Changing US Support for Public Health Data Use Through Pandemic and Political Turmoil.

Policy Points This study examines the impact of several world-changing events in 2020, such as the pandemic and widespread racism protests, on the US population's comfort with the use of identifiable data for public health. Before the 2020 election, there was no significant difference between Democrats and Republicans. However, African Americans exhibited a decrease in comfort that was different from other subgroups. Our findings suggest that the public remained supportive of public health data activities through the pandemic and the turmoil of 2020 election cycle relative to other data use. However, support among African Americans for public health data use experienced a unique decline compared to other demographic groups. CONTEXT: Recent legislative privacy efforts have not included special provisions for public health data use. Although past studies documented support for public health data use, several global events in 2020 have raised awareness and concern about privacy and data use. This study aims to understand whether the events of 2020 affected US privacy preferences on secondary uses of identifiable data, focusing on public health and research uses. METHODS: We deployed two online surveys-in February and November 2020-on data privacy attitudes and preferences using a choice-based-conjoint analysis. Participants received different data-use scenario pairs-varied by the type of data, user, and purpose-and selected scenarios based on their comfort. A hierarchical Bayes regression model simulated population preferences. FINDINGS: There were 1,373 responses. There was no statistically significant difference in the population's data preferences between February and November, each showing the highest comfort with population health and research data activities and the lowest with profit-driven activities. Most subgroups' data preferences were comparable with the population's preferences, except African Americans who showed significant decreases in comfort with population health and research. CONCLUSIONS: Despite world-changing events, including a pandemic, we found bipartisan public support for using identifiable data for public health and research. The decreasing support among African Americans could relate to the increased awareness of systemic racism, its harms, and persistent disparities. The US population's preferences support including legal provisions that permit public health and research data use in US laws, which are currently lacking specific public health use permissions.

Effectiveness and safety of laparoscopic Roux-en-Y gastric bypass for the treatment of type 2 diabetes mellitus.

Gastric bypass may be conducted to aid in glycemic control in adults with type 2 diabetes mellitus (T2DM). The aim of the present study was to investigate the clinical results of diabetes remission and metabolic syndrome in individuals with T2DM after undergoing a gastric bypass. A total of 85 patients (39 men and 46 women) with T2DM underwent laparoscopic Roux-en-Y gastric bypass (LRYGB). Data regarding patient demographics, body mass index (BMI), co-morbidities and details of diabetes mellitus, including disease duration, remission, ß-cell function, blood lipid levels and nutritive status were prospectively collected and analyzed. The mean duration from the onset of T2DM was 7.79±4.84 years (range, 1 month to 22 years). The preoperative mean BMI was 31.60±4.10 (range, 28.53-48.10 kg/m2), mean percentage of body fat was 36.35±9.12% (range, 18-56%), and the mean HbA1c was 8.32±2.13% (range, 7-15.9%). Five patients (5.9%) developed complications without mortality. T2DM and ß-cell function were significantly improved from by month 6 after surgery (P<0.05). Improvements in central obesity, blood pressure (BP; systolic and diastolic) control, blood lipid levels were observed, without malnutrition or severe anemia. Therefore, the present results indicate that laparoscopic RYGBP is a safe and effective procedure for improving glycemic control, obesity, body fat percentage and BP in patients with T2DM and obesity.

Dynorphin A analogs containing a conformationally constrained phenylalanine derivative in position 4: reversal of preferred stereochemistry for opioid receptor affinity and discrimination of kappa vs. delta receptors.

Analogs of the opioid peptide [D-Ala8]dynorphin A-(1-11)NH2 containing optically pure (R)- and (S)-2-aminotetralin-2-carboxylic acid (Atc) in position 4 were synthesized and evaluated for opioid receptor affinity. These peptides are the first reported dynorphin A analogs containing a conformationally constrained amino acid in place of the important aromatic residue Phe4. By incorporating resolved Atc isomers, the opioid receptor affinity and the stereochemistry of the constrained residue could be unambiguously correlated. Both Dyn A analogs containing Atc in position 4 retained nanomolar affinity for kappa and mu opioid receptors. Unexpectedly the peptide containing (R)-Atc, corresponding to a conformationally constrained D-Phe analog, displaying higher affinity for both kappa and mu receptors than the peptide containing (S)-Atc. In contrast [D-Phe4,D-Ala8]Dyn A-(1-11)NH2 exhibited significantly lower affinity for kappa and mu receptors than the parent peptide, as expected. Conformational restriction of the Phe4 sidechain or incorporation of D-Phe in position 4 had the largest effect on delta receptor affinity, yielding compounds with negligible affinity for these receptors. Thus, there appear to be distinctly different structural requirements for this residue for kappa vs. delta receptors, and it is possible to completely distinguish between these two receptors by changing a single residue in Dyn A.