Tiwala, Gaining Trust to Recruit Filipino American Families: CARE-T2D Study.

OBJECTIVE: Filipino Americans have greater risk for type 2 diabetes (T2D) and related complications compared to other Asian populations and non-Hispanic Whites. There are few diabetes intervention studies focused on Filipinos and limited evidence regarding the best recruitment strategies for this hard-to-reach population. METHODS: This article examined barriers and facilitators to recruitment of Filipino families for the "Caring for Asian Americans through Research and Education on T2D" (CARE-T2D) study, which took place in California from June 2018 through June 2019. RESULTS: Recruitment of 50 Filipino dyads (parent with T2D and adult child) were successfully met. Gaining trust through culturally tailored strategies was key in recruiting Filipino participants. Tiwala (gaining trust) strategies involved: 1) using Filipino staff as role models for research engagement and 2) incorporating narrative communications or "kuwentuhan" (Filipino cultural storytelling) with recruitment. Other facilitating strategies included in-person presentations at local colleges and organizations, Filipino community leaders' support, snowball sampling, previous study participant listservs, and posting fliers on family/friends' personal social media sites. Barriers to recruitment included research mistrust, confidentiality concerns, and risks of violating cultural values. CONCLUSION: To our knowledge, this is the first study to recruit Filipino family dyads. Findings will inform researchers and clinicians on how best to recruit Filipino families in community health-related research and public health programs.

Plasma-Alginate Composite Material Provides Improved Mechanical Support for Stem Cell Growth and Delivery.

Blood plasma-based products have been recently utilized in different tissue engineering applications, ranging from soft tissue repair to bone regeneration. Plasma contains fibrinogen which can be converted to an insoluble fibrin-laden gel in the presence of activated thrombin. In tissue engineering, these plasma-based materials can serve either as a three-dimensional scaffold to deliver therapeutic cells in vivo or as a growth factor-rich supply for tissue regeneration. Unfortunately, plasma-based materials are often mechanically weak and easily deformed, thus limiting their usability in harsh clinical settings. Simpler methods to create sturdier plasma-based materials are therefore needed. To this end, we hypothesized that combining alginate with plasma can create a composite plasma material with improved mechanical properties. Incorporating alginate into plasma produced composite gels with increasing bulk stiffness, as measured by rheology. Specifically, the plasma-alginate composite (PAC) gels with an alginate concentration of 2.86 mg/mL were 10-fold stiffer than pure plasma gels (11 vs 112 Pa). Interestingly, gel lysis rates were unchanged despite increasing alginate concentration (lysis time approximately 50 min). Adipose-derived stem cells cultured in the stiffer PAC gels expressed stemness markers (THY1, ENG, NT5E) at levels comparable to those in the pure plasma gels. Similarly, proangiogenic factor secretion was also constant across all gel conditions. In sum, we envision this PAC gel system will extend the use of plasma gel-based therapies into more rigorous clinical applications.

"I don't have to explain, people understand": Acceptability and Cultural Relevance of a Mobile Health Lifestyle Intervention for Filipinos with Type 2 Diabetes.

BACKGROUND: Filipino Americans have the highest risk for obesity-related type 2 diabetes and related complications compared with all major Asian American subgroups. Identifying effective interventions to improve Filipino health outcomes are needed to reduce this health disparity. OBJECTIVE: To assess the acceptability and cultural relevance of the PilAm Go4Health program - a culturally adapted mobile health weight-loss lifestyle intervention including virtual social networking for Filipino Americans with type 2 diabetes. DESIGN SETTING PARTICIPANTS: Qualitative semi-structured post-program interviews explored perceptions of 45 Filipino Americans with type 2 diabetes in Northern California regarding their perceptions of the acceptability and cultural relevance of PilAm Go4Health. Participants' mean age was 57.6 years. Sixty-seven interviews were recorded, transcribed, and thematically analyzed by four independent coders. RESULTS: Over half (n=26, 57.8%) of the respondents found that a culturally tailored intervention program enhanced their engagement. All (n=45) of the respondents felt that mobile health technology promoted their self-efficacy. A majority of the respondents (n=29, 64.4%) expressed that they progressed from despair to self-efficacy as a result of their participation in the intervention. More than one-fourth of the participants (n=13, 28.8%) discussed that the intervention needed further cultural tailoring. CONCLUSIONS: Overall, PilAm Go4Health - a mobile health weight-loss lifestyle intervention - was acceptable and culturally relevant for Filipino Americans with type 2 diabetes. Findings may help inform clinician and researchers on effective intervention strategies for diabetes self-management when designing interventions for diverse populations.

Development of a Mobile Phone-Based Weight Loss Lifestyle Intervention for Filipino Americans with Type 2 Diabetes: Protocol and Early Results From the PilAm Go4Health Randomized Controlled Trial.

BACKGROUND: Filipino Americans are the second largest Asian subgroup in the United States, and were found to have the highest prevalence of obesity and type 2 diabetes (T2D) compared to all Asian subgroups and non-Hispanic whites. In addition to genetic factors, risk factors for Filipinos that contribute to this health disparity include high sedentary rates and high fat diets. However, Filipinos are seriously underrepresented in preventive health research. Research is needed to identify effective interventions to reduce Filipino diabetes risks, subsequent comorbidities, and premature death. OBJECTIVE: The overall goal of this project is to assess the feasibility and potential efficacy of the Filipino Americans Go4Health Weight Loss Program (PilAm Go4Health). This program is a culturally adapted weight loss lifestyle intervention, using digital technology for Filipinos with T2D, to reduce their risk for metabolic syndrome. METHODS: This study was a 3-month mobile phone-based pilot randomized controlled trial (RCT) weight loss intervention with a wait list active control, followed by a 3-month maintenance phase design for 45 overweight Filipinos with T2D. Participants were randomized to an intervention group (n=22) or active control group (n=23), and analyses of the results are underway. The primary outcome will be percent weight change of the participants, and secondary outcomes will include changes in waist circumference, fasting plasma glucose, glycated hemoglobin A1c, physical activity, fat intake, and sugar-sweetened beverage intake. Data analyses will include descriptive statistics to describe sample characteristics and a feasibility assessment based on recruitment, adherence, and retention. Chi-square, Fisher's exact tests, t-tests, and nonparametric rank tests will be used to assess characteristics of randomized groups. Primary analyses will use analysis of covariance and linear mixed models to compare primary and secondary outcomes at 3 months, compared by arm and controlled for baseline levels. RESULTS: Recruitment was completed in January, 2016, and participant follow-up continued through June, 2016. At baseline, mean age was 57 years, 100% (45/45) of participants self-identified as Filipinos, and the cohort was comprised of 17 males and 28 females. Overall, participants were obese with a baseline mean body mass index of 30.2 kg/m2 (standard deviation 4.9). The majority of participants were immigrants (84%, 38/45), with 47% (21/45) living in the United States for more than 10 years. One third of all participants (33%, 15/45) had previously used a pedometer. CONCLUSIONS: This study will provide preliminary evidence to determine if the PilAm Go4Health weight loss lifestyle intervention is feasible, and if the program demonstrates potential efficacy to reduce risks for metabolic syndrome in Filipinos with T2D. Positive results will lend support for a larger RCT to evaluate the effectiveness of the PilAm Go4Health intervention for Filipinos. CLINICALTRIAL: ClinicalTrials.gov: NCT02290184; https://clinicaltrials.gov/ct2/show/NCT02290184 (Archived at http://www.webcitation.org/6k1kUqKSP).

Cystathionine: A novel oncometabolite in human breast cancer.

In this study, we have identified cystathionine (CTH), a sulfur containing metabolite, to be selectively enriched in human breast cancer (HBC) tissues (∼50-100 pmoles/mg protein) compared with undetectable levels in normal breast tissues. The accumulation of CTH, specifically in HBC, was attributed to the overexpression of cystathionine beta synthase (CBS), its synthesizing enzyme, and the undetectable levels of its downstream metabolizing enzyme, cystathionine gamma lyase (CGL). Interestingly both CBS and CGL could not be detected in normal breast tissues. We further observed that CTH protected HBC cells against excess reactive oxygen species (ROS) and chemotherapeutic drug-induced apoptosis. Moreover, CTH promoted both mitochondrial and endoplasmic reticulum homeostasis in HBC cells. As both the mitochondria and the endoplasmic reticulum are key organelles regulating the onset of apoptosis, we reasoned that endogenous CTH could be contributing towards increasing the apoptotic threshold in HBC cells. An increased apoptotic threshold is a hallmark of all cancer types, including HBC, and is primarily responsible for drug resistance. Hence this study unravels one of the possible pathways that may contribute towards drug resistance in HBC.