The Role of Prosocial Behavior in Promoting Physical Activity, as an Indicator of Resilience, in a Low-Income Neighborhood.

The purpose of this study was to examine the effect of prosocial behavior on physical activity, as an indicator of resilience, in a low-income neighborhood with adverse built environment and social conditions. Resilience is an important factor that promotes the ability for individuals to overcome hardships, and understanding resilience as it relates to health behavior is important in the efforts to improve the health and wellbeing of vulnerable communities. There are many constructs of resilience, and we selected physical activity as an indicator of resilience because of the role of physical activity in health promotion. A community based participatory research approach was utilized to conduct a door knock survey in a sample of 2,457 households in a low-income, historically African-American neighborhood. Fifty-seven percent of residents completed the survey. Physical activity was the dependent variable and we controlled for key demographics, resident health, primary mode of transportation and neighborhood safety. Prosocial behavior was the primary independent variable. We conducted descriptive, bivariate and multivariate analyses and found prosocial behavior was significantly correlated with moderate physical activity, despite adverse conditions. Our results indicate that prosocial behavior plays an important role in an individual's ability to engage in health-promoting behaviors, such as physical activity, despite challenges.

Ethical and Legal Challenges Associated with Public Molecular Autopsies.

There is a national movement supporting the retention and use of bio-specimens from deceased individuals for the purpose of genetic testing. This manuscript discusses the significance of postmortem genetic testing in the context of death determination by medical examiners (i.e., public molecular autopsies). We highlight distinctive concerns that are raised in the areas of consent, confidentiality, and return of results when genetic testing is performed as part of a public molecular autopsy. We believe our manuscript will contribute to the development of a robust ethical and legal framework for genetic testing in this context.

Altered Mucosal Microbiome Diversity and Disease Severity in Sjögren Syndrome.

There is mounting evidence that the microbiome has potent immunoregulatory functions. We assessed the effects of intestinal dysbiosis in a model of Sjögren syndrome (SS) by subjecting mice to desiccating stress (DS) and antibiotics (ABX). We characterized the conjunctival, tongue and fecal microbiome profiles of patients with SS. Severity of ocular surface and systemic disease was graded. 16S ribosomal RNA gene sequencing characterized the microbiota. ABX + DS mice had a significantly worse dry eye phenotype compared to controls, a decrease in Clostridium and an increase in Enterobacter, Escherichia/Shigella, and Pseudomonas in stool after ABX + DS for 10 days. Goblet cell density was significantly lower in ABX treated groups compared to controls. Stool from SS subjects had greater relative abundances of Pseudobutyrivibrio, Escherichia/Shigella, Blautia, and Streptococcus, while relative abundance of Bacteroides, Parabacteroides, Faecalibacterium, and Prevotella was reduced compared to controls. The severity of SS ocular and systemic disease was inversely correlated with microbial diversity. These findings suggest that SS is marked by a dysbiotic intestinal microbiome driven by low relative abundance of commensal bacteria and high relative abundance of potentially pathogenic genera that is associated with worse ocular mucosal disease in a mouse model of SS and in SS patients.

Legal Barriers to Adolescent Participation in Research About HIV and Other Sexually Transmitted Infections.

Whether adolescents can participate in clinical trials of pharmacologic therapies for HIV prevention, such as preexposure prophylaxis, without parental permission hinges on state minor consent laws. Very few of these laws explicitly authorize adolescents to consent to preventive services for HIV and other sexually transmitted infections. Unclear state laws may lead to research cessation. We have summarized legal, ethical, and policy considerations related to adolescents' participation in HIV and sexually transmitted infection prevention research in the United States, and we have explored strategies for facilitating adolescents' access.

Aqueous Tear Deficiency Increases Conjunctival Interferon-γ (IFN-γ) Expression and Goblet Cell Loss.

PURPOSE: To investigate the hypothesis that increased interferon-γ (IFN-γ) expression is associated with conjunctival goblet cell loss in subjects with tear dysfunction. METHODS: Goblet cell density (GCD) was measured in impression cytology from the temporal bulbar conjunctiva, and gene expression was measured in cytology samples from the nasal bulbar conjunctiva obtained from 68 subjects, including normal control, meibomian gland disease (MGD), non-Sjögren syndrome (non-SSATD)-, and Sjögren syndrome (SSATD)-associated aqueous tear deficiency. Gene expression was evaluated by real-time PCR. Tear meniscus height (TMH) was measured by optical coherence tomography. Fluorescein and lissamine green dye staining evaluated corneal and conjunctival disease, respectively. Between-group mean differences and correlation coefficients were calculated. RESULTS: Compared to control, IFN-γ expression was significantly higher in both ATD groups, and its receptor was higher in SSATD. Expression of IL-13 and its receptor was similar in all groups. Goblet cell density was lower in the SSATD group; expression of MUC5AC mucin was lower and cornified envelope precursor small proline-rich region (SPRR)-2G higher in both ATD groups. Interferon-γ transcript number was inversely correlated with GCD (r = -0.37, P < 0.04) and TMH (r = -0.37, P = 0.02), and directly correlated with lissamine green staining (r = 0.51, P < 0.001) and SPRR-2G expression (r = 0.32, P < 0.05). CONCLUSIONS: Interferon-γ expression in the conjunctiva was higher in aqueous deficiency and correlated with goblet cell loss and severity of conjunctival disease. These results support findings of animal and culture studies showing that IFN-γ reduces conjunctival goblet cell number and mucin production.

Effects of Dry Eye Therapies on Environmentally Induced Ocular Surface Disease.

PURPOSE: To evaluate the effectiveness of artificial tears and corticosteroids on mitigating the acute ocular surface response to low-humidity environments. DESIGN: Single-group, crossover clinical trial. METHODS: Twenty subjects with aqueous deficient dry eye were enrolled. Subjects meeting inclusion criteria at visit 1 were exposed to a baseline 90-minute low-humidity environment at visit 2. They then used artificial tears for 2 weeks prior to low-humidity exposure at visit 3, followed by 0.1% dexamethasone for 2 weeks prior to the final low-humidity exposure at visit 4. Outcome measures included corneal and conjunctival staining, blink rate, and irritation symptoms before and after each low-humidity exposure. Digital polymerase chain reaction (PCR) was performed to measure HLA-DR RNA transcripts in conjunctival cells taken by impression cytology at each visit. RESULTS: There was significantly less corneal and conjunctival epitheliopathy after the low-humidity exposure at visit 4 compared to after the low-humidity exposure at visit 3 (P = .003). Subjects reported significantly less eye irritation during the low-humidity exposure after using the dexamethasone (visit 4) compared to artificial tears (visit 3) (P = .01). HLA-DR transcripts significantly decreased after the stress at visit 4 (post dexamethasone) compared to visit 2. CONCLUSION: Our study demonstrates that corticosteroid eye drops mitigate the acute adverse effects of an experimental low-humidity challenge, likely owing to suppression of stress-activated inflammatory pathways. While extended use of corticosteroids is not indicated, other anti-inflammatory therapies with activity against stress-activated pathways may prove as effective.