Protocol of the HARMONY study: A culturally relevant, randomized-controlled, stress management intervention to reduce cardiometabolic risk in African American women.

BACKGROUND: African American Women (AAW) are at high risk for stress-related cardiometabolic (CM) conditions including obesity, heart disease, and diabetes. Prior interventions lack attention to culturally-nuanced stress phenomena (Superwoman Schema [SWS], contextualized stress, and network stress), which are positively and significantly associated with unhealthy eating and sedentary behavior. PURPOSE: The HARMONY Study is designed to test a culturally tailored mindfulness-based stress management intervention to address SWS, contextualized stress, and network stress as potential barriers to adherence to healthy exercise and eating goals. The study will help AAW build on their strengths to promote cardiometabolic health by enhancing positive reappraisal, self-regulation, and self-efficacy as protective factors against chronic stress-inducing biobehavioral morbidity and mortality risk. METHODS: This two-arm, randomized-controlled trial will test the effects of two group-based, online interventions. HARMONY 1 includes culturally-tailored exercise and nutrition education. HARMONY 2 includes mindfulness-based stress reduction, exercise, and nutrition education. We aim to recruit 200 AAW ≥ 18 years old with CM risk. RESULTS: Primary outcomes (actigraphy and carotenoid levels) and secondary outcomes (body composition, inflammatory markers, glucose metabolism, and stress) are being collected at baseline and 4-, 8-, and 12-months post-intervention. Intent-to-treat, data analytic approaches will be used to test group differences for the primary outcomes. DISCUSSION: This study is the first to address culturally-nuanced stress phenomena in AAW (SWS, network stress, and contextualized stress) using culturally-tailored stress management, exercise, and nutrition educational approaches to reduce biobehavioral CM risk among AAW. Quantitative and qualitative results will inform the development of scalable and sustainable CM risk-reduction programming for AAW. TRIAL REGISTRATION: The Multiple PIs registered the clinical trial (Identifier: NCT04705779) and reporting of summary results in ClinicalTrials.gov in accordance with the NIH Policy on the Dissemination of NIH-Funded Clinical Trial Information, within the required timelines.

Synthesis, biochemical, and biological evaluation of C2 linkage derivatives of amino sugars, inhibitors of glucokinase from Trypanosoma cruzi.

Eighteen amino sugar analogues were screened against Trypanosoma cruzi glucokinase (TcGlcK), a potential drug-target of the protozoan parasite in order to assess for viable enzyme inhibition. The analogues were divided into three amino sugar scaffolds that included d-glucosamine (d-GlcN), d-mannosamine (d-ManN), and d-galactosamine (d-GalN); moreover, all but one of these compounds were novel. TcGlcK is an important metabolic enzyme that has a role in producing G6P for glycolysis and the pentose phosphate pathway (PPP). The inhibition of these pathways via glucose kinases (i.e., glucokinase and hexokinase) appears to be a strategic approach for drug discovery. Glucose kinases phosphorylate d-glucose with co-substrate ATP to yield G6P and the formed G6P enters both pathways for catabolism. The compound screen revealed five on-target confirmed inhibitors that were all from the d-GlcN series, such as compounds 1, 2, 4, 5, and 6. Four of these compounds were strong TcGlcK inhibitors (1, 2, 4, and 6) since they were found to have micromolar inhibitory constant (Ki) values around 20 µM. Three of the on-target confirmed inhibitors (1, 5, and 6) revealed notable in vitro anti-T. cruzi activity with IC50 values being less than 50 µM. Compound 1 was benzoyl glucosamine (BENZ-GlcN), a known TcGlcK inhibitor that was the starting point for the design of the compounds in this study; in addition, TcGlcK - compound 1 inhibition properties were previously determined [D'Antonio, E. L. et al. (2015) Mol. Biochem. Parasitol. 204, 64-76]. As such, compounds 5 and 6 were further evaluated biochemically, where formal Ki values were determined as well as their mode of TcGlcK inhibition. The Ki values determined for compounds 5 and 6 were 107 ± 4 µM and 15.2 ± 3.3 µM, respectively, and both of these compounds exhibited the competitive inhibition mode.

Encapsulation Approaches for In-Stent Wireless Magnetoelastic Sensors.

Wireless magnetoelastic sensors offer significant potential for measuring the accumulation of biomass within stents - enabling early detection prior to stent occlusion - but the encapsulation of these sensors remains a critical challenge. The encapsulation must allow the sensors to navigate the curvature and accommodate the contact forces imparted during and after the implantation procedure, while also leaving the sensor open to mechanical interaction with the biomass during the extended period of deployment. This paper is focused on the encapsulation of ribbon-like magnetoelastic sensors (12.5 mm x 1 mm x 60 µm) within plastic biliary stents (inner diameter of 2.54 mm). The compromise between two polymer-based package designs - one mechanically flexible (Type F) and one mechanically stiff (Type S) - is evaluated. The primary advantage of the Type F package is the flexibility during the delivery process while that of the Type S package is in maintaining a strong signal even when the stent is in a curved bile duct. The maximum thicknesses of the Type F and S packages are 0.53 mm and 0.74 mm, respectively. Mechanical tests show that both types protect the sensors from forces imparted by a standard introducer, and allow the encapsulated sensors to accommodate bending with a radius of curvature as small as 3 cm. The Type F package has also been tested in situ, in the bile duct of a porcine carcass. The signal is measurable with a wireless range of 10 cm, at a resonant frequency of 159 kHz and a quality factor of 397.

Wireless Strain Measurement with a Micromachined Magnetoelastic Resonator Using Ringdown Frequency Locking.

Resonant magnetoelastic devices are widely used as anti-theft tags and are also being investigated for a range of sensing applications. The vast majority of magnetoelastic devices are operated at resonance, and rely upon an external interface to wirelessly detect the resonant frequency, and other characteristics. For micromachined devices, this detection method must accommodate diminished signal strength and elevated resonant frequencies. Feedthrough of the interrogating stimulus to the detector also presents a significant challenge. This paper describes a method of interrogating wireless magnetoelastic strain sensors using a new frequency-lock approach. Following a brief excitation pulse, the sensor ring-down is analyzed and a feedback loop is used to match the excitation frequency and the resonant frequency. Data acquisition hardware is used in conjunction with custom software to implement the frequency-lock loop. Advantages of the method include temporal isolation of interrogating stimulus from the sensor response and near real-time tracking of resonant frequencies. The method was investigated using a family of wireless strain sensors with resonant frequencies ranging from 120 to 240 kHz. Strain levels extending to 3.5 mstrain and sensitivities up to 14300 ppm/mstrain were measured with response times faster than 0.5 s. The standard deviation of the locked frequency did not exceed 0.1%.

In vivo and in situ evaluation of a wireless magnetoelastic sensor array for plastic biliary stent monitoring.

This paper presents the in vivo and in situ evaluation of a system that wirelessly monitors the accumulation of biliary sludge in a plastic biliary stent. The sensing element, located within the stent, is a passive array of magnetoelastic resonators that is queried by a wireless electromagnetic signal. The in vivo and in situ testing uses commercially-available plastic biliary stents, each enhanced with an array of ribbon sensors (formed from Metglas™ 2826 MB). The sensor array is approximately 70 mm long and contains individual resonators that are 1 mm in width and have lengths of 10 mm, 14 mm, and 20 mm. The array is anchored into the 2.8 mm inner-diameter stent using a thermal staking technique. For the in situ testing, an instrumented stent is placed in various locations within the abdominal cavity of a female domestic swine carcass to evaluate the wireless range of the system; these results show that a wireless signal can be obtained from a range of at least 7.5 cm from a sensor array covered in bile. The in vivo testing includes the endoscopic implantation of an instrumented stent into the bile duct of a swine. After implantation, the swine was housed for a period of 4 weeks, during which the animal showed no ill effects and followed the expected growth curve from 29 kg to 42 kg. At the conclusion of the in vivo test, the animal was euthanized, and the instrumented stent explanted and examined. The results presented in this paper indicate that the monitoring system does not adversely affect the health of the animal and can feasibly provide sufficient wireless range after implantation.

Primary meningeal rhabdomyosarcoma.

Primary meningeal rhabdomyosarcoma is a rare primary brain malignancy, with scant case reports. While most reports of primary intracranial rhabdomyosarcoma occur in pediatric patients, a handful of cases in adult patients have been reported in the medical literature. We report the case of a 44-year-old male who developed primary meningeal rhabdomyosarcoma. After developing episodes of right lower extremity weakness, word finding difficulty, and headaches, a brain magnetic resonance imaging (MRI) demonstrated a vertex lesion with radiographic appearance of a meningeal-derived tumor. Subtotal surgical resection was performed due to sagittal sinus invasion and initial pathology was interpreted as an anaplastic meningioma. Re-review of pathology demonstrated rhabdomyosarcoma negative for alveolar translocation t(2;13). Staging studies revealed no evidence of disseminated disease. He was treated with stereotactic radiotherapy with concurrent temozolamide to be followed by vincristine, actinomycin-D, and cyclophosphamide (VAC) systemic therapy.

Screening, brief intervention, and referral to treatment for military spouses experiencing alcohol and substance use disorders: a literature review.

This paper provides an overview of alcohol and substance use issues in military spouses, and explore how the screening, brief intervention, and referral to treatment (SBIRT) model may enable health care providers to identify individuals at risk for developing substance use related disorders. The information presented is based on a broad literature scan relating to the characteristics of the military lifestyle, health infrastructure, screening and intervention processes, and the uses of SBIRT in military and civilian settings. Current literature suggests that military spouses, and families, tend to be at different points in their life course than civilian families of similar ages. Marrying earlier and having children sooner coupled with military lifestyle stressors place them at increased risk for developing adverse coping mechanisms, particularly during deployment. SBIRT has been recognized as an effective method among civilian patients although there is limited research on the efficacy of SBIRT for military spouses at risk of or experiencing substance use problems.

In situ and ex vivo evaluation of a wireless magnetoelastic biliary stent monitoring system.

This paper presents the in situ and ex vivo evaluation of a system that wirelessly monitors the accumulation of intimal tissue and sludge in a biliary stent. The sensing element, located within the stent, is a magnetoelastic resonator that is queried by a wireless radio frequency signal. The in situ testing uses a commercially-available self-expanding biliary stent enhanced with a 1 mm x 25 mm magnetoelastic ribbon sensor (formed from Metglas 2605SA1). The stent has a conformal magnetic layer (consisting of strontium ferrite particles suspended in polydimethylsiloxane) that biases the sensor. The external interrogation module is able to acquire a signal from the sensor from a distance of at least 5 cm while the sensor is implanted in a porcine carcass and loaded with biological fluids. The ex vivo testing uses bile harvested from the porcine carcass. The response of a 1 mm x 25 mm magnetoelastic ribbon sensor is first calibrated with fluids of known density and viscosity, and the calibrated sensor is used to estimate that the viscosity of the harvested bile is 2.7-3.7 cP. The test results presented in this paper illustrate the fundamental usability of the system when the sensor is implanted, loaded by biological fluids, and interrogated in a surgical setup.

Influence of papermill sludge on growth of Medicago sativa, Festuca rubra and Agropyron trachycaulum in gold mine tailings: a greenhouse study.

A greenhouse study was undertaken to determine the suitability of adding papermill sludge to neutral/alkaline gold mine tailings to improve the establishment of Festuca rubra, Agropyron trachycaulum and Medicago sativa. Festuca rubra root and shoot biomass and A. Trachycaulum shoot biomass were increased with papermill sludge amendment. The addition of papermill sludge and fertilizer drastically increased the shoot and root biomass of M. sativa (20-30 times) while A. trachycaulum and F. rubra showed a more moderate increase in growth. Photosynthetic pigment content of the leaves was higher in papermill sludge treatments than in the treatments without papermill sludge. The organic carbon content, macro-aggregate content and field capacity of the gold mine tailings were increased while the bulk density was decreased by the addition of papermill sludge. This study suggests that addition of papermill sludge and adequate fertilization can alleviate some of the adverse conditions of neutral/alkaline gold mine tailings.

Diet-specific social support among rural adolescents.

OBJECTIVE: The relationships among primary sources of social support in adolescents' environments (family and friends) and eating behaviors (fat and fiber consumption) were examined in a sample of rural adolescents. DESIGN: Cross-sectional baseline health surveys were administered in classrooms as part of a larger randomized trial evaluating a cancer education program. SETTING: Data were collected in middle schools drawn from 22 rural counties in Virginia and New York. PARTICIPANTS: 1942 sixth graders with a modal age of 12 years, roughly equal gender distribution, and racially diverse (53% white, 37% black). MAIN OUTCOME MEASURE: Variables included a 10-item scale of social support from family and friends for healthy eating, a brief food frequency questionnaire estimating daily grams of fat and fiber intake, and demographics (age, gender, race). ANALYSIS: Hierarchical multiple regressions and analyses of variance (ANOVAs). RESULTS: Controlling for demographics, family and friend support were found to significantly predict fat (P < .05) and fiber (P < .01) intake. Black respondents reported higher support from friends than did white adolescents (F = 47.49, P < .01). IMPLICATIONS FOR RESEARCH AND PRACTICE: Support for healthful eating was related to healthful dietary practices and differed among racial subgroups. Identifying and fostering sources of positive support for healthful eating is critical to developing effective health promotion programs targeting high-risk adolescents.