Association of PKLR gene copy number, expression levels and enzyme activity with 2,3,7,8-TCDD exposure in individuals exposed to Agent Orange/Dioxin in Vietnam.

2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TCDD) is the most toxic congener of dioxin and has serious long-term effects on the environment and human health. Pyruvate Kinase L/R (PKLR) gene expression levels and gene variants are associated with pyruvate kinase enzyme deficiency, which has been identified as the cause of several diseases linked to dioxin exposure. In this study, we estimated PKLR gene copy number and gene expression levels using real-time quantitative PCR (RT-qPCR) assays, genotyped PKLR SNP rs3020781 by Sanger sequencing, and quantified plasma pyruvate kinase enzyme activity in 100 individuals exposed to Agent Orange/Dioxin near Bien Hoa and Da Nang airfields in Vietnam and 100 healthy controls. The means of PKLR copy numbers and PKLR gene expression levels were significantly higher, while pyruvate kinase enzyme activity was significantly decreased in Agent Orange/Dioxin-exposed individuals compared to healthy controls (P < 0.0001). Positive correlations of PKLR gene copy number and gene expression with 2,3,7,8-TCDD concentrations were observed (r = 0.2, P = 0.045 and r = 0.54, P < 0.0001, respectively). In contrast, pyruvate kinase enzyme activity was inversely correlated with 2,3,7,8-TCDD concentrations (r = -0.52, P < 0.0001). PKLR gene copy number and gene expression levels were also inversely correlated with pyruvate kinase enzyme activity. Additionally, PKLR SNP rs3020781 was found to be associated with 2,3,7,8-TCDD concentrations and PKLR gene expression. In conclusion, PKLR copy number, gene expression levels, and pyruvate kinase enzyme activity are associated with 2,3,7,8-TCDD exposure in individuals living in Agent Orange/Dioxin-contaminated areas.

Results of the George Washington University cancer center's comprehensive cancer control cancer communication mentorship program and implications for future practice.

PURPOSE: The Comprehensive Cancer Control Cancer Communication Mentorship Program ("Mentorship Program") was created by the George Washington University Cancer Center (GWCC) to provide technical assistance (TA) in implementing evidence-based cancer screening communication interventions and support networking for comprehensive cancer control (CCC) professionals. The Mentorship Program matched entry-to mid-level CCC professionals with health communication and/or CCC experts and offered monthly web-based discussions with academic researchers and practitioners who shared their knowledge and provided applied learning opportunities throughout mentees' project planning, implementation and evaluation. The program objective was for mentees to improve health communication skills and apply evidence-based knowledge to reduce the burden of cancer. METHODS: A mixed methods evaluation was conducted, including a qualitative description of each project and its outcomes as well as quantitative measures of satisfaction with the program and self-rated changes in competence. RESULTS: Mentees represented the following locations: New Jersey, Arkansas, Michigan, West Virginia, and Republic of Palau. Project topics ranged from increasing Human papillomavirus (HPV) vaccinations to increasing screening uptake for colorectal cancer, lung cancer, cervical cancer, and breast cancer. Evaluation results from pre- and post-program communication competency self-assessments and mid- and post-program surveys revealed that the Mentorship Program advanced personal and professional goals and improved public health communication skills. CONCLUSION: The Mentorship Program achieved its objectives for peer networking and offering expert TA in cancer prevention and control communication, offering a promising model for others involved in supporting implementation of evidence in practice.

Determination of Pharmaceutical Residues by UPLC-MS/MS Method: Validation and Application on Surface Water and Hospital Wastewater.

In this study, an analytical method for the simultaneous determination of 7 major pharmaceutical residues in Vietnam, namely, carbamazepine, ciprofloxacin, ofloxacin, ketoprofen, paracetamol, sulfamethoxazole, and trimethoprim, in surface water and hospital wastewater has been developed. The method includes enrichment and clean-up steps by solid phase extraction using mix-mode cation exchange, followed by identification and quantification using an ultrahigh-performance liquid chromatography and tandem mass spectrometry and employing electrospray ionization (UPLC-ESI-MS/MS). Seven target compounds were separated on the reversed phase column and detected in multiple reaction monitoring (MRM) mode within 6 minutes. The present study also optimized the operating parameters of the mass spectrometer to achieve the highest analytical signals for all target compounds. All characteristic parameters of the analytical method were investigated, including linearity range, limit of detection, limit of quantification, precision, and accuracy. The important parameter in UPLC-ESI-MS/MS, matrix effect, was assessed and implemented via preextraction and postextraction spiking experiments. The overall recoveries of all target compounds were in the ranges from 55% to 109% and 56 % to 115% for surface water and hospital wastewater, respectively. Detection limits for surface water and hospital wastewater were 0.005-0.015 µg L-1 and 0.014-0.123 µg L-1, respectively. The sensitivity of the developed method was allowed for determination of target compounds at trace level in environmental water samples. The in-house validation of the developed method was performed by spiking experiment in both the surface water and hospital wastewater matrix. The method was then applied to analyze several surface water and hospital wastewater samples taken from West Lake and some hospitals in Vietnam, where the level of these pharmaceutical product residues was still missed. Sulfamethoxazole was present at a high detection frequency in both surface water (33% of analyzed samples) and hospital wastewater (81% of analyzed samples) samples.

Evaluation of Preoperative Weight Loss for Elective Hernia Repair in the Veteran Population.

The safety and efficacy of preoperative weight loss before elective nonbariatric surgery is controversial. We evaluated the effect of planned surgical delay for a preoperative weight loss trial in hernia repairs. Four hundred and fourteen patients undergoing elective hernia repair between July 2008 and May 2012 at a Level 1B VA Medical Center were identified. Included patients were divided into two groups: those who underwent immediate hernia repair (nontrial) and those who underwent weight loss trial before hernia repair (TRIAL). Twenty-two patients were categorized in the TRIAL group, and 392 in nontrial. Time from surgical evaluation to operation was longer in the TRIAL vs nontrial group (226 days vs 113 days, P = 0.001). Outcome measures were similar between groups. Net change in body mass index (BMI) was -2.2 per cent in TRIAL vs -0.86 per cent in nontrial patients (P = 0.440). Of the TRIAL patients, ten obtained a poor result (<3% decreased BMI), nine a moderate result (3-10% decreased BMI), and three a good result (>10% decreased BMI). Weight loss trials in elective hernia patients appear to be safe, although they result in significant delay to surgery and confer no difference in postoperative outcomes. Thus, efficacy of preoperative weight loss trials may be limited.