Postpartum home blood pressure monitoring and lifestyle intervention in overweight and obese individuals the first year after gestational hypertension or pre-eclampsia: A pilot feasibility trial.

OBJECTIVE: To test the feasibility of a randomised trial of home blood pressure monitoring paired with a remote lifestyle intervention (Heart Health 4 New Moms) versus home blood pressure monitoring alone versus control in individuals with a hypertensive disorder of pregnancy in the first year postpartum. DESIGN: Single-blinded three-arm randomised clinical trial. SETTING: Two tertiary care hospitals and a community organisation. POPULATION: Postpartum overweight and obese individuals with a hypertensive disorder of pregnancy and without pre-pregnancy hypertension or diabetes. METHODS: We assessed the feasibility of recruitment and retention of 150 participants to study completion at 1-year postpartum with randomisation 1:1:1 into each arm. Secondary aims were to test effects of the interventions on weight, blood pressure and self-efficacy. RESULTS: Over 23 months, we enrolled 148 of 400 eligible, screened individuals (37%); 28% black or other race and mean pre-pregnancy body mass index (BMI) of 33.4 ± 6.7 kg/m2 . In total, 129 (87%) participants completed the 1-year postpartum study visit. Overall, 22% of participants developed stage 2 hypertension (≥140/90 mmHg or on anti-hypertensive medications) by 1 year postpartum. There were no differences in weight or self-efficacy across the study arms. CONCLUSION: In this pilot, randomised trial, we demonstrate feasibility of HBPM paired with a lifestyle intervention in the first year postpartum. We detected high rates of ongoing hypertension, emphasising the need for the development of effective interventions in this population.

Evaluation of dietary habits and cooking confidence using virtual teaching kitchens for perimenopausal women.

BACKGROUND: The transition to menopause is a time when women are at increased risk for chronic and cardiovascular diseases, and weight gain. This study evaluates the efficacy of virtual teaching kitchen (TK) interventions on cooking confidence and consumption of a healthy diet in women over 45. METHODS: This teaching kitchen intervention is a synchronous online series of classes for perimenopausal women, with 45 min of live cooking and 15 min of nutrition discussion. From September 2020 through January 2022, participants completed online pre- post-intervention surveys addressing weight, eating habits, cooking confidence and self-efficacy. Analysis used paired samples t-test and Wilcoxon signed rank sum test for normally and non-normal distributed data respectively. RESULTS: Of the 609 unique participants, 269 women completed both pre and post surveys after attending classes. Participants self-reported a statistically significant decreased weight (p < 0.001), increased daily consumption of fruit/vegetables (p < 0.039), fish (p < 0.001) and beans (p < 0.005), and decreased daily consumption of red meat (p < 0.001), sugary beverages (p < 0.029) and white grains (p < 0.039). There was significant improvement in cooking self-efficacy and confidence. CONCLUSIONS: Virtual teaching kitchens were effective in improving culinary and dietary habits among peri- and post-menopausal women. This early evidence suggests that teaching kitchens can effectively reach larger populations for healthy behavioral modification. TRIAL REGISTRATION: Study obtained IRB exemption.

Representative literature on the phytonutrients category: Phenolic acids.

Research concerning the benefits derived from dietary polyphenols, a significant class within the family of phytonutrients, has increased considerably in the last decade. Prior to the late 1990s, the nutritional spotlight focused on the antioxidant capabilities of carotenoids, vitamins, and minerals. More recently, however, research has emerged in strong support of the antioxidant capacity of polyphenols and their role in the prevention and/or treatment of certain cancers, diabetes, cardiovascular diseases, and inflammation. Polyphenols are categorized according to the nature of their carbon skeleton, ranging from basic phenolic molecules to highly complex compounds, such as flavonoids, the most common and widely studied of all phenolic compounds. The most prevalent phenolic acids include ellagic acid, gallic acid, tannic acid, and capsaicin.

Accuracy of Maternal Self-Report of Recent Preeclampsia among Healthy Women.

Background: Preeclampsia history signals a higher risk for cardiovascular disease, but its value as a risk marker relies primarily on self-report. To identify the accuracy of maternal self-reports of recent preeclampsia, we conducted a validation study among women recruited to a web-based trial. Methods: Women with preeclampsia in the past 5 years were recruited to Heart Health 4 Moms. Preeclampsia was self-reported through an online recruitment questionnaire and affirmed via phone screen. Accuracy of maternal self-report was quantified using positive predictive value (PPV) versus medical record evidence of preeclampsia using three definitions: (1) documentation of clinician diagnosis, (2) American College of Obstetricians and Gynecologists (ACOG) 2002 diagnostic criteria (gestational hypertension and proteinuria), and (3) ACOG 2013 diagnostic criteria (gestational hypertension and proteinuria or systemic symptoms). Results: Complete medical records were received for 290 women who delivered from 2011 to 2016 and were predominantly non-Hispanic White (81.7%) with a mean age of 31.2 ± 4.8 years. Mean length of recall was 13.6 ± 14.7 months. The majority of women (92.1%) had medical record evidence of preeclampsia using ≥1 of the definitions. Maternal self-report of preeclampsia was validated for 88.3% based on clinician diagnosis, 59.0% with ACOG 2002, and 65.2% with ACOG 2013. Conclusions: In this validation study of U.S. women, the majority accurately self-reported their preeclampsia diagnosis based on medical record review. A higher proportion of self-reports validated by clinician diagnosis than ACOG criteria, suggesting women remember the diagnosis given by their provider and providers may not always follow or document criteria when making a diagnosis.

In vitro characterization of axitinib interactions with human efflux and hepatic uptake transporters: implications for disposition and drug interactions.

Axitinib is an inhibitor of tyrosine kinase vascular endothelin growth factor receptors 1, 2, and 3. The ATP-binding cassette (ABC) and solute carrier (SLC) transport properties of axitinib were determined in selected cellular systems. Axitinib exhibited high passive permeability in all cell lines evaluated (Papp ≥ 6 × 10(-6) cm/s). Active efflux was observed in Caco-2 cells, and further evaluation in multidrug resistance gene 1 (MDR1) or breast cancer resistance protein (BCRP) transfected Madin-Darby canine kidney cells type 2 (MDCK) cells indicated that axitinib is at most only a weak substrate for P-glycoprotein (P-gp) but not BCRP. Axitinib showed incomplete inhibition of P-gp-mediated transport of digoxin in Caco-2 cells and BCRP transport of topotecan in BCRP-transfected MDCK cells with IC50 values of 3 µM and 4.4 µM, respectively. Axitinib (10 mg) did not pose a risk for systemic drug interactions with P-gp or BCRP per regulatory guidance. A potential risk for drug interactions through inhibition of P-gp and BCRP in the gastrointestinal tract was identified because an axitinib dose of 10 mg divided by 250 mL was greater than 10-fold the IC50 for each transporter. However, a GastroPlus simulation that considered the low solubility of axitinib resulted in lower intestinal concentrations and suggested a low potential for gastrointestinal interactions with P-gp and BCRP substrates. Organic anion transporting polypeptide 1B1 (OATP1B1) and OATP1B3 transfected human embryonic kidney 293 (HEK293) cells transported axitinib to a minor extent but uptake into suspended hepatocytes was not inhibited by rifamycin SV suggesting that high passive permeability predominates. Mouse whole-body autoradiography revealed that [(14)C]axitinib-equivalents showed rapid absorption and distribution to all tissues except the brain. This suggests that efflux transport of axitinib may occur at the mouse blood-brain barrier.

Nudibranchia (Mollusca: Gastropoda) from San Matías Gulf, Northern Argentine Patagonia.

The San Matías gulf is a marine biodiversity hotspot located in the Argentinean Patagonia. Although there are several studies on gastropod mollusks from Argentina, nudibranchs remain less studied. In this faunistic assessment 15 species of nudibranchs were found in San Matías gulf, including two new family records for Argentina: Coryphellidae and Dotidae. Although Magellanic nudibranchs are clearly predominant in this area, warm water species such as Doto uva and Coryphella cf. verta are recorded and the known geographic range of five species is extended. In addition, Rostanga pulchra and Diaulula hispida extend their range to the north of the Argentine Patagonia.

Identification of novel substrates for human cytochrome P450 2J2.

Several antihistamine drugs including terfenadine, ebastine, and astemizole have been identified as substrates for CYP2J2. The overall importance of this enzyme in drug metabolism has not been fully explored. In this study, 139 marketed therapeutic agents and compounds were screened as potential CYP2J2 substrates. Eight novel substrates were identified that vary in size and overall topology from relatively rigid structures (amiodarone) to larger complex structures (cyclosporine). The substrates displayed in vitro intrinsic clearance values ranging from 0.06 to 3.98 mul/min/pmol CYP2J2. Substrates identified for CYP2J2 are also metabolized by CYP3A4. Extracted ion chromatograms of metabolites observed for albendazole, amiodarone, astemizole, thioridazine, mesoridazine, and danazol showed marked differences in the regioselectivity of CYP2J2 and CYP3A4. CYP3A4 commonly metabolized compounds at multiple sites, whereas CYP2J2 metabolism was more restrictive and limited, in general, to a single site for large compounds. Although the CYP2J2 active site can accommodate large substrates, it may be more narrow than CYP3A4, limiting metabolism to moieties that can extend closer toward the active heme iron. For albendazole, CYP2J2 forms a unique metabolite compared with CYP3A4. Albendazole and amiodarone were evaluated in various in vitro systems including recombinant CYP2J2 and CYP3A4, pooled human liver microsomes (HLM), and human intestinal microsomes (HIM). The Michaelis-Menten-derived intrinsic clearance of N-desethyl amiodarone was 4.6 greater in HLM than in HIM and 17-fold greater in recombinant CYP3A4 than in recombinant CYP2J2. The resulting data suggest that CYP2J2 may be an unrecognized participant in first-pass metabolism, but its contribution is minor relative to that of CYP3A4.

Randomized Trial to Reduce Cardiovascular Risk in Women with Recent Preeclampsia.

Background: To reduce cardiovascular disease (CVD) risk, we tested an online intervention to improve healthy lifestyle for women with recent preeclampsia. Materials and Methods: We conducted a randomized controlled 9-month clinical trial, Heart Health 4 Moms (HH4M), among 151 U.S. women with preeclampsia within 5 years. Sample size was planned to detect differences of 0.5 standard deviation units in primary outcomes between study arms. Preeclampsia history was validated by medical records; women with chronic hypertension were excluded. The intervention included online educational modules, a community forum, and communication with a lifestyle coach. The control group received internet links to CVD risk reduction information. Primary outcomes were self-efficacy to eat a healthy diet and increase physical activity; change in physical in/activity; adherence to the Dietary Approaches to Stop Hypertension (DASH) diet; and knowledge of and personal control over CVD risk. Secondary outcomes were weight and blood pressure. Results: In the intervention arm, 84% of participants accessed at least one online educational module; 89% completed at least three scheduled calls with the coach. At 9 months, intervention participants reported significantly greater knowledge of CVD risk factors (corrected p = 0.01), increased self-efficacy for healthy eating (p = 0.03), and less physical inactivity than controls (p = 0.0006). The groups did not differ in sense of personal control of CVD risk factors, adherence to the DASH diet, self-efficacy for physical activity, or reported physical activity. There were no differences in secondary outcomes between groups. Conclusions: The HH4M program improved CVD risk knowledge, self-efficacy to achieve a healthy diet, and reduced physical inactivity among women with recent preeclampsia.

The zinc finger and C-terminal domains of MTA proteins are required for FOG-2-mediated transcriptional repression via the NuRD complex.

FOG-2 is a transcriptional co-regulator that is required for cardiac morphogenesis as mice deficient in this factor die during mid-gestation of cardiac malformations. FOG-2 interacts with GATA4 to attenuate GATA4-dependent gene expression. The first 12 amino acids of FOG-2 (the FOG Repression Motif) are necessary to mediate this repression. To determine the mechanism by which the FOG Repression Motif functions, we identified 7 polypeptides from rat cardiac nuclear extracts that co-purified with a GST-FOG-2 fusion protein. All proteins identified are members of the NuRD nucleosome remodeling complex. Using in vitro binding and co-immunoprecipitation assays, we demonstrate that Metastasis-Associated proteins (MTA)-1, 2 and 3 and Retinoblastoma binding proteins RbAp46 and RbAp48 interact with FOG-2, but not with a mutant form of FOG-2 that is unable to repress transcription. Furthermore, we define a novel domain located in the C-terminal portion of MTA-1 that mediates the FOG-2/MTA-1 interaction. We also demonstrate that knockdown of MTA protein expression dramatically impairs the ability of FOG-2 to repress GATA4 activity. Finally, we show that the zinc finger domain of MTA-1 is required for FOG-2-mediated transcriptional repression and that this domain interacts with RbAp46 and RbAp48 subunits of the NuRD complex. Together, these results demonstrate the importance of FOG-2/MTA/RbAp interactions for FOG-2-mediated transcriptional repression and further define the molecular interactions between the FOG Repression Motif and the NuRD complex.

Beyond pass/fail: a procedure for evaluating the effect of carryover in bioanalytical LC/MS/MS methods.

Eliminating carryover from bioanalytical methods can be a time and resource consuming process. While it is necessary to investigate root causes of the carryover and reduce problem areas, complete elimination of carryover may not be practical or even possible. The purpose of this paper is to suggest an avenue to investigate the effect of carryover within an analytical run rather than employ a simple pass/fail criterion. With more robust carryover information a risk threshold level can be established for individual injections based on the peak response of the previous injection. It is then possible to quickly evaluate the risk that any value in an analytical run has been adversely affected by a previous injection. Those samples which are identified as "at risk" can be reanalyzed to obtain a value that is not affected.

Improving the postpartum care of women with a recent history of preeclampsia: a focus group study.

OBJECTIVE: Women with prior preeclampsia are at increased risk of cardiovascular disease (CVD). This study investigated barriers and facilitators toward learning about this link and engaging in lifestyle modifications to reduce this risk. METHODS: Four focus groups were held with 14 women within 6 months of a preeclamptic pregnancy. RESULTS: Participants were unaware of the link between preeclampsia and CVD, suggested improvements to provider-patient communication, and discussed the benefits of social support and online tracking (weight, blood pressure) in making lifestyle modifications. CONCLUSIONS: Solutions offered may improve efforts to modify lifestyle and communication between providers and women about this link.

Occupational health profile of Brazilian immigrant housecleaners in Massachusetts.

The occupational health and safety conditions of a sample of Brazilian housecleaners in Massachusetts are examined in this article. We administered a main survey to a convenience sample of 626 Brazilian immigrant workers of all trades and a supplemental survey to 163 Brazilian housecleaners in Massachusetts in 2005 and 2006. Survey questions addressed housecleaner demographics, socioeconomic status, working conditions, and hazards of housecleaning work. Housecleaners are exposed to a variety of ergonomic, chemical, and biological hazards. Professional housecleaners' work is fast-paced, requires awkward postures, and involves repetitive movements, use of force, and heavy lifting. The most common symptoms reported include back pain, and pain in the muscles, arms, legs, neck, shoulder, hands, fingers, and feet. To reduce exposures to occupational hazards, we propose the substitution of green cleaners for toxic chemical cleaning products, the use of ergonomic equipment, the use of personal protective equipment, and changes in work organization.

The N termini of Friend of GATA (FOG) proteins define a novel transcriptional repression motif and a superfamily of transcriptional repressors.

Members of the Friend of GATA (FOG) family of transcriptional co-factors are required for the development of both the cardiovascular and hematopoietic systems. FOG proteins physically interact with members of the GATA family of transcriptional activators and modulate their activity. We have previously shown that FOG-2 can bind to the N-terminal zinc finger of GATA4 and, via this interaction, repress GATA4-mediated transcriptional activation of various cardiac promoters. In this report we further characterize the domain of FOG-2 necessary for repression of GATA4 transcriptional activity. We show that FOG-2-mediated repression is not blocked by the histone deacetylase inhibitor tricostatin A, suggesting that FOG-2 repression of GATA4 occurs via a histone deacetylase independent mechanism. N-terminal deletion mutants of FOG-2 revealed that the first 12 amino acids of FOG-2 are necessary for FOG-2-mediated repression. Fusion of these 12 amino acids to the DNA binding domain of GAL4 demonstrated that this region is sufficient to mediate transcriptional repression even when recruited to a heterologous promoter. Single amino acid substitutions within this N-terminal domain of FOG-2 defined the critical amino acid sequence as RRKQxxPxxI. Interestingly, a search of the NCBI protein data base identified several other partially characterized zinc finger transcriptional repressors from various vertebrate species that contained this motif at their N terminus. Taken together, these observations define a novel transcriptional repression motif and a superfamily of zinc finger transcriptional repressors.

The use of the polymerase chain reaction and restriction fragment length polymorphism technique associated with the classical morphology for characterization of Lymnaea columella, L. viatrix, and L. diaphana (Mollusca: Lymnaeidae).

The specific identification of Lymnaeid snails is based on a comparison of morphological characters of the shell, radula, renal and reproductive organs. However, the identification is complicated by dissection process, intra and interspecific similarity and variability of morphological characters. In the present study, polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) techniques targeted to the first and second internal transcribed spacers (ITS1 and ITS2) rDNA and to the mitochondrial 16S ribosomal gene (16S rDNAmt) were used to differentiate the species Lymnaea columella, L. viatrix, and L. diaphana from some localities of Brazil, Argentina, and Uruguay as well as to verify whether the molecular results corroborates the classical morphological method.PCR-RFLP analysis of the ITS1, ITS2, and 16S using 12 restriction enzymes revealed characteristic patterns for L. columella and L. diaphana which were concordant with the classical morphology. On the other hand, for L. viatrix populations a number of 1 to 6 profiles were generated while morphology provided the species pattern results.

The use of the polymerase chain reaction and restriction fragment length polymorphism technique associated with the classical morphology for characterization of Lymnaea columella, L. viatrix, and L. diaphana (Mollusca: Lymnaeidae)

The specific identification of Lymnaeid snails is based on a comparison of morphological characters of the shell, radula, renal and reproductive organs. However, the identification is complicated by dissection process, intra and interspecific similarity and variability of morphological characters. In the present study, polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) techniques targeted to the first and second internal transcribed spacers (ITS1 and ITS2) rDNA and to the mitochondrial 16S ribosomal gene (16S rDNAmt) were used to differentiate the species Lymnaea columella, L. viatrix, and L. diaphana from some localities of Brazil, Argentina, and Uruguay as well as to verify whether the molecular results corroborates the classical morphological method.PCR-RFLP analysis of the ITS1, ITS2, and 16S using 12 restriction enzymes revealed characteristic patterns for L. columella and L. diaphana which were concordant with the classical morphology. On the other hand, for L. viatrix populations a number of 1 to 6 profiles were generated while morphology provided the species pattern results.