Use of the Veggie Meter® as a tool to objectively approximate fruit and vegetable intake among youth for evaluation of preschool and school-based interventions.

BACKGROUND: Reflection spectroscopy is an emerging, non-invasive objective measure used to approximate fruit and vegetable intake. The present study aimed to use a reflection spectroscopy device (the Veggie Meter®, Longevity Link Corporation, Salt Lake City, UT, USA) to assess skin carotenoid status in preschool, middle- and high-school students and to examine associations between skin carotenoids and self-reported dietary intake. METHODS: In Autumn 2018, we used the Veggie Meter® to assess skin carotenoids and age-appropriate validated dietary assessment measures to approximate fruit and vegetable (FV) intake. Preschool participants completed a previously validated pictorial liking tool using an iPad (Apple Inc., Cupertino, CA, USA). Middle-school participants completed selected questions from the validated School Physical Activity and Nutrition (SPAN) (Michael & Susan Dell Center for Healthy Living, University of Texas, Austin, TX, USA) questionnaire regarding frequency of their FV and beverage intake on the previous day, with additional questions about physical activity. High-school participants' FV intake was assessed using the Fruit and Vegetable Screener (National Cancer Institute, Bethesda, MD, USA). Spearman correlation coefficients were used to determine bivariate associations between measures of dietary intake and Veggie Meter®-assessed skin carotenoid levels. RESULTS: Mean (SD) Veggie Meter® readings were 266 (82.9), 219 (68.1) and 216 (67.2) among preschool, middle- and high-school students. There was an inverse association between soda intake and Veggie Meter® readings (r = -0.22, P = 0.03) among middle-school students; and a positive association between daily fruit intake and Veggie Meter® readings (r = 0.25, P = 0.06) among high-school students. CONCLUSIONS: The Veggie Meter® comprises a promising evaluation tool for preschool and school-based nutrition interventions.

Implementing healthier foodservice guidelines in hospital and federal worksite cafeterias: barriers, facilitators and keys to success.

BACKGROUND: Healthy foodservice guidelines are being implemented in worksites and healthcare facilities to increase access to healthy foods by employees and public populations. However, little is known about the barriers to and facilitators of implementation. The present study aimed to examine barriers to and facilitators of implementation of healthy foodservice guidelines in federal worksite and hospital cafeterias. METHODS: Using a mixed-methods approach, including a quantitative survey followed by a qualitative, in-depth interview, we examined: (i) barriers to and facilitators of implementation; (ii) behavioural design strategies used to promote healthier foods and beverages; and (iii) how implementation of healthy foodservice guidelines influenced costs and profitability. We used a purposive sample of five hospital and four federal worksite foodservice operators who recently implemented one of two foodservice guidelines: the United States Department of Health and Human Services/General Services Administration Health and Sustainability Guidelines ('Guidelines') in federal worksites or the Partnership for a Healthier America Hospital Healthier Food Initiative ('Initiative') in hospitals. Descriptive statistics were used to analyse quantitative survey data. Qualitative data were analysed using a deductive approach. RESULTS: Implementation facilitators included leadership support, adequate vendor selections and having dietitians assist with implementation. Implementation barriers included inadequate selections from vendors, customer complaints and additional expertise required for menu labelling. Behavioural design strategies used most frequently included icons denoting healthier options, marketing using social media and placement of healthier options in prime locations. CONCLUSIONS: Lessons learned can guide subsequent steps for future healthy foodservice guideline implementation in similar settings.

The hypogonadal mouse: reproductive functions restored by gene therapy.

The hypogonadal (hpg) mouse lacks a complete gonadotropin-releasing hormone (GnRH) gene and consequently cannot reproduce. Introduction of an intact GnRH gene into the genome of these mutant mice resulted in complete reversal of the hypogonadal phenotype. Transgenic hpg/hpg homozygotes of both sexes were capable of mating and producing offspring. Pituitary and serum concentrations of luteinizing hormone, follicle-stimulating hormone, and prolactin were restored to those of normal animals. Immunocytochemistry and in situ hybridization showed that GnRH expression was restored in the appropriate hypothalamic neurons of the transgenic hpg animals, an indication of neural-specific expression of the introduced gene.

The effects of traffic light labelling versus cartoon labelling on food and beverage purchases in a children's hospital setting.

This study's purpose was to examine changes in healthy and unhealthy items purchased following the implementation of traffic light and cartoon labelling in a small retail food venue (Café Bay) in a children's hospital in eastern North Carolina. Between October 2015 and March 2016, daily food and beverage sales from Café Bay were obtained during baseline, traffic light labelling, a washout period, cartoon labelling (on healthy foods only) and a final washout period. Pearson chi-squared tests and multiple linear regressions were used to examine effects of labelling strategies, controlling for the holidays. In unadjusted analyses, traffic light labelling was associated with significant decreases in purchases of unhealthy items purchased, while cartoon labelling was associated with increases in unhealthy items purchased. In adjusted linear regression analysis, traffic light labelling was associated with fewer unhealthy purchases and thus may have potential to decrease the amount of unhealthy items purchased in a children's hospital food retail venue.

Multiple regulatory domains in the mouse mammary tumor virus long terminal repeat revealed by analysis of fusion genes in transgenic mice.

Transcription initiated within the mouse mammary tumor virus (MTV) long terminal repeat (LTR) is regulated by glucocorticoids, androgens, and estrogen. However, expression of the virus in vivo and transcription of MTV LTR fusion genes in transgenic mice are not readily interpretable solely in terms of the influence of these hormones. To investigate whether there is a regulatory role for sequences within the LTR but outside the region known to be responsible for glucocorticoid induction, we have produced transgenic mice carrying genes in which various regions of the LTR have been linked to the human growth hormone gene. Analysis of expression of the fusion genes in these transgenic mice has demonstrated that the 5' end of the LTR can profoundly influence transcription initiated within the MTV LTR.

Haploid-specific transcription of protamine-myc and protamine-T-antigen fusion genes in transgenic mice.

The protamines are small, basic, arginine-rich proteins synthesized postmeiotically in the testes. Analysis of the regulation of synthesis of the protamine mRNA and protein is restricted by the difficulty in culturing and manipulating the cells in which transcription and translation occur. To avoid these problems, we have produced transgenic mice carrying fusion genes in which sequences 5' to the mouse protamine-2 gene have been linked to exons 2 and 3 of the mouse c-myc gene and, separately, to the simian virus 40 (SV40) early region. We show here that the prot.myc gene is correctly regulated; transcription is detected only in the round spermatids. In one family of transgenic mice carrying the 5' protamine-SV40 T-antigen fusion gene, SV40 early-region mRNA accumulated to the highest level in the testes but was also detected in the thymuses, brains, hearts, and preputial glands of the animals. Although we have demonstrated specific transcription of these fusion genes in the round spermatids, we were not able to detect the SV40 T-antigen protein.

Human purine nucleoside phosphorylase and adenosine deaminase: gene transfer into cultured cells and murine hematopoietic stem cells by using recombinant amphotropic retroviruses.

Cell lines were established which produced high titers (approximately 10(6) infectious units per ml) of amphotropic, replication-defective recombinant retroviruses which transduced sequences encoding either human purine nucleoside phosphorylase (PNP) or adenosine deaminase (ADA). These viruses also contained a human hypoxanthine phosphoribosyltransferase gene as a selectable marker and a mouse metallothionein promoter (MMP) sequence just upstream from the PNP or ADA genes. Virus structure was maintained through the replication cycle if a short (216-base pair) MMP sequence was used. However, the use of a longer (1,834-base pair) MMP sequence resulted in the deletion of a significant portion of the recombinant virus genome, including the transcriptional regulatory elements of the MMP sequence. Northern analysis indicated a predominance of genome length transcripts in cells infected with deleted virus. The demonstration of substantial human PNP or ADA activity in virus-infected mouse fibroblasts by isozyme analysis suggested that active gene product was translated from either spliced or bicistronic message. The deleted ADA and PNP viruses were introduced into mouse hematopoietic stem cells by cocultivating freshly explanted bone marrow with virus producer cells. The infected marrow cells were injected into irradiated, syngeneic recipient mice, and the presence of integrated ADA or PNP proviral sequences was demonstrated in the DNA of spleen colonies by Southern analysis. Failure of these integrated proviral sequences to express active, human isozyme in spleen colony tissue indicated the existence of some regulatory constraint not active in cultured mouse cells.

Magnetic resonance profiling of human skin in vivo using GARField magnets.

It is shown that one-dimensional magnetic resonance imaging (MRI-profiling) of human forearm and side-of-hand skin in vivo is possible using GARField magnets. Strong profile contrast originating from differing molecular mobility is seen for stratum corneum and viable epidermis. The first in vivo spatially-resolved field-gradient measurements of water self-diffusivity, D, in the stratum corneum (2.0 x 10(-6) cm(2)/s) and viable epidermis (8.5 x 10(-6) cm(2)/s) are reported. Also reported are spatially resolved measurements of the (1)H spin-lattice relaxation time, T(1), the spin-spin relaxation time, T(2). It is further shown that the application of moisturizing agents to the skin noticeably affects the profiles. However, universal behavior is not seen as both signal increases and decreases are observed dependent on agent and volunteer.

A dominant phenocopy of hypopituitarism in transgenic mice resulting from central nervous system synthesis of human growth hormone.

We have produced a line of transgenic mice in which expression of human GH has been detected only in the cerebral cortex. Both male and female transgenic mice are growth inhibited with respect to their nontransgenic littermates. Mouse GH mRNA and insulin-like growth factor-I mRNA levels in the pituitary and liver, respectively, are reduced, and circulating insulin-like growth factor-I levels are lower in these mice. Within the hypothalamus somatostatin mRNA levels are increased and GH-releasing factor mRNA levels are reduced compared to those in nontransgenic littermates. We suggest that the growth retardation in these mice is a consequence of the ectopic human GH disturbing the normal controls that regulate mouse GH synthesis and release from the pituitary. These mice provide a resource for analysis of the regulation of GH production and demonstrate that a dominant phenocopy can be made by producing transgenic mice that have local production of an extra-cellular hormone.

Severity of osteopenia in estrogen-deficient women with anorexia nervosa and hypothalamic amenorrhea.

Reduced bone density is observed in over half of women with anorexia nervosa (AN), in whom the risk of fracture is significantly increased even at a young age. It is unknown to what extent low bone density in AN differs from other conditions of premenopausal osteoporosis and is related to estrogen deficiency and/or other factors, such as nutritional status. We therefore investigated bone loss in nutritionally replete and nutritionally deplete amenorrheic women by comparing patients with AN (n = 30) to age-matched subjects with hypothalamic amenorrhea (HA; n = 19) in whom duration of amenorrhea, prior estrogen use, and age of menarche were comparable. Healthy, age-matched, eumenorrheic women were studied as a control group (NL; n = 30). Weight and nutritionally dependent factors including (body mass index, 20.7 +/- 0.3 vs. 16.7 +/- 0.3 kg/m2; P < 0.0001), insulin-like growth factor I (270 +/- 18 vs. 203 +/- 17 ng/mL; P < 0.01), percent body fat (26% vs. 19%; P < 0.0001), and lean body mass (38.7 +/- 1.1 vs. 34.3 +/- 0.8, P < 0.01) were significantly different between the HA and AN groups, respectively. The bone densities of the anterior-posterior (AP) spine, total hip, and total body measured by dual energy x-ray absortiometry were reduced in both amenorrheic groups compared to those in control subjects, but were significantly lower in women with AN than in those with HA. The t scores for AP spine and hip were -1.80 +/- 0.15 (AN), -0.80 +/- 0.22 (HA), and 0.28 +/- 0.19 SD (NL) for the AP spine and -1.62 +/- 0.17 (AN), -0.51 +/- 0.21 (HA), and 0.25 +/- 0.16 (NL) for the total hip, respectively (P < 0.01 for all comparisons). Among the amenorrheic subjects, duration of amenorrhea, age of menarche, and N-telopeptide were inversely correlated with bone density at all sites, whereas body mass index, insulin-like growth factor I, lean body mass, and fat intake were positively correlated with bone density at all sites measured. In multivariate regression analyses, bone density was most significantly related to lean body mass (P = 0.05 and P = 0.03 for the spine and hip, respectively), but not to the duration of amenorrhea or other indexes of estrogen status among patients with AN. In contrast, bone density of the lumbar spine was significantly related to weight and duration of amenorrhea among patients with HA. These data demonstrate that the severity of osteopenia in AN is greater than that in patients with HA and is critically dependent upon nutritional factors in addition to the degree or duration of estrogen deficiency itself. Lean body mass, independent of the duration or severity of estrogen deficiency, is an important predictor of bone loss among women with AN.

Changes in regional fat redistribution and the effects of estrogen during spontaneous weight gain in women with anorexia nervosa.

BACKGROUND: Anorexia nervosa is a disease of severe acquired undernutrition with a high and increasing prevalence among young women in the United States. OBJECTIVE: The objective was to investigate the effects of spontaneous outpatient weight recovery and estrogen administration on fat distribution in patients with anorexia nervosa. DESIGN: Twenty-seven amenorrheic women aged 26.6 +/- 1.2 y with anorexia nervosa were identified through an outpatient study of bone loss and were randomly assigned to receive or not receive estrogen without any dietary intervention other than calcium and multivitamin supplements. Body composition was measured at baseline and at 6 and 9 mo and was compared with cross-sectional values obtained in 20 healthy, eumenorrheic, age-matched (25.4 +/- 0.5 y) control subjects. RESULTS: Twenty of the 27 patients with anorexia aged 27.0 +/- 1.3 y spontaneously gained weight (4.1 +/- 0.9 kg); body mass index (in kg/m(2)) increased from 16.1 +/- 0.3 to 17.5 +/- 0.4. Fat mass and lean mass accounted for 68% and 32% of the gain in total body mass, respectively. With spontaneous weight gain, there was a significant increase in the percentage of trunk fat from 32.4 +/- 1.3% at baseline to 36.5 +/- 1.0% at 9 mo (P = 0.03), which correlated with urinary free cortisol (r = 0.66, P = 0.003). Estrogen treatment was not protective against the gain in trunk fat with spontaneous weight gain. CONCLUSIONS: In women with anorexia nervosa, spontaneous weight gain is associated with a significant increase in trunk adiposity, and estrogen administration may not protect against the accumulation of central fat with weight gain.

The effect of blood on ocular fundus reflectance and determination of some optical properties of retinal blood vessels.

Light reflected from 50 micrometer diameter spots on the fundi of two adult rhesus monkeys was measured as a function of wavelength in 10 nm jumps from 400 to 900 nm. The areas measured were a retinal artery and vein, areas of the disk, macula, and retina devoid of visible blood vessels, and the foveola. The eyes of the two monkeys were then exsanguinated, the blood vessels were filled with normal saline, and reflectances of the same spots on the fundi were again measured. The pairs of reflectance curves were compared and demonstrated that blood is not the major determinant of the characteristic shapes of the retinal tissue spectral reflectance curves. From the pre-exsanguination and postexsanguination data, the isolated retinal artery and vein wall reflectances were determined to be 0.020 and 0.009, respectively, their transmittances 0.837 and 0,977, and the fractions of light absorbed by them 0.143 and 0.014, respectively, in the visible spectral region below 500 nm.

Reflection of light by small areas of the ocular fundus.

Light reflected from 50 micrometer spots on the fundi of two rhesus monkeys and three human volunteers was measured as a function of wavelength in 10 nm. jumps from 400 to 900 nm. The areas measured were a retinal artery and vein, areas of the disk, macula, and retina devoid of visible blood vessels, and the fovea.

Interdisciplinary group approach to occupational safety and health administration standard: reductions in cost and duplication of effort.

After the December 1991 publication of the Occupational Safety and Health Administration standard, "Occupational Exposure to Bloodborne Pathogens; Final Rule," medical facilities in the United States were challenged to meet the mandates of this standard with massive training in a relatively short time. An interdisciplinary task force composed of representative members of a major health maintenance organization was charged with the task of developing a training plan for 11 Southern California medical centers and their 42 satellite medical offices. The task force ultimately developed, refined, and distributed a Trainer Guidebook that could be used by a variety of disciplines. This guidebook provided a method by which the information could be disseminated concisely, thoroughly, and promptly. The processes used in this project can be applied to other health care educational situations. The purpose of this article is to share these processes.

Gonadal development and gametogenesis in the hypogonadal mouse are restored by gene transfer.

These results describe controlled regulation of a mammalian neural gene in transgenic mice. Analysis of truncated GnRH-GAP genes in transgenic mice will enable us to define the DNA sequences responsible for this control. Furthermore, by separate mutation of the GnRH and GAP coding sequences we will be able to determine the relative importance of these two peptides in the development and maintenance of reproductive function.

The natural history of cigarette smoking from adolescence to adulthood in a midwestern community sample: multiple trajectories and their psychosocial correlates.

Previous research on the natural history of smoking has focused on overall group trajectories without considering the possibility of risk subgroup variation. To address this limitation, the authors of the present study aimed to identify subgroups with varying trajectories of smoking behavior. The authors accomplished this within a cohort-sequential study of a large community sample (N = 8,556) with measurements spanning ages 11-31. After removing 2 a priori groups (abstainers and erratics), the authors empirically identified 4 trajectory groups--early stable smokers, late stable smokers, experimenters, and quitters--and psychosocial variables from adolescence and young adulthood were significantly distinguished among them. Given recent advances in quantitative methods, it is now feasible to consider subgroups of trajectories within an overall longitudinal design.

Is readmission to hospital an indicator of poor process of care for patients with heart failure?

BACKGROUND: Controversy exists about the appropriateness of using readmission as an indicator of the quality of care. A study was undertaken to measure the validity and predictive ability of readmission in this context. METHODS: An evaluation study was performed in patients discharged alive with heart failure from three Swiss academic medical centres. Process quality indicators were derived from evidence based guidelines for the management and treatment of heart failure. Readmissions were calculated from hospital administrative data. The predictive ability of readmissions was evaluated using bivariate and multivariate analyses, and validity by calculating sensitivity, specificity, positive and negative predictive value, using process indicators as the "gold standard". RESULTS: Of 1055 eligible patients discharged alive, 139 (13.2%) were readmitted within 30 days. The adjusted odds ratio (OR) for absence of measurement of left ventricular function was 0.70 (95% CI 0.45 to 1.08) for readmissions. In patients with left ventricular systolic dysfunction, three dose categories of angiotensin converting enzyme inhibitor were examined using ordinal logistic regression. The adjusted OR for these categories was 1.07 (95% CI 0.56 to 2.06) for readmissions. When using process indicators as the gold standard to assess the validity of readmissions, sensitivity ranged from 0.08 to 0.17 and specificity from 0.86 to 0.93. CONCLUSIONS: Readmission did not predict and was not a valid indicator of the quality of care for patients with heart failure admitted to three Swiss university hospitals.

A longitudinal study of children of alcoholics: predicting young adult substance use disorders, anxiety, and depression.

This study tested the specificity of parent alcoholism effects on young adult alcohol and drug abuse/dependence, anxiety, and depression, and tested whether adolescent symptomatology and substance use mediated parent alcoholism effects. Participants were from a longitudinal study in which a target child was assessed in adolescence and young adulthood with structured interview measures (N = 454 families at Time 1). Results showed unique effects of parent alcoholism on young adult substance abuse/dependence diagnoses over and above the effects of other parental psychopathology. There was some evidence of parent alcoholism effects on young adult depression and of maternal alcoholism effects on young adult anxiety, although these were not found consistently across subsamples. Mediational models suggested that parent alcoholism effects could be partially (but not totally) explained by adolescent externalizing symptoms.

Hydroxyurea in two pregnant women with sickle cell anemia.

Hydroxyurea is classified as an S-phase antineoplastic agent (pregnancy category D). Two women became pregnant while taking hydroxyurea for sickle cell anemia and delivered live infants with no congenital anomalies. Although teratogenic effects of hydroxyurea were reported in animal studies, several case reports suggest the agent may have minimal teratogenic effects on the developing fetus. Fourteen cases of hydroxyurea therapy in pregnant patients with acute or chronic myelogenous leukemia, primary thrombocythemia, or sickle cell disease are reported in the literature. Three pregnancies were terminated by elective abortion; one woman developed eclampsia and delivered a phenotypically normal stillborn infant. All other patients delivered live, healthy infants without congenital anomalies. Further studies with larger numbers of patients receiving hydroxyurea during pregnancy, with longer follow-up of exposed children and more careful assessment of fetotoxic effects, are required before the agent can be promoted as safe in pregnancy.

Similar effects of D(1)/D(2) receptor blockade on feeding and locomotor behavior.

Recent evidence suggests an important relationship between dopamine (DA) modulation of feeding and locomotor activity. To investigate this relationship, the free-feeding and locomotor behavior of rats under the influence of D(1)/D(2) antagonist cis-flupenthixol was examined. DA antagonists are known to produce within-session declines in reinforced behavior, with behavioral suppression occurring only after a number of normal responses have been emitted. In the present study, cis-flupenthixol (0.30 mg/kg ) produced a within-session decrement in both free-feeding behavior and in locomotor/exploratory activity of animals in an environment that had never been paired with food. In addition to producing similar patterns of disruption in feeding and locomotion, the drug also produced a similar magnitude of suppression in the two behaviors. The results show that disruption of DA activity suppresses locomotor/exploratory activity in a manner that closely mirrors neuroleptic suppression of feeding. Although neuroleptic-induced suppression of locomotion and feeding are traditionally presumed to reflect an attenuation of DA motor and reward functions, respectively, the present results suggest that DA plays a similar role in the modulation of these two behaviors.