The Mediating Role of Kynurenine Pathway Metabolites on the Relationship Between Inflammation and Muscle Mass in Oldest-Old Men.

Tryptophan (TRP) metabolites along the kynurenine (KYN) pathway (KP) have been found to influence muscle. Proinflammatory cytokines are known to stimulate the degradation of TRP down the KP. Given that both inflammation and KP metabolites have been connected with loss of muscle, we assessed the potential mediating role of KP metabolites on inflammation and muscle mass in older men. Five hundred and five men (85.0 ±â€…4.2 years) from the Osteoporotic Fractures in Men cohort study with measured D3-creatine dilution (D3Cr) muscle mass, KP metabolites, and inflammation markers (C-reactive protein [CRP], alpha-1-acid glycoprotein [AGP] and a subsample [n = 305] with interleukin [IL-6, IL-1ß, IL-17A] and tumor necrosis factor-α [TNF-α]) were included in the analysis. KP metabolites and inflammatory markers were measured using liquid chromatography-tandem mass spectrometry and immunoassays, respectively. 23%-92% of the inverse relationship between inflammatory markers and D3Cr muscle mass was mediated by KP metabolites (indirect effect p < .05). 3-hydroxyanthranilic acid (3-HAA), quinolinic acid (QA), TRP, xanthurenic acid (XA), KYN/TRP, 3-hydroxykynurenine (3-HK)/3-HAA, QA/3-HAA, and nicotinamide (NAM)/QA mediated the AGP relationship. 3-HAA, QA, KYN/TRP, 3-HK/XA, HKr ratio, 3-HK/3-HAA, QA/3-HAA, and NAM/QA mediated the CRP. KYN/TRP, 3-HK/XA, and NAM/QA explained the relationship for IL-6 and 3-HK/XA and QA/3-HAA for TNF-α. No mediation effect was observed for the other cytokines (indirect effect p > .05). KP metabolites, particularly higher ratios of KYN/TRP, 3-HK/XA, 3-HK/3-HAA, QA/3-HAA, and a lower ratio of NAM/QA, mediated the relationship between inflammation and low muscle mass. Our preliminary cross-sectional data suggest that interventions to alter D3Cr muscle mass may focus on KP metabolites rather than inflammation per se.

Cardiopulmonary Exercise Testing in a Prospective Multicenter Cohort of Older Adults.

PURPOSE: Cardiorespiratory fitness (CRF) measured by peak oxygen consumption (V̇O 2peak ) declines with aging and correlates with mortality and morbidity. Cardiopulmonary exercise testing (CPET) is the criterion method to assess CRF, but its feasibility, validity, and reliability in older adults are unclear. Our objective was to design and implement a dependable, safe, and reliable CPET protocol in older adults. METHODS: V̇O 2peak was measured by CPET, performed using treadmill exercise in 875 adults ≥70 yr in the Study of Muscle, Mobility and Aging (SOMMA). The protocol included a symptom-limited peak (maximal) exercise and two submaximal walking speeds. An adjudication process was in place to review tests for validity if they met any prespecified criteria (V̇O 2peak <12.0 mL·kg -1 ·min -1 ; maximum heart rate <100 bpm; respiratory exchange ratio <1.05 and a rating of perceived exertion <15). A subset ( N = 30) performed a repeat test to assess reproducibility. RESULTS: CPET was safe and well tolerated, with 95.8% of participants able to complete the V̇O 2peak phase of the protocol. Only 56 (6.4%) participants had a risk alert and only two adverse events occurred: a fall and atrial fibrillation. Mean ± SD V̇O 2peak was 20.2 ± 4.8 mL·kg -1 ·min -1 , peak heart rate 142 ± 18 bpm, and peak respiratory exchange ratio 1.14 ± 0.09. Adjudication was indicated in 47 tests; 20 were evaluated as valid and 27 as invalid (18 data collection errors, 9 did not reach V̇O 2peak ). Reproducibility of V̇O 2peak was high (intraclass correlation coefficient = 0.97). CONCLUSIONS: CPET was feasible, effective, and safe for older adults, including many with multimorbidity or frailty. These data support a broader implementation of CPET to provide insight into the role of CRF and its underlying determinants of aging and age-related conditions.

Nutrient Metabolites Associated With Low D3Cr Muscle Mass, Strength, and Physical Performance in Older Men.

BACKGROUND: The relationship between amino acids, B vitamins, and their metabolites with D3-creatine (D3Cr) dilution muscle mass, a more direct measure of skeletal muscle mass, has not been investigated. We aimed to assess associations of plasma metabolites with D3Cr muscle mass, as well as muscle strength and physical performance in older men from the Osteoporotic Fractures in Men cohort study. METHODS: Out of 1 425 men (84.2 ±â€…4.1 years), men with the lowest D3Cr muscle mass (n = 100), slowest walking speed (n = 100), lowest grip strength (n = 100), and a random sample (n = 200) serving as a comparison group to the low groups were included. Metabolites were analyzed using liquid chromatography-tandem mass spectrometry. Metabolite differences between the low groups and random sample and their relationships with the muscle outcomes adjusted for confounders and multiple comparisons were assessed using t-test/Mann-Whitney-Wilcoxon and partial correlations, respectively. RESULTS: For D3Cr muscle mass, significant biomarkers (p < .001) with ≥10% fold difference and largest partial correlations were tryptophan (Trp; r = 0.31), kynurenine (Kyn)/Trp; r = -0.27), nicotinamide (Nam)/quinolinic acid (Quin; r = 0.21), and alpha-hydroxy-5-methyl-tetrahydrofolate (hm-THF; r = -0.25). For walking speed, hm-THF, Nam/Quin, and Quin had the largest significance and fold difference, whereas valine (r = 0.17), Trp (r = 0.17), HKyn/Xant (r = -0.20), neopterin (r = -0.17), 5-methyl-THF (r = -0.20), methylated folate (r = -0.21), and thiamine (r = -0.18) had the strongest correlations. Only hm-THF was correlated with grip strength (r = -0.21) and differed between the low group and the random sample. CONCLUSIONS: Future interventions focusing on how the Trp metabolic pathway or hm-THF influences D3Cr muscle mass and physical performance declines in older adults are warranted.

Clinical Consultation Guide: Pelvic Floor Prehabilitation.

Training of the pelvic floor muscles (PFMs) as part of a multimodal prehabilitation program that includes cardiovascular and hip strengthening and patient education can yield patient benefits after urologic surgery. A personalized, multifaceted, holistic care plan that includes PFM training should be developed by an interdisciplinary team. Further research is needed to identify the impact of PFM prehabilitation on various urologic and surgical outcomes.

Cardiopulmonary Exercise Testing in a Prospective Multicenter Cohort of Older Adults: The Study of Muscle, Mobility and Aging (SOMMA).

BACKGROUND: Cardiorespiratory fitness (CRF) measured by peak oxygen consumption (VO2peak) declines with aging and correlates with mortality and morbidity. Cardiopulmonary Exercise Testing (CPET) has long been the criterion method to assess CRF, but its feasibility, efficacy and reliability in older adults is unclear. The large, multicenter Study of Muscle, Mobility and Aging (SOMMA) employed CPET to evaluate the mechanisms underlying declines in mobility with aging among community-dwelling older adults. Our primary objective was to design and implement a CPET protocol in older adults that was dependable, safe, scientifically valuable, and methodologically reliable. METHODS: CPET was performed using treadmill exercise in 875 adults ≥70 years. A composite protocol included a symptom-limited peak exercise phase and two submaximal phases to assess cardiopulmonary ventilatory indices during 1) participants' preferred walking speed and 2) at slow walking speed of 1.5 mph (0.67 m/s). An adjudication process was in place to review tests for validity if they met any prespecified criteria (VO2peak <12.0 ml/kg/min; maximum heart rate (HR) <100 bpm; respiratory exchange ratio (RER) <1.05 and a rating of perceived exertion <15). A repeat test was performed in a subset (N=30) to assess reproducibility. RESULTS: CPET was safe and well tolerated, with 95.8% of participants able to complete the VO2peak phase of the protocol. Only 56 (6.4%) participants had a risk alert during any phase of testing and only two adverse events occurred during the peak phase: a fall and atrial fibrillation. The average ± standard deviation for VO2peak was 20.2 ± 4.8 mL/kg/min, peak HR 142 ± 18 bpm, and peak RER 1.14 ± 0.09. VO2peak and RER were slightly higher in men than women. Adjudication was indicated in 47 participants; 20 were evaluated as valid, 27 as invalid (18 had a data collection error, 9 did not reach VO2peak). Reproducibility of VO2peak was high (intraclass correlation coefficient=0.97). CONCLUSIONS: CPET was feasible, effective and safe for community-dwelling older adults, many of whom had multimorbidity and frailty. These data support a broader implementation of CPET to provide important insight into the role of CRF and its underlying determinants in aging and age-related conditions and diseases. Clinical Perspective: What Is New?: Performing cardiopulmonary exercise testing in a community dwelling older adult with multimorbidities or frailty is feasible and exceptionally safe under highly trained exercise physiologists and physician supervision.Reproducibility of VO2peak among community-dwelling older adults with significant clinical complexity was high (intraclass correlation coefficient=0.97).The VO2peak observed was comparable to established normative data for older adults, and adds merit to the limited data collected on VO2peak norms in older adults.What Are the Clinical Implications?: Ventilatory gas collection during clinical cardiac stress testing may be valuable to plan of care in routine management of older adults due to the important role of aerobic fitness on morbidity and mortality.Cardiopulmonary exercise testing can provide insight into the role of cardiorespiratory fitness and its underlying determinants in aging and age-related conditions and diseases.

The relationship between visual function and physical performance in the Study of Muscle, Mobility and Aging (SOMMA).

PURPOSE: The relationship of types of visual function to different aspects of physical function, especially strength and coordination, has been understudied, but delineation of these relationships could suggest potentially modifiable targets prior to the onset of disability. METHODS: Cross-sectional analysis of visual function (self-reported eyesight and eye disease, visual acuity, contrast sensitivity) and physical function tests in 877 older adults (mean age 76.36±5.01 years, 59.2% women, and 13.3% Black race). Separate linear regression models were constructed for short physical performance battery (SPPB), expanded SPPB (eSPPB), their components (gait speed, chair stand, balance, narrow walk), stair climb, four-square step, leg extension peak power and strength, and grip strength. RESULTS: In adjusted models, worse acuity, worse contrast sensitivity, and self-reported poor vision were significantly associated with worse performance on the eSPPB and four-square step test. Worse contrast sensitivity, but not acuity, was significantly associated with shorter balance times, slower chair stand pace, longer stair climb time, and worse SPPB score. Associations of worse acuity and contrast sensitivity with weaker leg extension power, leg strength, and grip strength were attenuated by covariate adjustment. Self-reported macular degeneration, but not cataract or glaucoma, was associated with worse performance on SPPB, eSPPB, balance, stair climb, and four-square step tests in adjusted models. Worse contrast sensitivity and macular degeneration remained associated with worse SPPB and balance after controlling for visual acuity and self-reported eyesight. CONCLUSIONS: Poor contrast sensitivity was more strongly associated with worse physical performance than acuity, especially for complex tasks that dynamically challenge coordination and balance. Future studies should examine if older adults with contrast sensitivity impairment would benefit from targeted intervention to decrease their risk of disability.

The Study of Muscle, Mobility and Aging (SOMMA): A Unique Cohort Study About the Cellular Biology of Aging and Age-related Loss of Mobility.

BACKGROUND: The Study of Muscle, Mobility and Aging (SOMMA) aims to understand the biological basis of many facets of human aging, with a focus on mobility decline, by creating a unique platform of data, tissues, and images. METHODS: The multidisciplinary SOMMA team includes 2 clinical centers (University of Pittsburgh and Wake Forest University), a biorepository (Translational Research Institute at Advent Health), and the San Francisco Coordinating Center (California Pacific Medical Center Research Institute). Enrollees were age ≥70 years, able to walk ≥0.6 m/s (4 m); able to complete 400 m walk, free of life-threatening disease, and had no contraindications to magnetic resonance or tissue collection. Participants are followed with 6-month phone contacts and annual in-person exams. At baseline, SOMMA collected biospecimens (muscle and adipose tissue, blood, urine, fecal samples); a variety of questionnaires; physical and cognitive assessments; whole-body imaging (magnetic resonance and computed tomography); accelerometry; and cardiopulmonary exercise testing. Primary outcomes include change in walking speed, change in fitness, and objective mobility disability (able to walk 400 m in 15 minutes and change in 400 m speed). Incident events, including hospitalizations, cancer diagnoses, fractures, and mortality are collected and centrally adjudicated by study physicians. RESULTS: SOMMA exceeded its goals by enrolling 879 participants, despite being slowed by the COVID-19 pandemic: 59.2% women; mean age 76.3 ± 5.0 years (range 70-94); mean walking speed 1.04 ± 0.20 m/s; 15.8% identify as other than Non-Hispanic White. Over 97% had data for key measurements. CONCLUSIONS: SOMMA will provide the foundation for discoveries in the biology of human aging and mobility.

LabMate: Development and Implementation of a Novel Livestreaming Platform for Hybrid or Remote Laboratory Course Delivery.

Online course delivery has increased in prevalence, particularly due to the onset in 2020 of the COVID-19 pandemic. Biomedical engineering laboratory courses pose unique challenges when transitioning to a remote or hybrid space. Here, we describe a novel approach to online lab delivery to improve student learning and engagement in a required introductory biomedical engineering laboratory class. The presented work focuses on the implementation and assessment of a novel approach to remote lab delivery named LabMate, which is a mobile, multi-view livestreaming platform that connects students to an in-person class remotely. Surveys of student and instructor participants assessed hardware quality and areas of improvement. Focus groups with students who had taken the course in an online format previously were conducted after a demonstration of the system. Survey responses were overall positive; however, some areas of improvement were identified, such as audio quality and video quality. Students and instructors appreciated the ability to deliver class synchronously online rather than perform make-up labs. Focus group participants found LabMate to be more engaging and enjoyable than prior online lab experiences. Students and instructors preferred LabMate over other online lab delivery methods. The students found the experience to be more dynamic and engaging, providing them with the opportunity to develop some of the core competencies of a biomedical engineering student.

Development and Implementation of a Remote Enzyme Kinetics Laboratory Exercise.

The COVID-19 pandemic imposed many new challenges on educational systems and increased the demand for novel strategies for effectively teaching laboratory skills without in-person instruction and without access to laboratory space, including critical specialized equipment. While this novel remote instruction modality is compatible with teaching the theory behind experimental techniques, the lack of lab activities that enable learning of laboratory skills severely limits the outcome of instruction. In order to overcome this problem and effectively supplement lectures with hands-on laboratory exercises, we developed an at-home enzyme kinetics lab that provides a safe alternative to traditional enzyme kinetics instructional labs typically performed in a laboratory setting. The combination of a simple design of the activity, accessibility of equipment used, and relatively low overall cost yields an effective exercise for teaching experimental design and basic laboratory skills remotely while providing a unique opportunity for students to learn about enzyme kinetics.

Mineralized collagen scaffolds fabricated with amniotic membrane matrix increase osteogenesis under inflammatory conditions.

Defects in craniofacial bones occur congenitally, after high-energy impacts, and during the course of treatment for stroke and cancer. These injuries are difficult to heal due to the overwhelming size of the injury area and the inflammatory environment surrounding the injury. Significant inflammatory response after injury may greatly inhibit regenerative healing. We have developed mineralized collagen scaffolds that can induce osteogenic differentiation and matrix biosynthesis in the absence of osteogenic media or supplemental proteins. The amniotic membrane is derived from placentas and has been recently investigated as an extracellular matrix to prevent chronic inflammation. Herein, we hypothesized that a mineralized collagen-amnion composite scaffold could increase osteogenic activity in the presence of inflammatory cytokines. We report mechanical properties of a mineralized collagen-amnion scaffold and investigated osteogenic differentiation and mineral deposition of porcine adipose-derived stem cells within these scaffolds as a function of inflammatory challenge. Incorporation of amniotic membrane matrix promotes osteogenesis similarly to un-modified mineralized collagen scaffolds, and increases in mineralized collagen-amnion scaffolds under inflammatory challenge. Together, these findings suggest that a mineralized collagen-amnion scaffold may provide a beneficial environment to aid craniomaxillofacial bone repair, especially in the course of defects presenting significant inflammatory complications.

Retrospective survey of endoparasitism identified in feces of client-owned dogs in North America from 2007 through 2018.

Our main study objective was to determine the prevalence and trend of parasitic infection in client-owned dogs examined at the veterinary parasitology diagnostic laboratory of Oklahoma State University over the past 12 years. All results of centrifugal flotation, saline direct smear, sedimentation, Baermann, acid-fast staining for Cryptosporidium detection, and Giardia antigen examinations on fecal samples from client-owned dogs submitted to the Boren Veterinary Medical Hospital and Oklahoma Animal Disease Diagnostic Laboratory of Oklahoma State University from 2007 through 2018 were included. The impact of sex, age, and seasonality on the prevalence of parasitic infection was also statistically evaluated. A total of 7,409 cases were included for this study. Majority of cases (79.58%; 5,896/7,409) did not include any parasites, eggs, larva, oocysts, or cysts. Approximately 15.41% (1,142/7,409) of client-owned dogs were infected by at least one parasite, and 5.01% (371/7,409) of dogs were infected by multiple parasites. The most common parasite stage observed was Ancylostoma eggs (8.23%; 610/7,409), followed by Cystoisospora oocysts (5.02%; 372/7,409), Giardia cysts/antigen (4.06%; 301/7,409), Trichuris vulpis eggs (2.74%; 203/7,409), Toxocara canis eggs (2.54%; 188/7,409), Dipylidium caninum proglottids/egg packets (0.84%; 62/7,409), taeniid proglottids/eggs (0.47%; 35/7,409), Sarcocystis sporocysts (0.38%; 28/7,409), Cryptosporidium oocysts (0.30%; 22/7,409), Strongyloides stercoralis larvae (0.20%; 15/7,409), Alaria eggs (0.19%; 14/7,409), Toxascaris leonina eggs (0.18%; 13/7,409), Capillaria eggs (0.16%; 12/7,409), Hammondia-like small coccidian oocysts (0.16%; 12/7,409), Uncinaria stenocephala eggs (0.13%; 10/7,409), Spirometra eggs (0.09%; 7/7,409), Physaloptera eggs (0.09%; 7/7,409), Heterobilharzia americana eggs (0.08%; 6/7,409), Nanophyetus salmincola eggs (0.08%; 6/7,409), trichomonads (0.08%; 6/7,409), Mesocestoides proglottids/eggs (0.05%; 4/7,409), Baylisascaris eggs (0.01%; 1/7,409), Macracanthorhynchus eggs (0.01%; 1/7,409), and Paragonimus kellicotti eggs (0.01%; 1/7,409). In addition to endoparasites, some ectoparasites, such as Demodex mites (0.22%; 16/7,409), Otodectes cynotis mites (0.01%; 1/7,409), Rhipicephalus sanguineus ticks (0.01%; 1/7,409), and Sarcoptes scabiei mites (0.01%; 1/7,409), were detected by fecal examinations. Pseudo/spurious parasites were identified in approximately 4.35% of cases (322/7,409). There was no statistically significant difference for parasite prevalence between sexes (p = 0.3231). However, statistically significant differences were observed with certain parasites when compared by age groups, and generally, prevalence of parasitism decreased as age of client-owned dogs increased (p < 0.0001). Statistical analyses also revealed significant differences by months (p = 0.0013). Overall, the prevalence of parasitic infection in client-owned dogs decreased over the past 12 years (p < 0.0001).

Using Isotemporal Analyses to Examine the Relationships Between Daytime Activities and Cancer Recurrence Biomarkers in Breast Cancer Survivors.

BACKGROUND: For breast cancer survivors, moderate to vigorous physical activity (MVPA) is associated with improved survival. Less is known about the interrelationships of daytime activities (sedentary behavior [SB], light-intensity physical activity, and MVPA) and associations with survivors' health outcomes. This study will use isotemporal substitution to explore reallocations of time spent in daytime activities and associations with cancer recurrence biomarkers. METHODS: Breast cancer survivors (N = 333; mean age 63 y) wore accelerometers and provided fasting blood samples. Linear regression models estimated the associations between daytime activities and cancer recurrence biomarkers. Isotemporal substitution models estimated cross-sectional associations with biomarkers when time was reallocated from of one activity to another. Models were adjusted for wear time, demographics, lifestyle factors, and medical conditions. RESULTS: MVPA was significantly associated with lower insulin, C-reactive protein, homeostatic model assessment of insulin resistance, and glucose, and higher sex hormone-binding globulin (all P < .05). Light-intensity physical activity and SB were associated with insulin and homeostatic model assessment of insulin resistance (both P < .05). Reallocating 18 minutes of SB to MVPA resulted in significant beneficial associations with insulin (-9.3%), homeostatic model assessment of insulin resistance (-10.8%), glucose (-1.7%), and sex hormone-binding globulin (7.7%). There were no significant associations when 79 minutes of SB were shifted to light-intensity physical activity. CONCLUSIONS: Results illuminate the possible benefits for breast cancer survivors of replacing time spent in SB with MVPA.

Retrospective survey of parasitism identified in feces of client-owned cats in North America from 2007 through 2018.

Ownership of domestic cats in North America has been on the increase; however, there are only a few surveys conducted on the prevalence of parasitism in client-owned cats over years. Our study objective was to evaluate parasite prevalence through statistical analysis of fecal examination results for client-owned cats on samples submitted to the veterinary parasitology diagnostic laboratory of Oklahoma State University over a 12-year period. All results of centrifugal flotation, saline direct smear, sedimentation, and Baermann examinations on fecal samples submitted to the Boren Veterinary Medical Hospital and Oklahoma Animal Disease Diagnostic Laboratory of Oklahoma State University from 2007 through 2018 were included. The impacts of sex, age, and seasonality on the prevalence of infection were also analyzed. A total of 2586 client-owned cat cases were included for this study. Parasites, eggs, oocysts, larvae, or cysts were not detected in the majority of cases (75.5%; 1,953/2586). Approximately 18.8% (485/2586) of client-owned cats were infected by one parasite, and 5.7% (148/2586) of cats were infected by multiple parasites. The most common parasite stage observed was Cystoisospora oocysts (9.4%; 243/2586), followed by Toxocara cati eggs (7.8%; 202/2586), Giardia cysts (4.0%; 104/2586), Alaria eggs (3.5%; 91/2586), Ancylostoma eggs (1.2%; 32/2586), taeniid proglottids/eggs (1.2%; 30/2586), Dipylidium caninum proglottids/egg packets (1.1 %; 29/2586), and Eucoleus aerophilus eggs (0.7%; 18/2586). Less commonly, Physalopetra eggs (0.19%; 5/2586), Toxascaris leonina eggs (0.19%; 5/2586), Tritrichomonas blagburni trophozoites (0.15%; 4/2586), Ollulanus tricuspis larvae/adults (0.12%; 3/2586), Platynosomum fastosum eggs (0.12%; 3/2586), Aelurostrongylus abstrusus larvae (0.08%; 2/2323), Sarcocystis sporocysts (0.08%; 2/2586), Spirometra eggs (0.08%; 2/2586), Mesocestoides proglottids/eggs (0.08%; 2/2586), Trichuris felis eggs (0.08%; 2/2586), Cryptosporidium oocysts (0.04%; 1/2586), and Toxoplasma-like small coccidian oocysts (0.04%; 1/2586) were detected. Additionally, fecal examinations revealed some ectoparasites: Demodex mites (0.9%; 24/2586), Cheyletiella mites (0.15%; 4/2586), and Otodectes cynotis mites (0.04%; 1/2586). There was no statistical significance between different sex groups (p = 0.3316). Age affected the prevalence of Cystoisospora, T. cati, Giardia, and Alaria infections with prevalence decreasing as age increased (p < 0.0001). Statistical analyses also revealed significant differences by months; the higher prevalence of infection occurred from summer through fall (p = 0.0004). Overall, as the number of submittals increased, the prevalence of infection increased over the last 12 years (p < 0.0001). This study supports continuing the current practice of routine broad-spectrum anthelmintic and ectoparasitic treatments for client-owned cats as well as annual/biannual fecal examination.

A comparison of accelerometry analysis methods for physical activity in older adult women and associations with health outcomes over time.

This study compared five different methods for analyzing accelerometer-measured physical activity (PA) in older adults and assessed the relationship between changes in PA and changes in physical function and depressive symptoms for each method. Older adult females (N = 144, Mage = 83.3 ± 6.4yrs) wore hip accelerometers for six days and completed measures of physical function and depressive symptoms at baseline and six months. Accelerometry data were processed by five methods to estimate PA: 1041 vertical axis cut-point, 15-second vector magnitude (VM) cut-point, 1-second VM algorithm (Activity Index (AI)), machine learned walking algorithm, and individualized cut-point derived from a 400-meter walk. Generalized estimating equations compared PA minutes across methods and showed significant differences between some methods but not others; methods estimated 6-month changes in PA ranging from 4 minutes to over 20 minutes. Linear mixed models for each method tested associations between changes in PA and health. All methods, except the individualized cut-point, had a significant relationship between change in PA and improved physical function and depressive symptoms. This study is among the first to compare accelerometry processing methods and their relationship to health. It is important to recognize the differences in PA estimates and relationship to health outcomes based on data processing method. Abbreviation: Machine Learning (ML); Short Physical Performance Battery (SPPB); Center of Epidemiologic Studies Depression Scale (CES-D); Physical Activity (PA); Activity Index (AI); Activities of Daily Living (ADL).

Physical Activity Change in an RCT: Comparison of Measurement Methods.

Objectives: We aimed to quantify the agreement between self-report, standard cut-point accelerometer, and machine learning accelerometer estimates of physical activity (PA), and exam- ine how agreement changes over time among older adults in an intervention setting. Methods: Data were from a randomized weight loss trial that encouraged increased PA among 333 postmenopausal breast cancer survivors. PA was estimated using accelerometry and a validated questionnaire at baseline and 6-months. Accelerometer data were processed using standard cut-points and a validated machine learning algorithm. Agreement of PA at each time-point and change was assessed using mixed effects regression models and concordance correlation. Results: At baseline, self-report and machine learning provided similar PA estimates (mean dif- ference = 11.5 min/day) unlike self-report and standard cut-points (mean difference = 36.3 min/ day). Cut-point and machine learning methods assessed PA change over time more similarly than other comparisons. Specifically, the mean difference of PA change for the cut-point versus machine learning methods was 5.1 min/day for intervention group and 2.9 in controls, whereas it was ≥ 24.7 min/day for other comparisons. Conclusions: Intervention researchers are facing the issue of self-report measures introducing bias and accelerometer cut-points being insensi- tive. Machine learning approaches may bridge this gap.

Comparison of diagnostic techniques for detection of Giardia duodenalis in dogs and cats.

BACKGROUND: An evaluation of currently available in-clinic diagnostic tests for Giardia duodenalis infection of dogs and cats has not been performed. In addition, there is discordance among published diagnostic comparisons. The absence of a true gold standard for detecting Giardia duodenalis also complicates diagnostic evaluations. OBJECTIVES: To evaluate diagnostic tests commercially available in the United States for detecting Giardia duodenalis in dogs and cats, in comparison to a widely used reference test, the direct immunofluorescent assay (IFA), and also to compare the results of 2 methods of analysis: comparison of diagnostic tests to a reference test (IFA) and Bayesian analysis. ANIMALS: Fecal samples from a convenience sample of 388 cats and dogs located in Colorado, Oklahoma, and Virginia. METHODS: Fecal samples were tested for Giardia duodenalis by zinc sulfate centrifugal fecal flotation and 4 different commercial diagnostic immunoassays. Results were analyzed via Bayesian analysis and by comparison to the IFA as the reference test. RESULTS: Sensitivity and specificity by comparison to IFA was ≥82% and ≥90%, respectively, for all diagnostic tests in dogs and cats. When analyzed via Bayesian analysis, sensitivity and specificity were ≥83% and ≥95%, respectively. When ZnSO4 centrifugal fecal flotation results were combined with immunoassay results, there was no longer a significant difference between the sensitivities of the commercial in-clinic immunoassays. CONCLUSION AND CLINICAL RELEVANCE: The Bayesian analysis validates using IFA as the reference test. Differences in commercial in-clinic immunoassay sensitivities can be mitigated when the results are combined with ZnSO4 centrifugal fecal flotation results.

Shape-fitting collagen-PLA composite promotes osteogenic differentiation of porcine adipose stem cells.

Craniomaxillofacial bone defects can occur as a result of congenital, post-oncologic, and high-energy impact conditions. The scale and irregularity of such defects motivate new biomaterials to promote regeneration of the damaged bone. We have recently described a mineralized collagen scaffold capable of instructing stem cell osteogenic differentiation and new bone infill in the absence of traditional osteogenic supplements. Herein, we report the integration of a millimeter-scale reinforcing poly (lactic acid) frame fabricated via 3D-printing into the mineralized collagen scaffold with micron-scale porosity to form a multi-scale mineralized collagen-PLA composite. We describe modifications to the PLA frame design to increase the compressive strength (Young's Modulus, ultimate stress and strain) of the composite. A critical challenge beyond increasing the compressive strength of the collagen scaffold is addressing challenges inherent with the irregularity of clinical defects. As a result, we examined the potential for modifying the frame architecture to render the composite with increased compressive strength in one axis or radial compressibility and shape-fitting capacity in an orthogonal axis. A library of mineralized collagen-PLA composites was mechanically characterized via compression testing and push-out test to describe mechanical performance and shape-fitting capacity. We also report in vitro comparison of the bioactivity of porcine adipose derived stem cells in the mineralized collagen-PLA composite versus the mineralized collagen scaffold via metabolic activity, gene expression, and functional matrix synthesis. The results suggest that incorporation of the PLA reinforcing frame does not negatively influence the osteoinductive nature of the mineralized collagen scaffold. Together, these findings suggest a strategy to address often competing bioactivity, mechanical strength, and shape-fitting design requirements for biomaterials for craniomaxillofacial bone regeneration.

A zoonotic parasite, Linguatula serrata, infection in a dog imported from Ethiopia to the United States.

A moderate number of oval-shaped, 114.7 × 61.3 µm in size, amber-colored, arthropod-like eggs that had chitinous, smooth, semi-thickened outer wall and 2-4 short appendages armed with 2 terminal hook-like structures were detected in multiple fecal samples from an approximately 9-month-old, intact female, collie-mixed dog that had been recently imported from Ethiopia to Oklahoma, United States. Initially the unusual arthropod-like eggs were considered to be a pseudoparasite, most likely mite eggs. However, based on the history of the dog, morphology of the eggs, and presence of the eggs in repetitive fecal flotations, a pentastomid, Linguatula serrata, was suspected. DNA extraction and PCR analysis of the partial 18S rRNA gene were performed on the eggs, and nucleic acid sequence showed 100% homology to L. serrata, a parasite of dogs, and L. arctica, a parasite of Norwegian reindeers. Rhinoscopy and head CT scan on the dog failed to demonstrate adult parasites or detect any pathologic changes. At this time, pentastomid eggs were no longer observed on fecal flotation. Due to the possibility of juvenile stages of the parasite still migrating in the dog, fluralaner (Bravecto®, Merck) was administered and continuing treatment recommended for at least 6 months. A follow-up fecal examination conducted a month after the treatment did not reveal any parasites or eggs. This is a case report of canine linguatuliasis diagnosed in Oklahoma, United States.

Protocol for a cross sectional study of cancer risk, environmental exposures and lifestyle behaviors in a diverse community sample: the Community of Mine study.

BACKGROUND: Physical inactivity and unhealthy diet are modifiable behaviors that lead to several cancers. Biologically, these behaviors are linked to cancer through obesity-related insulin resistance, inflammation, and oxidative stress. Individual strategies to change physical activity and diet are often short lived with limited effects. Interventions are expected to be more successful when guided by multi-level frameworks that include environmental components for supporting lifestyle changes. Understanding the role of environment in the pathways between behavior and cancer can help identify what environmental conditions are needed for individual behavioral change approaches to be successful, and better recognize how environments may be fueling underlying racial and ethnic cancer disparities. METHODS: This cross-sectional study was designed to select participants (n = 602 adults, 40% Hispanic, in San Diego County) from a range of neighborhoods ensuring environmental variability in walkability and food access. Biomarkers measuring cancer risk were measured with fasting blood draw including insulin resistance (fasting plasma insulin and glucose levels), systemic inflammation (levels of CRP), and oxidative stress measured from urine samples. Objective physical activity, sedentary behavior, and sleep were measured by participants wearing a GT3X+ ActiGraph on the hip and wrist. Objective measures of locations were obtained through participants wearing a Qstarz Global Positioning System (GPS) device on the waist. Dietary measures were based on a 24-h food recall collected on two days (weekday and weekend). Environmental exposure will be calculated using static measures around the home and work, and dynamic measures of mobility derived from GPS traces. Associations of environment with physical activity, obesity, diet, and biomarkers will be measured using generalized estimating equation models. DISCUSSION: Our study is the largest study of objectively measured physical activity, dietary behaviors, environmental context/exposure, and cancer-related biomarkers in a Hispanic population. It is the first to perform high quality measures of physical activity, sedentary behavior, sleep, diet and locations in which these behaviors occur in relation to cancer-associated biomarkers including insulin resistance, inflammation, impaired lipid metabolism, and oxidative stress. Results will add to the evidence-base of how behaviors and the built environment interact to influence biomarkers that increase cancer risk. TRIAL REGISTRATION: ClinicalTrials.gov NCT02094170 , 03/21/2014.

Fecal survey of parasites in free-roaming cats in northcentral Oklahoma, United States.

Cats can be infected by various intestinal parasites, some that are zoonotic. Although surveys of parasite prevalence in owned and shelter cats have been published, none addressed free-roaming, wild-trapped, domestic cat (Felis catus) populations. An opportunity to determine the prevalence of intestinal parasites in wild-trapped, free-roaming cats in northcentral Oklahoma, United States occurred through a trap-neuter-return (TNR) program conducted at Oklahoma State University, Boren Veterinary Medical Hospital, between February 2015 and April 2016. Approximately 1 g to 5 g of feces was collected from 846 free-roaming cats either from cage traps, when available, or rectally using disposable fecal loops and examined by centrifugal fecal flotation tests with 33% zinc sulfate solution. Parasite infections were confirmed by microscopic detection of eggs, cysts, or oocysts and visual detection of proglottids. Approximately 63.9% (541/846) of free-roaming cats were infected by at least one parasite, and 24.9% (211/846) of cats were infected by multiple parasites. The most common intestinal parasite infections detected were: Toxocara cati (44.6%; 377/846), followed by Alaria (13.4%; 113/846), Ancylostoma (11.2%; 95/846), Cystoisospora (9.7%; 82/846), taeniids (7.7%; 65/846), Dipylidium caninum (4.5%; 38/846), Physaloptera (2.2%; 19/846), Eucoleus aerophilus (1.4%; 12/846), Giardia (1.2%; 10/846), and a small (10-12 µm in diameter) Toxoplasma-like oocyst (0.1%; 1/846). A few ectoparasites, Demodex gatoi (0.5%; 4/846) and Cheyletiella (0.1%; 1/846), were also detected by fecal flotation. Our findings indicate that a higher prevalence of parasite infections occurs in free-roaming cats in Oklahoma than in owned cats, and these free-roaming cats contribute to contamination of the environment with several zoonotic parasites. Regional data on the prevalence of parasites in free-roaming cats can aid in the justification for parasite control programs in owned cats since both can share the same environment and supports the current practice of routine broad-spectrum anthelmintic and ectoparasite treatments for owned cats.