotional experience may be a promising target of intervention to reduce inflammation with potential effects on psychological and cancer outcomes in men with prostate cancer.

Cancer-related masculine threat, emotional approach coping, and physical functioning following treatment for prostate cancer.

OBJECTIVE: Aspects of masculinity and gender role, particularly those that are traditional and restrictive, are related to poorer physical and psychological outcomes in men with cancer. This longitudinal study uses a cancer-specific assessment to determine whether cancer-related masculine threat (CMT) predicts prostate-related (i.e., urinary, bowel, sexual) functioning over time, and whether cancer-related emotional approach coping (EAC) processes explain these relationships. Whether coping self-efficacy and emotional suppression explain effects of CMT on EAC also is tested. METHODS: Sixty-six men (M age = 65.76; SD = 9.04) who underwent radical prostatectomy and/or radiation therapy for localized prostate cancer within two years were assessed on physical and psychological variables at study entry (T1), and two (T2) and four (T3) months later. RESULTS: Analyses controlling for baseline functioning and age revealed that CMT predicted declines in (T1 to T3) urinary (B = -.21, p < .05), bowel (B = -.24, p < .05), and sexual (B = -.17, p < .05) function. CMT also predicted decreased emotional processing (T1 to T2), but not emotional expression. Decreased emotional processing predicted declining prostate-related functioning and helps explain the effect of CMT on bowel and sexual (but not urinary) functioning. Low coping self-efficacy (p < .05), but not emotional suppression, was a mechanism by which CMT predicted emotional processing. CONCLUSIONS: The extent to which men believe that cancer is inconsistent with their masculinity exacerbates declines in prostate-related functioning following cancer treatment. CMT likely shapes coping responses and negatively affects the efficacy of emotion-directed coping. Emotion-regulating coping processes, particularly the ability to process cancer-related emotions, appears to be one pathway through which gender role affects recovery from prostate cancer.

Post-traumatic disorder symptoms and blunted diurnal cortisol production in partners of prostate cancer patients.

Prostate cancer (PC) is the most common cancer diagnosed in men, and research suggests that coping with this illness can cause significant distress in patients as well as their partners. This study examined the relationship of caregiving for a partner with PC with diurnal cortisol output in women between the ages of 42 and 75 years old. Participants were women whose partners had PC (n = 19) and women who were in relationships with men with no diagnosed medical illness (n = 26). Women provided saliva samples (4 times per day over 3 days) in their natural environment. The Structured Clinical Interview for DSM-IV Axis-I Disorders was also conducted to assess for the presence of post-traumatic stress disorder (PTSD) and major depression. Partners of men with PC had lower daily cortisol output across the three days than controls, F(1,444.08) = 20.72, p<.001). They were also more likely to report PTSD symptoms with 68.4% of PC partners fulfilling criteria for sub-threshold PTSD as compared to 23.1% of controls (χ(2) = 11.30, p = .01). Mixed model analyses revealed that the presence of sub-threshold PTSD symptoms significantly predicted cortisol production, F(1,419.64) = 5.10, p<.01). Regardless of caregiver status, women who reported at least sub-threshold PTSD symptoms had lower cortisol production than those with no PTSD symptoms. Major depression did not explain differences in cortisol production between partners of PC patients and controls. Although these findings are preliminary, they highlight the importance of developing interventions aimed at reducing risk of psychopathology in partners of men with PC.

Sleep depth and fatigue: role of cellular inflammatory activation.

Individuals with underlying inflammation present with a high prevalence of non-specific co-morbid symptoms including sleep disturbance and fatigue. However, the association between cellular expression of proinflammatory cytokines, alterations of sleep depth and daytime fatigue has not been concurrently examined. In healthy adults (24-61 years old), evening levels of monocyte intracellular proinflammatory cytokine production were assessed prior to evaluation of polysomnographic sleep and measures of fatigue the following day. Stimulated monocyte production of interleukin-6 (IL-6), but not tumor necrosis factor α (TNF-α), was negatively associated with slow wave sleep (ΔR²=.17, p=.029). In contrast, stimulated monocyte production of IL-6 was positively associated with rapid-eye movement (REM) sleep duration during the first sleep cycle (ΔR²=.26, p<.01). Moreover, evening stimulated production of IL-6 was associated with fatigue the following day (ΔR²=.17, p=.05). Mediation analyses showed that slow wave sleep, but not REM sleep duration, mediated the relationship between evening levels of IL-6 production and daytime fatigue. These results indicate that increases in stimulated monocyte production of IL-6 may be associated with decreases in slow wave sleep and increases in REM sleep duration. Relative loss of slow wave sleep may be one pathway through which cellular inflammation leads to daytime fatigue.

Disrupted sleep in breast and prostate cancer patients undergoing radiation therapy: the role of coping processes.

BACKGROUND: Sleep problems are a common complaint in cancer patients that have been understudied. METHODS: This study examined changes in sleep in 33 breast cancer (BC) patients and 23 prostate cancer (PC) patients during radiation therapy and over a 6-month followup. Coping processes were examined as predictors of sleep. Self-reported sleep was assessed at eight time-points before, during, and after treatment using the Medical Outcomes Study-Sleep Scale. The COPE Scale was used to assess coping processes before treatment onset. RESULTS: Mixed effects linear modeling analyses revealed that both BC and PC patients reported the most sleep problems prior to and during the early weeks of treatment. Coping strategies predicted sleep trajectories in both groups. In particular, approach coping predicted better sleep in PC patients, whereas avoidance coping predicted worst sleep in both PC and BC patients (p's<0.05). CONCLUSION: These findings highlight the importance of evaluating sleep in patients as they undergo treatment for cancer. Additionally, they suggest that interventions aimed at increasing the use of approach-oriented coping strategies may improve sleep and quality of life in these patients.

Influence of education and neighborhood poverty on pressor responses to phenylephrine in African-Americans and Caucasian-Americans.

Although neighborhood disadvantage has been linked to the development of cardiovascular disease, the mechanism through which living in impoverished neighborhoods is associated with poor cardiovascular health is not well understood. Additionally, it is not clear whether individual socioeconomic status (SES) interacts with neighborhood factors to influence cardiovascular outcomes. Using multilevel modeling, we examined the interaction between neighborhood poverty and individual SES on pressor responses to an alpha agonist, phenylephrine (PE), in an adult sample of 105 African-Americans and 106 Caucasian-Americans. Neighborhood poverty was assessed using census block data gathered from the Census Bureau. Education and occupation were used to assess individual SES. Pressor responsiveness was calculated as the systolic and diastolic blood pressure (BP) response to a 100-microg PE bolus administered intravenously. There was a significant interaction between education and neighborhood poverty on pressor responses. Higher education was associated with smaller BP responses to PE; but only in individuals who lived in neighborhoods in which less than 5% of the residents lived below the poverty line. Occupation was unrelated to pressor responses to PE. These results suggest that neighborhood characteristics play an important role in cardiovascular functioning.

To assess, to control, to exclude: effects of biobehavioral factors on circulating inflammatory markers.

Behavioral scientists have increasingly included inflammatory biology as mechanisms in their investigation of psychosocial dynamics on the pathobiology of disease. However, a lack of standardization of inclusion and exclusion criteria and assessment of relevant control variables impacts the interpretation of these studies. The present paper reviews and discusses human biobehavioral factors that can affect the measurement of circulating markers of inflammation. Keywords relevant to inflammatory biology and biobehavioral factors were searched through PubMed. Age, sex, and hormonal status, socioeconomic status, ethnicity and race, body mass index, exercise, diet, caffeine, smoking, alcohol, sleep disruption, antidepressants, aspirin, and medications for cardiovascular disease are all reviewed. A tiered set of recommendations as to whether each variable should be assessed, controlled for, or used as an exclusion criteria is provided. These recommendations provide a framework for observational and intervention studies investigating linkages between psychosocial and behavioral factors and inflammation.

Coping style and sleep quality in men with cancer.

BACKGROUND: Few studies have characterized the effects of cancer diagnosis and treatment on sleep quality in men with cancer, and even fewer have identified mediators between psychosocial factors and physical symptoms. It has been debated whether active, approach-oriented, coping behaviors or more passive, avoidance-oriented, coping behaviors are more important to the preservation of sleep quality. PURPOSE: This study tested the impact of coping style (i.e., approach vs. avoidance) on sleep quality and depressive symptoms and intrusive thoughts as putative mediators. METHODS: Utilizing a longitudinal design, men with cancer (N = 55) were assessed at study entry (T1) and again 6 months later (T2). Two indicators of sleep quality were assessed: severity of sleep disturbance symptoms and resulting interference with daily functioning from sleep problems. RESULTS: Higher use of avoidance coping at T1 was related to greater severity in sleep-related symptoms (p < 0.01) and more interference with daily functioning (p < 0.001) at T2. Approach coping at T1 was unrelated to indicators of sleep quality. Depressive symptoms and not intrusive thoughts mediated the relationship between avoidance coping and sleep symptom interference and partially mediated the effect on sleep symptom severity based on examination of bootstrapped standard errors for indirect paths. CONCLUSIONS: Avoidance of cancer-related stressors and circumstances likely contributes to declines in mood states and in turn compromises sleep. An individual's coping style may be an important consideration in the assessment and treatment of sleep problems in men with cancer.

Which measures of obesity are related to depressive symptoms and in whom?

The authors asked which obesity measurements were associated with depressive symptoms, whether this relationship differed by gender, and whether controlling for fatigue and response bias affected the relationship. A sample of 129 subjects (66 men, 63 women), with a mean age of 36.9 years and a mean Body Mass Index (BMI) of 26.4 participated in the study. Depressive symptoms, levels of fatigue, response bias, and anthropometrics were assessed. In women, but not men, BMI and percent of ideal body weight were related to depression. However, percent of body fat did not show a relationship with depression after controlling for fatigue and response bias. These findings suggest that women's depressive symptoms are more influenced by body size than body fat composition, whereas men's depressive symptoms seem to be unrelated to obesity.

Fatigue varies by social class in African Americans but not Caucasian Americans.

Socioeconomic status explains many ethnic disparities in health; however, mechanisms are hard to identify. Fatigue-a frequent complaint in patients and normals-is associated with poorer quality of life. We wondered if ethnicity and social class interact to explain fatigue. A total of 40 African Americans (AAs) and 64 Caucasian Americans (CAs) completed short forms of the Profile of Mood States (POMS-SF) and Multidimensional Fatigue Symptom Inventory (MFSI-SF). Participants were divided into high-middle and low social class groups (as per Hollingshead, 1958a). After controlling for gender, body mass index, depressive symptoms, and response bias, ethnicity and social class interacted for POMS-SF fatigue. AAs in the high-middle classes reported more fatigue than AAs in the low classes and CAs in the high-middle classes. Fatigue did not differ by class for CAs nor by ethnicity in the lower classes. Similar findings emerged for MFSI-SF general fatigue. Social class is important for understanding fatigue in AAs but not CAs.