Phenotype diffusion and one health: A proposed framework for investigating the plurality of obesity epidemics across many species.

We propose the idea of "phenotype diffusion," which is a rapid convergence of an observed trait in some human and animal populations. The words phenotype and diffusion both imply observations independent of mechanism as phenotypes are observed traits with multiple possible genetic mechanisms and diffusion is an observed state of being widely distributed. Recognizing shared changes in phenotype in multiple species does not by itself reveal a particular mechanism such as a shared exposure, shared adaptive need, particular stochastic process or a transmission pathway. Instead, identifying phenotype diffusion suggests the mechanism should be explored to help illuminate the ways human and animal health are connected and new opportunities for optimizing these links. Using the plurality of obesity epidemics across multiple species as a prototype for shared changes in phenotype, the goal of this review was to explore eco-evolutionary theories that could inform further investigation. First, evolutionary changes described by hologenome evolution, pawnobe evolution, transposable element (TE) thrust and the drifty gene hypothesis will be discussed within the context of the selection asymmetries among human and animal populations. Secondly, the ecology of common source exposures (bovine milk, xenohormesis and "obesogens"), niche evolution and the hygiene hypothesis will be summarized. Finally, we synthesize these considerations. For example, many agricultural breeds have been aggressively selected for weight gain, microbiota (e.g., adenovirus 36, toxoplasmosis) associated with (or infecting) these breeds cause experimental weight gain in other animals, and these same microbes are associated with human obesity. We propose applications of phenotype diffusion could include zoonotic biosurveillance, biocontainment, antibiotic stewardship and environmental priorities. The One Health field is focused on the connections between the health of humans, animals and the environment, and so identification of phenotype diffusion is highly relevant for practitioners (public health officials, physicians and veterinarians) in this field.

Association of elevation, urbanization and ambient temperature with obesity prevalence in the United States.

BACKGROUND: The macrogeographic distribution of obesity in the United States, including the association between elevation and body mass index (BMI), is largely unexplained. This study examines the relationship between obesity and elevation, ambient temperature and urbanization. METHODS AND FINDINGS: Data from a cross-sectional, nationally representative sample of 422603 US adults containing BMI, behavioral (diet, physical activity, smoking) and demographic (age, sex, race/ethnicity, education, employment, income) variables from the 2011 Behavioral Risk Factor Surveillance System were merged with elevation and temperature data from WorldClim and with urbanization data from the US Department of Agriculture. There was an approximately parabolic relationship between mean annual temperature and obesity, with maximum prevalence in counties with average temperatures near 18 °C. Urbanization and obesity prevalence exhibited an inverse relationship (30.9% in rural or nonmetro counties, 29.2% in metro counties with <250000 people, 28.1% in counties with population from 250000 to 1 million and 26.2% in counties with >1 million). After controlling for urbanization, temperature category and behavioral and demographic factors, male and female Americans living <500 m above sea level had 5.1 (95% confidence interval (CI) 2.7-9.5) and 3.9 (95% CI 1.6-9.3) times the odds of obesity, respectively, as compared with counterparts living ≥ 3000 m above sea level. CONCLUSIONS: Obesity prevalence in the United States is inversely associated with elevation and urbanization, after adjusting for temperature, diet, physical activity, smoking and demographic factors.

Prostate cancer screening practices and beliefs.

OBJECTIVE: To examine primary care physician prostate-specific antigen (PSA) testing and prostate cancer screening beliefs, practices, and trends over time. DESIGN: Longitudinal physician survey. SETTING: Community and academic primary care practices in a major East Coast city. PARTICIPANTS: Physicians with > or =100 patients enrolled in an HMO serving 90,000 patients were surveyed in 1993 and 1998 regarding prostate cancer screening beliefs and practices. In 1993, 176 physicians (76%) completed the survey. In 1998, 76% of the 1993 respondents responded to a second survey. Associations between and changes over time in beliefs and self-reported PSA testing were analyzed. MEASUREMENTS AND MAIN RESULTS: Physicians reported ordering PSA tests in 73% of health maintenance exams (HMEs) in 1993 and 81% of HMEs in 1998. PSA testing significantly increased between 1993 and 1998 with 43% of physicians reporting increased testing and only 13% reporting reduced testing. Between 1993 and 1998, physician attitudes favoring PSA testing increased although less than half of physicians believed that aggressive early treatment improved patient outcomes. Community versus academic practice location was also associated with PSA testing. CONCLUSIONS: Physicians reported high and increasing rates of PSA testing from 1993 to 1998 and more favorable attitudes toward PSA testing. Despite conflicting expert recommendations and a lack of consistent, high-quality supporting evidence, PSA screening appears to be increasingly considered a standard of care by practicing physicians. However, beliefs other than improved patient outcomes due to screening may be the primary drivers of increased PSA testing.

On the incidence of malignant tumors in routine autopsies.

The present study taken over a 12-year time period analyzes malignant tumors in a large number of autopsies, with specific consideration of the frequency and location, age and sex group distribution, and histologic classification of the tumors. The tumors were first evaluated in terms of specific organs and organ systems and were then histologically classified. On a total of 23338 subjects who died between the years 1960 and 1971, 17052 autopsies were carried out (73.1%) and only 15384 (65.9%) of these were evaluated for out study. Altogether we located 4911 cases of MT, i.e., 31.9% of the evaluated autopsies. The number of MT in the males slightly exceeded that in the females (2508[51.1%] MT and 2403 [48.9%] MT, respectively.) We calculated over 60% of the MT to be in the 7th and 8th age groups. By comparing the two time periods (1960-1965) and 1966-1971) we calculated a significant increase in the MT rate by 1.7%. This increase was found mainly to effect the males (the female group showed only a slight increase). The greatest number of MT were located in the digestive system with an MT rate of 26.2%; next came the urogenital system (23.4%) and then the respiratory system (18.7%). The respiratory system took first position of importance in the males with an MT rate of 30.3% followed by the digestive system with 27.4%. The urogenital system dominated in the females with a rate of 29.0%. The rate of MT of the respiratory system was significantly higher in the males...