An opt-out tobacco treatment group intervention within an intensive substance use disorders treatment program: Initial outcomes in the Veterans Health Administration.

INTRODUCTION: Despite steadily declining rates of tobacco use in the United States, individuals suffering from substance use disorders (SUD) and other mental illnesses continue to use tobacco at alarmingly high rates, resulting in increased mortality. Given the synergistic consequences to those who suffer from both tobacco use disorders (TUD) and other SUD, embedding tobacco treatment into structured SUD programs using an opt-out approach may yield a greater impact. The current study compares clinical outcomes (i.e., quit attempts and prescription of tobacco cessation medications) for an opt-out versus opt-in approach to tobacco treatment. METHODS: Tobacco use information was collected prior to and after implementation of an opt-out, eight-session, tobacco group treatment intervention. Patient self-report and medical chart review were utilized to identify individuals who began a tobacco cessation medication during treatment as well as those who reported quitting tobacco, defined as sustained tobacco abstinence for at least seven days. The analysis includes a total of N = 332 Veterans who enrolled in the Intensive Outpatient Program (IOP). RESULTS: Those enrolled in the opt-out tobacco treatment group reported a significantly higher rate of quitting tobacco (24.57%) than those in the opt-in group (2.55%; p <.001). Likewise, the opt-out group was prescribed tobacco cessation medications at a significantly higher rate than the opt-in group (55.00% compared to 14.65%; p <.001). CONCLUSIONS: An opt-out treatment approach to TUD in SUD treatment settings produced improved outcomes, including significantly more patients engaged in TUD treatment and a higher overall rate of SUD treatment completion. IMPLICATIONS: Given the disproportionately high rate of tobacco use among those seeking treatment for SUD, enhanced tobacco cessation interventions could result in both improved tobacco as well as other substance use outcomes. The implementation of an opt-out tobacco treatment intervention embedded into SUD programming is supported by our findings of reduced tobacco use among patients.

Dual-energy X-ray absorptiometry: an effective approach for predicting broiler chicken body composition.

Two trials were carried out to develop and validate linear regression equations for body composition prediction using Dual-energy X-ray absorptiometry (DEXA). In Trial 1, 300 Cobb500 male chickens raised from 1 to 42 d of age were scanned in DEXA to estimate total weight, fat mass, soft lean tissue (SLT) mass, bone mineral content (BMC), and fat percentage. DEXA estimates were compared to body ash, crude fat, SLT (sum of protein and water) and scale body weight. The dataset was split, with 70% used for prediction equations development and 30% for testing, and the 5k-fold cross-validation analysis was used to optimize the equations. The R2, mean absolute error (MAE), and root-mean-squared error (RMSE) were used as precision and accuracy indicators. A negative correlation (ρ = -0.27) was observed for ash content, while no correlation was observed for protein content (P > 0.05). Predictive linear equations were developed to assess broiler weight (R2 = 0.999, MAE = 25.12, RMSE = 38.99), fat mass (R2 = 0.981, MAE = 13.87, RMSE = 21.28), ash mass (R2 = 0.956, MAE = 3.98, RMSE = 5.61), SLT mass (R2 = 0.997, MAE = 35.73, RMSE = 52.45), water mass (R2 = 0.997, MAE = 29.56, RMSE = 43.94), protein mass (R2 = 0.989, MAE = 12.94, RMSE = 19.05), fat content (R2 = 0.855, MAE = 0.81, RMSE = 1.05), SLT content (R2 = 0.658, MAE = 1.01, RMSE = 1.28), and water content (R2 = 0.678, MAE = 0.99, RMSE = 1.27). All equations passed the test. In Trial 2, 395 Cobb500 male chickens were raised from 1 to 42 d of age and used for validation of prediction equations. The equations developed for weight, fat mass, ash mass, SLT mass, water mass, and protein mass were validated. In conclusion, DEXA was found to be an effective approach for measuring the body composition of broilers when using predictive equations validated in this study for estimate calibration.

NASA POWER satellite meteorological system is a good tool for obtaining estimates of the temperature-humidity index under Brazilian conditions compared to INMET weather stations data.

Heat stress negatively affects livestock, with undesirable effects on animals' production and reproduction. Temperature and humidity index (THI) is a climatic variable used worldwide to study the effect of heat stress on farm animals. Temperature and humidity data can be obtained in Brazil through the National Institute of Meteorology (INMET), but complete data may not be available due to temporary failures on weather stations. An alternative to obtaining meteorological data is the National Aeronautics and Space Administration Prediction of Worldwide Energy Resources (NASA POWER) satellite-based weather system. We aimed to compare THI estimates obtained from INMET weather stations and NASA POWER meteorological information sources using Pearson correlation and linear regression. After quality check, data from 489 INMET weather stations were used. The hourly, average daily and maximum daily THI were evaluated. We found greater correlations and better regression evaluation metrics when average daily THI values were considered, followed by maximum daily THI, and hourly THI. NASA POWER satellite-based weather system is a suitable tool for obtaining the average and maximum THI values using information collected from Brazil, showing high correlations with THI estimates from INMET and good regression evaluation metrics, and can assist studies that aim to analyze the impact of heat stress on livestock production in Brazil, providing additional data to complement the existing information available in the INMET database.

Assessing dual-energy X-ray absorptiometry prediction of intramuscular fat content in beef longissimus steaks.

This study assessed the capability of dual-energy X-ray absorptiometry (DEXA) to predict intramuscular fat (IMF) content of beef longissimus steaks against chemical IMF as the gold standard. DEXA performance of fat% prediction was assessed using a leave-one-out cross validation method among Angus and Nellore steaks, which generated a chemical fat% range of 14.05-36.82% and 2.46-7.84%, respectively, and using pooled data. There was a significant positive association between DEXA predicted fat and chemical fat content. However, higher precision was found for pooled data (R2 = 0.95, RMSECV = 1.95) and Angus (R2 = 0.75, RMSECV = 2.39) than Nellore (R2 = 0.15, RMSECV = 1.22) group. Accuracy also had the same response with average slope values close to 1 for pooled data and Angus and a lower value (0.42) for Nellore group. DEXA precisely predicts IMF content across a wide range of fat content. However, its precision and accuracy of prediction within low-fat content samples are lower than in high-fat content.

Hydrodechlorination of Aryl Chlorides Under Biocompatible Conditions.

Developing nonenzymatic chemistry that is nontoxic to microbial organisms creates the potential to integrate synthetic chemistry with metabolism and offers new remediation strategies. Chlorinated organic compounds known to bioaccumulate and cause harmful environmental impact can be converted into less damaging derivatives through hydrodehalogenation. The hydrodechlorination of substituted aryl chlorides using Pd/C and ammonium formate in biological media under physiological conditions (neutral pH, moderate temperature, and ambient pressure) is reported. The reaction conditions were successful for a range of aryl chlorides with electron-donating and -withdrawing groups, limited by the solubility of substrates in aqueous media. Soluble substrates gave good yields (60-98%) of the reduction product within 48 h. The relative toxicities of each reaction component were tested separately and together against bacteria, and the reaction proceeded in bacterial cultures containing an aryl chloride with robust cell growth. This work offers an initial step toward the removal of aryl chlorides from waste streams that currently use bacterial degradation to remove pollutants.

Skeletal Muscle Development in Postnatal Beef Cattle Resulting from Maternal Protein Restriction during Mid-Gestation.

We aimed to investigate the effects of maternal protein restriction during mid-gestation on the skeletal muscle composition of the offspring. In the restriction treatment (RES, n = 9), cows were fed a basal diet, while in the control (CON, n = 9) group cows received the same RES diet plus the protein supplement during mid-gestation (100-200d). Samples of Longissimus dorsi muscle were collected from the offspring at 30d and 450d postnatal. Muscle fiber number was found to be decreased as a result of maternal protein restriction and persisted throughout the offspring's life (p < 0.01). The collagen content was enhanced (p < 0.05) due to maternal protein restriction at 30d. MHC2X mRNA expression tended to be higher (p = 0.08) in RES 30d offspring, however, no difference (p > 0.05) was found among treatments at 450d. Taken together, our results suggest that maternal protein restriction during mid-gestation has major and persistent effects by reducing muscle fiber formation and may slightly increase collagen accumulation in the skeletal muscle of the offspring. Although maternal protein restriction may alter the muscle fiber metabolism by favoring the establishment of a predominant glycolytic metabolism, the postnatal environment may be a determinant factor that establishes the different proportion of muscle fiber types.

Implementation of a pharmacist care manager model to expand availability of medications for opioid use disorder.

PURPOSE: The rise in opioid prescribing, often for chronic pain management, resulted in an increased prevalence of opioid use disorder (OUD) throughout the United States, including within the Veterans Affairs (VA) healthcare system. The veteran population has been especially vulnerable to opioid-related harms, but rates of prescribing medications for OUD have been low. Use of care manager models for OUD have increased access to treatment. In this article we provide an overview of a clinical pharmacist care manager (CPCM) model for medications for OUD treatment implemented within the Minneapolis Veterans Affairs Health Care System. SUMMARY: A CPCM model for medications for OUD was identified as a care model that would address patient and facility barriers to effective OUD treatment. Pharmacists were integral in program development and implementation and served as the main care providers. An interim evaluation of the program established that the proportion of patients with OUD receiving medications for opioid use disorder (MOUD) had increased, with use of the program resulting in treatment of 109 unique patients during 625 visits. Key program implementation facilitators included the facility leadership establishing increased use of MOUD as a priority area, identification of a physician champion, and a history of successful expansion of clinical pharmacy specialist practice within the VA system. Implementation barriers included factors related to provider engagement, patient identification, and program support. The CPCM model of provision of MOUD expanded the pharmacist role in buprenorphine management. CONCLUSION: The need to increase the number of patients receiving MOUD led to the implementation of a CPCM model. The program was effectively implemented into practice and expanded the availability of MOUD, which allowed patients to access treatment in multiple care settings.

Biocatalytic Friedel-Crafts Alkylation Using a Promiscuous Biosynthetic Enzyme.

The Friedel-Crafts alkylation is commonly used in organic synthesis to form aryl-alkyl C-C linkages. However, this reaction lacks the stereospecificity and regiocontrol of enzymatic catalysis. Here, we describe a stereospecific, biocatalytic Friedel-Crafts alkylation of the 2-position of resorcinol rings using the cylindrocyclophane biosynthetic enzyme CylK. This regioselectivity is distinct from that of the classical Friedel-Crafts reaction. Numerous secondary alkyl halides are accepted by this enzyme, as are resorcinol rings with a variety of substitution patterns. Finally, we have been able to use this transformation to access novel analogues of the clinical drug candidate benvitimod that are challenging to construct with existing synthetic methods. These findings highlight the promise of enzymatic catalysis for enabling mild and selective C-C bond-forming synthetic methodology.

Early life determinants of lung function change from childhood to adolescence.

RATIONALE: Little is known about how perinatal and childhood factors influence lung function change between childhood and adolescence. OBJECTIVES: To investigate possible early life predictors of change in FEV1 between age 8 and 16 years. In addition, to investigate possible predictors of having persistently low lung function (FEV1 <25th percentiles both at age 8 and 16) up to adolescence. METHODS: The BAMSE birth cohort study collected data throughout childhood on environmental factors, individual characteristics, and spirometric measures at 8 and 16 years (n = 1425). Associations between early life predictors (n = 31) and FEV1 increase between 8 and 16 years were assessed with linear regression. Predictors of having persistently low lung function were examined. RESULTS: Few factors were consistently associated with altered lung function growth, although low birth weight, asthma heredity (paternal), secondhand smoke in infancy, and season of birth had a significant impact (p-value ≤0.01). The majority of subjects stayed however within the same category of lung function between ages 8 and 16 years (in total 821/1425 = 58%). Predictors associated with having persistently low lung function were gestational age, secondhand smoke (at 2 and 8 years of age), and factors related to lower respiratory tract infections in infancy. CONCLUSIONS: In summary, rather few exposures in childhood were identified to have a significant impact on lung function growth between childhood and adolescence. Our data support previous study findings indicating that lung function development is influenced by factors before birth and in infancy, including second hand tobacco smoke.

Tobacco smoke exposure in early life and adolescence in relation to lung function.

Maternal smoking during pregnancy is associated with impaired lung function among young children, but less is known about long-term effects and the impact of adolescents' own smoking. We investigated the influence of maternal smoking during pregnancy, secondhand smoke exposure and adolescent smoking on lung function at age 16 years.The BAMSE (Barn/Child, Allergy, Milieu, Stockholm, Epidemiology) birth cohort collected information on participants' tobacco smoke exposure through repeated questionnaires, and measured saliva cotinine concentrations at age 16 years. Participants performed spirometry and impulse oscillometry (IOS) at age 16 years (n=2295).Exposure to maternal smoking during pregnancy was associated with reduced forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio of -1.1% (95% CI -2.0 to -0.2%). IOS demonstrated greater resistance at 5-20 Hz (R5-20) in participants exposed to maternal smoking during pregnancy. Adolescents who smoked had reduced FEV1/FVC ratios of -0.9% (95% CI -1.8 to -0.1%) and increased resistance of 6.5 Pa·L-1·s (95% CI 0.7 to 12.2 Pa·L-1·s) in R5-20 Comparable associations for FEV1/FVC ratio were observed for cotinine concentrations, using ≥12 ng·mL-1 as a cut-off for adolescent smoking.Maternal smoking during pregnancy was associated with lower FEV1/FVC ratios and increased airway resistance. In addition, adolescent smoking appears to be associated with reduced FEV1/FVC ratios and increased peripheral airway resistance.

A new strategy for aromatic ring alkylation in cylindrocyclophane biosynthesis.

Alkylation of aromatic rings with alkyl halides is an important transformation in organic synthesis, yet an enzymatic equivalent is unknown. Here, we report that cylindrocyclophane biosynthesis in Cylindrospermum licheniforme ATCC 29412 involves chlorination of an unactivated carbon center by a novel halogenase, followed by a previously uncharacterized enzymatic dimerization reaction featuring sequential, stereospecific alkylations of resorcinol aromatic rings. Discovery of the enzymatic machinery underlying this unique biosynthetic carbon-carbon bond formation has implications for biocatalysis and metabolic engineering.

Effects of Long-Term Exposure to Traffic-Related Air Pollution on Lung Function in Children.

Lung function in early life has been shown to be an important predictor for peak lung function in adults and later decline. Reduced lung function per se is associated with increased morbidity and mortality. With this review, we aim to summarize the current epidemiological evidence on the effect of traffic-related air pollution on lung function in children and adolescents. We focus in particular on time windows of exposure, small airway involvement, and vulnerable sub-groups in the population. Findings from studies published to date support the notion that exposure over the entire childhood age range seems to be of importance for lung function development. We could not find any conclusive data to support evidence of sup-group effects considering gender, sensitization status, and asthma status, although a possibly stronger effect may be present for children with asthma. The long-term effects into adulthood of exposure to air pollution during childhood remains unknown, but current studies suggest that these deficits may be propagated into later life. In addition, further research on the effect of exposure on small airway function is warranted.

Lung Function at 8 and 16 Years After Moderate-to-Late Preterm Birth: A Prospective Cohort Study.

BACKGROUND AND OBJECTIVE: Knowledge regarding lung function after moderately preterm birth is limited. We therefore investigated lung function at early school age and adolescence among children born moderately preterm. METHODS: Data were used from the Swedish prospective birth cohort BAMSE (Swedish abbreviation for Children, Allergy, Milieu, Stockholm, Epidemiology study; N = 4089), with a 4.8% prevalence of moderate to late preterm birth defined as a gestational age of 32 to 36 weeks. Participants underwent spirometry at ages 8 and 16 years, and impulse oscillometry additionally at age 16 years. In total, 2621 children (149 preterm and 2472 term) provided lung function data. RESULTS: At age 8 years, adjusted forced expiratory volume in 1 second was lower in preterm female subjects (-64 mL [95% confidence interval (CI): -118 to -10]) compared with term female subjects but not in preterm male subjects. At age 16 years, both genders in the preterm group demonstrated lower forced expiratory volume in 1 second (female subjects: -116 mL [95% CI: -212 to -20]; male subjects: -177 mL [95% CI: -329 to -25]) compared with the term group. For the preterm group, impulse oscillometry demonstrated higher adjusted resistance at 5 Hz (female subjects: 31.3 Pa·L(-1)·s(-1) [95% CI: 6.3 to 56.3]; male subjects: 34.9 Pa·L(-1)·s(-1) [95% CI: 12.0 to 57.7]) and frequency dependence of resistance (resistance at 5 and 20 Hz) for male subjects (20.9 Pa·L(-1)·s(-1) [95% CI: 9.8 to 31.9]) compared with the term group. CONCLUSIONS: Measures of airway function assessed in adolescence were reduced in children born moderate to late preterm, and no catch-up in lung function between ages 8 and 16 years was observed.

Early-Life Exposure to Traffic-related Air Pollution and Lung Function in Adolescence.

RATIONALE: Exposure to air pollution during infancy has been related to lung function decrements in 8-year-old children, but whether the negative effects remain into adolescence is unknown. OBJECTIVES: To investigate the relationship between long-term air pollution exposure and lung function up to age 16 years. METHODS: A total of 2,278 children from the Swedish birth cohort BAMSE (Children, Allergy, Milieu, Stockholm, Epidemiological Survey) performed spirometry at age 16 years. Levels of outdoor air pollution from local road traffic were estimated (nitrogen oxides [NOx] and particulate matter with an aerodynamic diameter of <10 µm [PM10]) for residential, daycare, and school addresses during the lifetime using dispersion modeling. Associations between exposure in different time windows and spirometry indexes were analyzed by linear regression and mixed effect models. MEASUREMENTS AND MAIN RESULTS: Exposure to traffic-related air pollution during the first year of life was associated with FEV1 at age 16 years of -15.8 ml (95% confidence interval [CI], -33.6 to 2.0 for a 10 µg/m(3) difference in NOx), predominately in males (-30.4 ml; 95% CI, -59.1 to -1.7), and in subjects not exposed to maternal smoking during pregnancy or infancy. Later exposures appeared to have had an additional negative effect. High exposure during the first year of life was also associated with odds ratios for FEV1 and FVC less than the lower limit of normal (LLN) (defined as a z-score < -1.64 SD) of 3.8 (95% CI, 1.3-10.9) and of 4.3 (95% CI, 1.2-15.0), respectively. The results for PM10 were similar to those for NOx. CONCLUSIONS: Exposure to traffic-related air pollution in infancy is negatively associated with FEV1 at age 16 years, leading to increased risk of clinically important deficits.

Early growth characteristics and the risk of reduced lung function and asthma: A meta-analysis of 25,000 children.

BACKGROUND: Children born preterm or with a small size for gestational age are at increased risk for childhood asthma. OBJECTIVE: We sought to assess the hypothesis that these associations are explained by reduced airway patency. METHODS: We used individual participant data of 24,938 children from 24 birth cohorts to examine and meta-analyze the associations of gestational age, size for gestational age, and infant weight gain with childhood lung function and asthma (age range, 3.9-19.1 years). Second, we explored whether these lung function outcomes mediated the associations of early growth characteristics with childhood asthma. RESULTS: Children born with a younger gestational age had a lower FEV1, FEV1/forced vital capacity (FVC) ratio, and forced expiratory volume after exhaling 75% of vital capacity (FEF75), whereas those born with a smaller size for gestational age at birth had a lower FEV1 but higher FEV1/FVC ratio (P < .05). Greater infant weight gain was associated with higher FEV1 but lower FEV1/FVC ratio and FEF75 in childhood (P < .05). All associations were present across the full range and independent of other early-life growth characteristics. Preterm birth, low birth weight, and greater infant weight gain were associated with an increased risk of childhood asthma (pooled odds ratio, 1.34 [95% CI, 1.15-1.57], 1.32 [95% CI, 1.07-1.62], and 1.27 [95% CI, 1.21-1.34], respectively). Mediation analyses suggested that FEV1, FEV1/FVC ratio, and FEF75 might explain 7% (95% CI, 2% to 10%) to 45% (95% CI, 15% to 81%) of the associations between early growth characteristics and asthma. CONCLUSIONS: Younger gestational age, smaller size for gestational age, and greater infant weight gain were across the full ranges associated with childhood lung function. These associations explain the risk of childhood asthma to a substantial extent.

Using non-enzymatic chemistry to influence microbial metabolism.

The structural manipulation of small molecule metabolites occurs in all organisms and plays a fundamental role in essentially all biological processes. Despite an increasing interest in developing new, non-enzymatic chemical reactions capable of functioning in the presence of living organisms, the ability of such transformations to interface with cellular metabolism and influence biological function is a comparatively underexplored area of research. This review will discuss efforts to combine non-enzymatic chemistry with microbial metabolism. We will highlight recent and historical uses of non-biological reactions to study microbial growth and function, the use of non-enzymatic transformations to rescue auxotrophic microorganisms, and the combination of engineered microbial metabolism and biocompatible chemical reactions for organic synthesis.

Risk factors and markers of asthma control differ between asthma subtypes in children.

BACKGROUND: There is limited understanding about risk factors for asthma, and few studies have presented an overall picture of factors associated with asthma subtypes in schoolchildren. The aim of this study was to evaluate risk factors and markers of asthma control associated with asthma subtypes up to preadolescence. METHODS: A Swedish birth cohort of 3015 children was followed for 12 yr using repeated parental questionnaires. At 8 yr, clinical investigation was performed, specifically evaluating lung function, allergic sensitization (IgE > 0.35 kUA /l), and body mass index (BMI). Children were categorized into three subtypes: transient asthma - asthma at 4 and 8, but not at 12 yr (n = 71), late-onset asthma - asthma at 12 yr, but not earlier (n = 103), and persistent asthma - asthma at 4, 8 and 12 yr (n = 125). RESULTS: At 8 yr of age, high BMI (>85th percentile), sensitization, and rhinitis were significantly associated with late-onset asthma (p < 0.05). Prominent risk factors at birth associated with persistent, but not late-onset asthma, were male sex, tobacco exposure and, heredity for atopy (p < 0.05). Children with persistent asthma were also found to have significantly reduced lung function at 8 yr of age, more eczema/rhinitis, and were more atopic than non-asthmatics (p < 0.05). For persistent asthma, symptoms changed from 8 to 12 yr, with fewer nocturnal symptoms, less healthcare utilization, and less frequent wheeze at 12 yr (p < 0.05). CONCLUSION: Risk factors differ between asthma subtypes and markers of asthma control vary with age up to preadolescence.

Expedient synthesis of fused azepine derivatives using a sequential rhodium(II)-catalyzed cyclopropanation/1-aza-Cope rearrangement of dienyltriazoles.

A general method for the formation of fused dihydroazepine derivatives from 1-sulfonyl-1,2,3-triazoles bearing a tethered diene is reported. The process involves an intramolecular cyclopropanation of an α-imino rhodium(II) carbenoid, leading to a transient 1-imino-2-vinylcyclopropane intermediate which rapidly undergoes a 1-aza-Cope rearrangement to generate fused dihydroazepine derivatives in moderate to excellent yields. The reaction proceeds with similar efficiency on gram scale. The use of catalyst-free conditions leads to the formation of a novel [4.4.0] bicyclic heterocycle.