"Prevention Produce": Integrating Medical Student Mentorship into a Fruit and Vegetable Prescription Program for At-Risk Patients.

INTRODUCTION: Fruit and vegetable prescription (FVRx) programs provide increased access to produce to food-insecure, at-risk populations, yet many lack the educational and social components to support long-term disease prevention. OBJECTIVES: To address these barriers, students at Penn State College of Medicine designed "Prevention Produce"-a modified FVRx program that integrated a community-based, month-long educational curriculum-and undertook preliminary evaluation. METHODS: Nine families deemed by clinicians as at risk of chronic disease and food insecurity received weekly $40 "prescriptions" for produce at partnering farmers markets. Participants were paired with medical student mentors who delivered weekly nutrition education modules and assisted in produce shopping. Preprogram and postprogram surveys were administered, categorizing perceptions and practices of healthy eating. All participants were interviewed by phone 3 years later to assess long-term impact. Medical students provided written reflections via online survey. RESULTS: Postprogram fruit and vegetable consumption increased, and more patients expressed efforts to include produce in every meal. More participants strongly agreed that fruits and vegetables prevented chronic diseases. In reflective interviews, participants praised the program's ease of use, mentor-patient relationship, and increased access to produce. Student mentors expressed gratitude for one-on-one interaction and felt empowered to learn and deliver nutrition education. CONCLUSION: Integration of an FVRx program with education, mentorship, and community-based focus may increase produce consumption and improve opinions about healthy eating. This program serves as a model for integrating preventive strategies within larger health care systems. Additionally, the model can facilitate early clinical interventions that may benefit medical trainees' professional development.

Randomized Controlled Trial of Hyalobarrier® Versus No Hyalobarrier® on the Ovulatory Status of Women with Periovarian Adhesions: A Pilot Study.

INTRODUCTION: Periadnexal adhesions are known to contribute to subfertility. The restoration of the tubo-ovarian anatomy is one the key principles in reproductive surgery, and this involves adhesiolysis. However, adhesion formation/reformation is very common after periovarian adhesiolysis. It is not known if the application of Hyalobarrier®, an anti-adhesion gel, around the adnexal region postsurgery influences ovulatory status. The study is a pilot randomized controlled trial (RCT) randomizing women into the application of Hyalobarrier® versus no Hyalobarrier® at the time of laparoscopy, where postsurgical ovulatory status and pregnancy rates were evaluated. METHODS: This was a pilot RCT where women were recruited from the gynecological and subfertility clinic who were deemed to require an operative laparoscopy. If intraoperatively they were found to have periovarian adhesions, they were randomized into having adhesiolysis with and without usage of Hyalobarrier®. Demographic details and intraoperative details including the severity, extent, and the ease of use of Hyalobarrier® were recorded. Prior to the surgery and postoperatively, the participants had their serum hormonal status (day 2 FSH, LH and day 21 progesterone) evaluated. Postoperatively, they underwent a follicular tracking cycle at 3 months. RESULTS: Fifteen women were randomized into use of Hyalobarrier® (study group) and 15 into the no Hyalobarrier® group (control group) between December 2011 and January 2014. There was no difference in the patient characteristics in terms of age, BMI, the number of previous pregnancies, or the extent, site, and severity of adhesions between the two groups. There was no significant difference between the study versus control groups in terms of the hormonal profile (day 2 FSH and day 21 progesterone) before or after surgery. The 3-month postoperative day 10-12 follicular tracking findings and endometrial thickness were similar between the study and control groups. Four women were pregnant in the study group (24%) and one in the control group (7%) cumulatively over 2 years. CONCLUSION: The use of Hyalobarrier® post salpingo-ovariolysis did not influence follicular development as inferred from the results of the day 21 progesterone and folliculogram on day 10-12 3-month postsurgery. TRIAL REGISTRATION: ISRCTN number, ISRCTN1833588. FUNDING: Nordic Pharma.

A new strategy for preparing molecular imaging and therapy agents using fluorine-rich (fluorous) soluble supports.

A convenient new strategy for producing radiolabeled compounds in high effective specific activity was developed using soluble fluorous supports. The reported methodology involves a fluorous linker group that is released from the substrate of interest upon reaction with radioiodine. The desired product can then be selectively separated from unreacted starting material and reaction byproducts using a simple fluorous solid-phase extraction procedure. The utility of this approach was demonstrated by labeling a series of benzoic acid derivatives which are commonly used to prepare molecular imaging agents. All compounds were produced in high radiochemical yields, purities, and effective specific activities. The strategy was further elaborated in that it was used to prepare a small collection of radiolabeled benzamides as a way of demonstrating the potential utility of this method for creating libraries of molecular imaging agents.