Acupuncture for Chronic Radiation-Induced Xerostomia in Head and Neck Cancer: A Multicenter Randomized Clinical Trial.

Importance: Patients with head and neck cancer who undergo radiotherapy can develop chronic radiation-induced xerostomia. Prior acupuncture studies were single center and rated as having high risk of bias, making it difficult to know the benefits of acupuncture for treating radiation-induced xerostomia. Objective: To compare true acupuncture (TA), sham acupuncture (SA), and standard oral hygiene (SOH) for treating radiation-induced xerostomia. Design, Setting, and Participants: A randomized, blinded, 3-arm, placebo-controlled trial was conducted between July 29, 2013, and June 9, 2021. Data analysis was performed from March 9, 2022, through May 17, 2023. Patients reporting grade 2 or 3 radiation-induced xerostomia 12 months or more postradiotherapy for head and neck cancer were recruited from community-based cancer centers across the US that were part of the Wake Forest National Cancer Institute Community Oncology Research Program Research Base. Participants had received bilateral radiotherapy with no history of xerostomia. Interventions: Participants received SOH and were randomized to TA, SA, or SOH only. Participants in the TA and SA cohorts were treated 2 times per week for 4 weeks. Those experiencing a minor response received another 4 weeks of treatment. Main Outcomes and Measures: Patient-reported outcomes for xerostomia (Xerostomia Questionnaire, primary outcome) and quality of life (Functional Assessment of Cancer Therapy-General) were collected at baseline, 4 (primary time point), 8, 12, and 26 weeks. All analyses were intention to treat. Results: A total of 258 patients (201 men [77.9%]; mean [SD] age, 65.0 [9.16] years), participated from 33 sites across 13 states. Overall, 86 patients were assigned to each study arm. Mean (SD) years from diagnosis was 4.21 (3.74) years, 67.1% (n = 173) had stage IV disease. At week 4, Xerostomia Questionnaire scores revealed significant between-group differences, with lower Xerostomia Questionnaire scores with TA vs SOH (TA: 50.6; SOH: 57.3; difference, -6.67; 95% CI, -11.08 to -2.27; P = .003), and differences between TA and SA (TA: 50.6; SA: 55.0; difference, -4.41; 95% CI, -8.62 to -0.19; P = .04) yet did not reach statistical significance after adjustment for multiple comparisons. There was no significant difference between SA and SOH. Group differences in Functional Assessment of Cancer Therapy-General scores revealed statistically significant group differences at week 4, with higher scores with TA vs SOH (TA: 101.6; SOH: 97.7; difference, 3.91; 95% CI, 1.43-6.38; P = .002) and at week 12, with higher scores with TA vs SA (TA: 102.1; SA: 98.4; difference, 3.64; 95% CI, 1.10-6.18; P = .005) and TA vs SOH (TA: 102.1; SOH: 97.4; difference, 4.61; 95% CI, 1.99-7.23; P = .001). Conclusions and Relevance: The findings of this trial suggest that TA was more effective in treating chronic radiation-induced xerostomia 1 or more years after the end of radiotherapy than SA or SOH. Trial Registration: ClinicalTrials.gov Identifier: NCT02589938.

Age-Related Differences in T-Cell Subsets in a Nationally Representative Sample of People Older Than Age 55: Findings From the Health and Retirement Study.

Though T-cell immunosenescence is a major risk factor for age-related diseases, susceptibility to infections, and responses to vaccines, differences in T-cell subset counts and representation by age and sex have not been determined for a large sample representative of the national population of the United States. We evaluated the counts of T-cell subsets including total, CD4+, and CD8+ T cells and their naïve (Tn), effector memory (Tem), and effector subsets, in the context of age, sex, and exposure to cytomegalovirus (CMV) infection among 8 848 Health and Retirement Study participants, a nationally representative study of adults older than 55 years. Total T cells (CD3+) and CD4+ cells declined markedly with age; CD8+ T cells declined somewhat less. While CD4+ T cell declines with age occurred for both CMV-seropositive and CMV-seronegative groups, total T cells and CD8+ cells were both substantially higher among the CMV-seropositive group. Numbers of Tn CD4+ and CD8+ cells were strongly and inversely related to age, were better conserved among women, and were independent of CMV seropositivity. By contrast, accumulation of the CD8+ and CD4+ Tem and effector subsets was CMV-associated. This is the first study to provide counts of T-cell subsets by age and sex in a national sample of US adults older than the age of 55 years. Understanding T-cell changes with age and sex is an important first step in determining strategies to reduce its impact on age-related diseases and susceptibility to infection.

The benefit of heart rate variability biofeedback and relaxation training in reducing trait anxiety.

Previous research studies have indicated that biofeedback treatment and relaxation techniques are effective in reducing psychological and physical symptoms (Hammond, 2005; Manzoni, G. M., Pagnini, F., Castelnuovo, G., & Molinari, E., 2008). However, dearth of studies has compared heart rate variability (HRV) biofeedback treatment and relaxation training to reduce trait anxiety. The objective of this study was to determine the effect of HRV biofeedback treatment and relaxation training in reducing trait anxiety compared to control group without any treatment using students in a science and engineering university of South Korea. For the present study, a total of 15 graduate students with moderate level of trait anxiety were recruited for 4 individual sessions every two weeks. They were randomly assigned into three groups: biofeedback treatment (n = 5), relaxation training (n = 5), and no treatment control group (n = 5). Our results revealed significant difference in change score of trait anxiety between the HRV biofeedback treatment and the no treatment control group. However, no significant difference was found between the relaxation training group and the no treatment control group. In addition, there was no significant difference between the HRV biofeedback treatment and the relaxation training. Results of the present study indicate that there is potential benefit in utilizing HRV biofeedback treatment for stress management programs and/or anxiety reduction treatment.

Cuing consumerism: situational materialism undermines personal and social well-being.

Correlational evidence indicates that materialistic individuals experience relatively low levels of well-being. Across four experiments, we found that situational cuing can also trigger materialistic mind-sets, with similarly negative personal and social consequences. Merely viewing desirable consumer goods resulted in increases in materialistic concerns and led to heightened negative affect and reduced social involvement (Experiment 1). Framing a computer task as a "Consumer Reaction Study" led to a stronger automatic bias toward values reflecting self-enhancement, compared with framing the same task as a "Citizen Reaction Study" (Experiment 2). Consumer cues also increased competitiveness (Experiment 3) and selfishness in a water-conservation dilemma (Experiment 4). Thus, the costs of materialism are not localized only in particularly materialistic people, but can also be found in individuals who happen to be exposed to environmental cues that activate consumerism-cues that are commonplace in contemporary society.

Poverty and biological risk: the earlier "aging" of the poor.

BACKGROUND: We examined age differences in levels of biological risk factors in the U.S. population by poverty status. It is not clear how socioeconomic status differentials in biological risk change with age because of mortality. METHODS: We used two nationally representative samples (National Health and Nutrition Examination Survey [NHANES] III, 1988-1994, and NHANES, 1999-2004) with data for more than 12,000 people aged 20 and older in each data set to examine biological risk for persons in families with incomes below and close to poverty level and those with higher income. We examined how mortality and life expectancy in the earlier sample are related to poverty status and biological risk. We examined life table survivorship to clarify how mortality differentially removes those who are poor and those with high biological risk from the population. RESULTS: Differences in biological risk by poverty status are larger before old age and become insignificant at older ages. Life expectancy at age 20 differs markedly by biological risk and poverty status. CONCLUSIONS: Population differentials in health at older ages result from a lifetime of differences. Socioeconomic differences in health in old age disappear because of health and mortality differentials at earlier ages. Poorer people "age" earlier and this affects the age pattern of social differentials.

Kinetics of low frequency sonodegradation of linear alkylbenzene sulfonate solutions.

The decomposition of sodium dodecylbenzene sulfonate (SDBS) in water by means of ultrasound irradiation at 20kHz was investigated. Experiments were conducted at surfactant concentrations of 175, 260 and 350 mg l(-1), liquid volumes of 120, 170 and 220 ml, temperatures of 20, 30 and 45 degrees C and applied power of 40, 80 and 125 W. The extent of degradation was followed monitoring substrate and organic carbon concentrations, while hydrogen peroxide concentration was also measured; the latter is a product of water sonolysis due to hydroxyl radical recombination. 80% SDBS conversion was achieved after 120 min of sonication at 125 W and 30 degrees C; nonetheless, SDBS and its degradation intermediates proved difficult to oxidise as only about 20-25% of the initial carbon content was transformed to carbon dioxide. At the initial stages of the reaction, degradation rate appears to be only weakly dependent on the substrate concentration with the rate increasing from 3.1 to 4 mg l(-1)min(-1) with increasing concentration from 175 to 350 mg l(-1). Degradation appears to occur at the bubble-liquid interface through hydroxyl radical-mediated reactions whose role was established by performing experiments in the presence of radical scavengers, namely potassium bromide and sodium benzoate. Degradation rates increased with increasing power and decreasing temperature and volume.

Age-related changes in sleep/wake patterns among Korean teenagers.

INTRODUCTION: As children go through the transition from childhood to adolescence, many shifts occur in sleep/wake patterns related to intrinsic and extrinsic developmental changes. These shifts have been shown to result in corresponding shifts in sleep phase (later sleep onset) and sleep deprivation among teenagers in Western societies. However, the effect of these developmental changes on the sleep habits of Korean teenagers has not been analyzed. This study aims to quantify age-related changes in sleep/wake patterns among Korean teenagers and elucidate cultural and other factors causing these changes. METHODS: The School Sleep Habits Survey was administered in homeroom classes to students in grades 5 to 12 (mean age: 13.7 +/- 2.4 years) selected via a 2-way stratification sampling method. The survey included items regarding usual sleep/wake patterns over the previous 2 weeks as well as measures of daytime sleepiness, sleep/wake-problem behavior, depressed mood, and morningness/eveningness. RESULTS: A total of 1457 students (52.9% male) completed the survey. The higher the grade, the later bedtime was found to be on both school days and weekends. There was a similar relationship between increasing grade and earlier wake time on school days, but higher grades were associated with later wake time on weekends. Total sleep time decreased by approximately 3 hours on school nights and 1 hour on weekend nights from grades 5 to 12. Adolescents were severely sleep deprived, with mean school-night total sleep times of 6.02, 5.62, and 4.86 hours for 10th-, 11th-, and 12th-graders, respectively. In the higher grades, there was a greater discrepancy between school nights and weekends in terms of bedtime and wake time, and the magnitude of weekend oversleep increased. Older students also reported more daytime sleepiness, more sleep/wake-problem behavior, more depressed mood, and more eveningness preference. The chief reasons students cited for their sleep deprivation differed across grades: Academic demands and entertainment (such as Internet and television) were reported by 5th- and 6th-graders, entertainment and then academic demands by 7th-, 8th-, and 9th-graders, and early school start time and academic demands by 10th-, 11th- and 12th-graders. CONCLUSIONS: This study clearly demonstrates that Korean adolescents do not get adequate sleep and that they have profound discrepancies in their sleep/wake patterns between school and weekend nights. Compared with previous studies from other countries, Korean students display even greater sleep deprivation and also more irregular sleep/wake patterns. This study also demonstrates that academic demands/stress and early school start time are the most important contributing factors for sleep deprivation among Korean adolescents. These findings stress the need to promote awareness of the magnitude of adolescent sleep deprivation and its detrimental effects in Korean society.

Preparation of a t,t conjugated linoleic acid methylester (CLA-Me) isomers mixture from synthetic CLA by methylation with BF3/methanol.

Mixtures of t,t conjugated linoleic acid methylester (t,t CLA-Me) isomers were prepared from synthetic CLA, consisting of 47.8% t10,c12 CLA; 45.5% c9,t11 CLA; 2.0% t,t CLA; and 4.7% others, by methylation with BF(3)/methanol (designated TT-TC/CT) in conjunction with purification at -68 degrees C for 24 h. The amount or composition of the TT-TC/CT was greatly affected by the concentration of BF(3) in methanol and the duration of methylation. The methylation of 50 mg of synthetic CLA for 30 min with 1 mL of 7.0% BF(3)/methanol produced a TT-TC/CT (21.54 mg) with the composition of 1.3% t12,t14; 5.9% t11,t13; 42.7% t10,t12; 44.0% t9,t11; 5.0% t8,t10; and 1.1% t 7,t9 CLA, whereas the methylation for 60 min with 14.0% BF(3)/methanol produced a TT-TC/CT (28.62 mg) with the composition of t,t CLA isomers different from that of TT-TC/CT by methylation for 30 min with 7.0% BF(3)/methanol. A large quantity of TT-TC/CT (14.15 g) with the composition similar to that of TT-TC/CT prepared from 50 mg of synthetic CLA was also prepared from 25 g of synthetic CLA. The purity of TT-TC/CT samples was greater than 98%. These results suggest that TT-TC/CT with a purity greater than 98% was easily prepared from synthetic CLA by BF(3)-catalyzed methylation, and the amount and composition of t,t CLA isomers of TT-TC/CT samples could be controlled by methylation conditions.

Inclusion complex of conjugated linoleic acid (CLA) with cyclodextrins.

Conjugated linoleic acid (CLA) inclusion complexes with alpha-cyclodextrin (alpha-CD), beta-cyclodextrin (beta-CD), and gamma-cyclodextrin (gamma-CD) (designated CLA/CDs inclusion complexes) were prepared to determine the mole ratio of CLA complexed with CDs and the oxidative stability of CLA in the CLA/CDs inclusion complexes. When measured by GC, (1)H NMR, and T(1) value analyses, 1 mole of CLA was complexed with 5 mol of alpha-CD, 4 mol of beta-CD, and 2 mol of gamma-CD. The oxidation of CLA induced at 35 degrees C for 80 h was completely prevented by the formation of CLA/CDs inclusion complexes.

Mass production of methane from food wastes with concomitant wastewater treatment.

We developed a process for production of methane at a pilot scale. This process consists of three stages. The first stage is a semianaerobic hydrolysis/acidogenic step in which organic wastes are converted to various sugars, amino acids, and volatile fatty acids (VFAs). Operation temperature and pH were 45 degrees C, and 5.0-5.5, respectively. Hydraulic retention time (HRT) was 2 d. To remove the putrid odor and to enhance the hydrolysis of organic wastes, a mixture of bacteria isolated from landfill soil was inoculated into the reactor. Total chemical oxygen demand (tCOD) and biological oxygen demand (BOD) were 36,000 mg/L and 40,000 mg/L, respectively. The second stage was an anaerobic acidogenic process, which can produce large amount of VFAs including acetate, propionate, butyrate, valerate, and caproate. Operation temperature and pH were 35 degrees C, and 5.0-5.5, respectively. HRT was 2 d. The third stage was a strictly anaerobic methane fermentation step producing methane and carbon dioxide from VFAs. The working volume of upflow anaerobic sludge blanket (UASB) type reactor was 1200 L, and operation temperature and pH were 41 degrees C, and 7.7-7.9, respectively. HRT was 12 d. Seventy two percent of methane at maximum was generated and the yield was 0.45-0.50 m3/kgVS of food wastes. Through the process, 88% of tCOD and 95% of BOD were removed. The wastewater was treated with the biological aerobic and anaerobic filters immobilized with heterotrophic and autotrophic nitrifying and denitrifying bacteria. Ninety percent of total nitrogen (T-N) was removed by this treatment. The residual T-N and total phosphorous (T-P) were removed by the algal periphyton treatment system. The final concentrations of nitrogen and phosphorous in the drain water were 53 and 7 mg/L, respectively.

Methylation methods for the quantitative analysis of conjugated linoleic acid (CLA) isomers in various lipid samples.

Precise methylation methods for various chemical forms of conjugated linoleic acid (CLA), which minimize the formation of t,t isomers and allylmethoxy derivatives (AMD) with the completion of methylation, were developed using a 50 mg lipid sample, 3 mL of 1.0 N H(2)SO(4)/methanol, and/or 3 mL of 20% tetramethylguanidine (TMG)/methanol solution(s). Free CLA (FCLA) was methylated with 1.0 N H(2)SO(4)/methanol (55 degrees C, 5 min). CLA esterified in safflower oil (CLA-SO) was methylated with 20% TMG/methanol (100 degrees C, 5 min), whereas CLA esterified in phospholipid (CLA-PL) was methylated with 20% TMG/methanol (100 degrees C, 10 min), followed by an additional reaction with 1.0 N H(2)SO(4)/methanol (55 degrees C, 5 min). Similarly, CLA esterified in egg yolk lipid (CLA-EYL) was methylated by base hydrolysis, followed by reaction with 1.0 N H(2)SO(4)/methanol (55 degrees C, 5 min). These results suggest that for the quantitative analysis of CLA in lipid samples by GC, proper methylation methods should be chosen on the basis of the chemical forms of CLA in samples.