The structure of NAD+ consuming protein Acinetobacter baumannii TIR domain shows unique kinetics and conformations.

Toll-like and interleukin-1/18 receptor/resistance (TIR) domain-containing proteins function as important signaling and immune regulatory molecules. TIR domain-containing proteins identified in eukaryotic and prokaryotic species also exhibit NAD+ hydrolase activity in select bacteria, plants, and mammalian cells. We report the crystal structure of the Acinetobacter baumannii TIR domain protein (AbTir-TIR) with confirmed NAD+ hydrolysis and map the conformational effects of its interaction with NAD+ using hydrogen-deuterium exchange-mass spectrometry. NAD+ results in mild decreases in deuterium uptake at the dimeric interface. In addition, AbTir-TIR exhibits EX1 kinetics indicative of large cooperative conformational changes, which are slowed down upon substrate binding. Additionally, we have developed label-free imaging using the minimally invasive spectroscopic method 2-photon excitation with fluorescence lifetime imaging, which shows differences in bacteria expressing native and mutant NAD+ hydrolase-inactivated AbTir-TIRE208A protein. Our observations are consistent with substrate-induced conformational changes reported in other TIR model systems with NAD+ hydrolase activity. These studies provide further insight into bacterial TIR protein mechanisms and their varying roles in biology.

Flipped ophthalmology classroom augmented with case-based learning.

BACKGROUND: Although the flipped classroom model provides an effective way to teach ophthalmology to medical students, there are concerns that it overburdens the learner. The purpose of this study was to assess medical students' perceptions of a case-based flipped classroom style compared with a traditional didactic lecture series and to evaluate the effects of case-based learning on students' confidence in managing common ophthalmic complaints. METHODS: We created an interactive, case-based flipped classroom ophthalmology curriculum. Paired pre- and post-clerkship surveys were distributed to students on the first and last day of the 2-week clerkship. Questions were formatted as statements using a 6-point Likert scale to assess students' prior exposure to a flipped classroom, perceptions of the flipped classroom curriculum, and confidence in evaluating ophthalmic complaints. RESULTS: A total of 75 students were included during the period July 2019 to March 2020. Pre-clerkship questionnaires revealed no preference for either teaching modality. Wilcoxon signed-rank testing comparing pre- and post-clerkship data revealed a significant increase in students' favoring the case-based flipped-classroom model. Participants reported significant reductions in pressure to perform, course burden, and overall anxiety as well as increased confidence in triaging common eye complaints. CONCLUSIONS: The case-based flipped classroom modality prioritizes key learning objectives while increasing student participation and confidence. The reproducibility and accessibility of standardized prepared video lectures and cases may help institutions to better incorporate ophthalmology into preexisting rotations.

Competitive TcO4-, IO3-, and CrO42- Incorporation into Ettringite.

Ettringite is a naturally occurring mineral found in cementitious matrices that is known for its ability to incorporate environmentally mobile oxyanion contaminants. To better assess this immobilization mechanism for contaminants within cementitious waste forms intended for nuclear waste storage, this work explores how mixed oxyanion contaminants compete for ettringite incorporation and influence the evolving mineralogy. Ettringite was precipitated in the presence of TcO4-, IO3-, and/or CrO42-, known contaminants of concern to nuclear waste treatment, over pre-determined precipitation periods. Solution analyses quantified contaminant removal, and the collected solid was characterized using bulk and microprobe X-ray diffraction coupled with pair distribution function and microprobe X-ray fluorescence analyses. Results suggest that ≥96% IO3- is removed from solution, regardless of ettringite precipitation time or the presence of TcO4- or CrO42-. However, TcO4- removal remained <20%, was not significantly improved with longer ettringite precipitation times, and decreased to zero in the presence of IO3-. When IO3- is co-mingled with CrO42-, calcite and gypsum are formed as secondary mineral phases, which allows for oxyanion partitioning, e.g., IO3- incorporation into ettringite, and CrO42- incorporation into calcite. Results from this work exemplify the importance of competitive immobilization when assessing waste form performance and environmental risk of contaminant release.

Hydroxide promotes ion pairing in the NaNO2-NaOH-H2O system.

Nitrite (NO2-) is a prevalent nitrogen oxyanion in environmental and industrial processes, but its behavior in solution, including ion pair formation, is complex. This solution phase complexity impacts industries such as nuclear waste treatment, where NO2- significantly affects the solubility of other constituents present in sodium hydroxide (NaOH)-rich nuclear waste. This work provides molecular scale information into sodium nitrite (NaNO2) and NaOH ion-pairing processes to provide a physical basis for later development of thermodynamic models. Solubility isotherms of NaNO2 in aqueous mixtures with NaOH and total alkalinity were also measured. Spectroscopic characterization of these solutions utilized high-field nuclear magnetic resonance spectroscopy (NMR) and Raman spectroscopy, with additional solution structure detailed by X-ray total scattering pairwise distribution function analysis (X-ray PDF). Despite the NO2- deformation Raman band's insensitivity to added NaOH in saturated NaNO2 solutions, 23Na and 15N NMR studies indicated the Na+ and NO2- chemical environments change likely due to ion pairing. The ion pairing correlates with a decrease in diffusion coefficient of solution species as measured by pulsed field gradient 23Na and 1H NMR. Two-dimensional correlation analyses of the 2800-4000 cm-1 Raman region and X-ray PDF indicated that saturated NaNO2 and NaOH mixtures disrupt the hydrogen network of water into a new structure where the length of the OO correlations is contracted relative to the typical H2O structure. Beyond describing the solubility of NaNO2 in a multicomponent electrolyte mixture, these results also indicate that nitrite exhibits greater ion pairing in mixtures of concentrated NaNO2 and NaOH than in comparable solutions with only NaNO2.

Immobilizing Pertechnetate in Ettringite via Sulfate Substitution.

Technetium-99 immobilization in low-temperature nuclear waste forms often relies on additives that reduce environmentally mobile pertechnetate (TcO4-) to insoluble Tc(IV) species. However, this is a short-lived solution unless reducing conditions are maintained over the hazardous life cycle of radioactive wastes (some ∼10,000 years). Considering recent experimental observations, this work explores how rapid formation of ettringite [Ca6Al2(SO4)3(OH)12·26(H2O)], a common mineral formed in cementitious waste forms, may be used to directly immobilize TcO4-. Results from ab initio molecular dynamics (AIMD) simulations and solid-phase characterization techniques, including synchrotron X-ray absorption, fluorescence, and diffraction methods, support successful incorporation of TcO4- into the ettringite crystal structure via sulfate substitution when synthesized by aqueous precipitation methods. One sulfate and one water are replaced with one TcO4- and one OH- during substitution, where Ca2+-coordinated water near the substitution site is deprotonated to form OH- for charge compensation upon TcO4- substitution. Furthermore, AIMD calculations support favorable TcO4- substitution at the SO42- site in ettringite rather than gypsum (CaSO4·2H2O, formed as a secondary mineral phase) by at least 0.76 eV at 298 K. These results are the first of their kind to suggest that ettringite may contribute to TcO4- immobilization and the overall lifetime performance of cementitious waste forms.

Cobbling Together the Myddosome.

An organism's ability to recognize and respond quickly and appropriately to pathogenic stimuli is a fundamental aspect of innate immunity. Harnessing the dynamic nature of fluorescent microscopy and the resolution of cryo-electron microscopy, Moncrieffe et al. (2020) characterize MyD88-only filaments and provide insight into the mechanisms underlying innate immune signaling.

Variability in Observation-based Onroad Emission Constraints from a Near-road Environment.

This study uses Las Vegas near-road measurements of carbon monoxide (CO) and nitrogen oxides (NOx) to test the consistency of onroad emission constraint methodologies. We derive commonly used CO to NOx ratios (ΔCO:ΔNOx) from cross-road gradients and from linear regression using ordinary least squares (OLS) regression and orthogonal regression. The CO to NOx ratios are used to infer NOx emission adjustments for a priori emissions estimates from EPA's MOtor Vehicle Emissions Simulator (MOVES) model assuming unbiased CO. The assumption of unbiased CO emissions may not be appropriate in many circumstances but was implemented in this analysis to illustrate the range of NOx scaling factors that can be inferred based on choice of methods and monitor distance alone. For the nearest road estimates (25m), the cross-road gradient and ordinary least squares (OLS) agree with each other and are not statistically different from the MOVES-based emission estimate while ΔCO:ΔNOx from orthogonal regression is significantly higher than the emitted ratio from MOVES. Using further downwind measurements (i.e., 115m and 300m) increases OLS and orthogonal regression estimates of ΔCO:ΔNOx but not cross-road gradient ΔCO:ΔNOx. The inferred NOx emissions depend on the observation-based method, as well as the distance of the measurements from the roadway and can suggest either that MOVES NOx emissions are unbiased or that they should be adjusted downward by between 10% and 47%. The sensitivity of observation-based ΔCO:ΔNOx estimates to the selected monitor location and to the calculation method characterize the inherent uncertainty of these methods that cannot be derived from traditional standard-error based uncertainty metrics.

Ion-ion interactions enhance aluminum solubility in alkaline suspensions of nano-gibbsite (α-Al(OH)3) with sodium nitrite/nitrate.

Despite widespread industrial importance, predicting metal solubilities in highly concentrated, multicomponent aqueous solutions is difficult due to poorly understood ion-ion and ion-solvent interactions. Aluminum hydroxide solid phase solubility in concentrated sodium hydroxide (NaOH) solutions is one such case, with major implications for ore refining, as well as processing of radioactive waste stored at U.S. Department of Energy legacy sites, such as the Hanford Site, Washington State. The solubility of gibbsite (α-Al(OH)3) is often not well predicted because other ions affect the activity of hydroxide (OH-) and aluminate (Al(OH)4-) anions. In the present study, we systematically examined the influence of key anions, nitrite (NO2-) and nitrate (NO3-), as sodium salts on the solubility of α-Al(OH)3 in NaOH solutions taking care to establish equilibrium from both under- and oversaturation. Rapid equilibration was enabled by use of a highly pure and crystalline synthetic nano-gibbsite of well-defined particle size and shape. Measured dissolved aluminum concentrations were compared with those predicted by an α-Al(OH)3 solubility model derived for simple Al(OH)4-/OH- systems. Specific anion effects were expressed as an enhancement factor (Alenhc) conveying the excess of dissolved aluminum. At 45 °C, NaNO2 and NaNO3-containing systems exhibited Alenhc values of 2.70 and 1.88, respectively, indicating significant enhancement. The solutions were examined by Raman and high-field 27Al NMR spectroscopy, indicating specific interactions including Al(OH)4--Na+ contact ion pairing and Al(OH)4--NO2-/NO3- ion-ion interactions. Dynamic evolution of the α-Al(OH)3 particles including growth and agglomeration was observed revealing the importance of dissolution/reprecipitation in establishing equilibrium. These studies indicate that incomplete ion hydration, as a result of the low water activity in these concentrated electrolytes, results in: (i) enhanced reactivity of the hydroxide ion with respect to α-Al(OH)3; (ii) increased concentrations of Al(OH)4- in solution; and (iii) stronger ion-ion interactions that act to stabilize the supersaturated solutions. This information on the mechanisms by which α-Al(OH)3 becomes supersaturated is essential for more energy-efficient aluminum processing technologies, including the treatment of millions of gallons of Al(OH)4--rich high-level radioactive waste.

Influential factors affecting black carbon trends at four sites of differing distance from a major highway in Las Vegas.

Elevated air pollution levels adjacent to major highways are an ongoing topic of public health concern worldwide. Black carbon (BC), a component of particulate matter (PM) emitted by diesel and gasoline vehicles, was measured continuously via a filter-based light absorption technique over ~ 16 months at four different stations positioned on a perpendicular trajectory to a major highway in Las Vegas, NV. During downwind conditions (winds from the west), BC at 20 m from the highway was 32 and 60% higher than concentrations at 100 and 300 m from the roadway, respectively. Overall highest roadside (20-m site) BC concentrations were observed during the time period of 4 a.m.-8 a.m. under low-speed variable winds (3.02 µg/m3) or downwind conditions (2.84 µg/m3). The 20-m site BC concentrations under downwind conditions are 85% higher on weekday periods compared to weekends during the time period of 4 a.m.-8 a.m. Whereas total traffic volume was higher on weekdays versus weekends and differed by approximately 3% on weekdays versus weekends, similarly, the detected heavy-duty fraction was higher on weekdays versus weekends and differed by approximately 21% on weekdays versus weekend. Low wind speeds predominated during early morning hours, leading to higher BC concentrations during early morning hours despite the maximum traffic volume occurring later in the day. No noticeable impact from the airport or nearby arterial roadways was observed, with the 300-m site remaining the lowest of the four-site network when winds were from the east. Multivariate linear regression analysis revealed that heavy-duty traffic volume, light-duty traffic volume, wind speed, weekday versus weekend, surface friction velocity, ambient temperature, and the background BC concentration were significant predictors of roadside BC concentrations. Comparison of BC and PM2.5 downwind concentration gradients indicates that the BC component contributes substantially to the PM2.5 increase in roadside environments. These results suggest that BC is an important indicator to assess the contribution of primary traffic emissions to near-road PM2.5 concentrations, providing opportunities to evaluate the feasibility and effectiveness of mitigation strategies.

Marking 15 years of the Genetic and Rare Diseases Information Center.

BACKGROUND: The Genetic and Rare Diseases Information Center (GARD), a program of the National Center for Advancing Translational Sciences, was established in 2002 to assist the public in finding reliable, timely, and easy-to-understand information about genetic and/or rare diseases in English or Spanish. OBJECTIVE: A review of longitudinal data on GARD inquiries from 2002 to 2016 and assessment of the results of two user satisfaction surveys were conducted to understand the demographics and needs of GARD customers over time. METHODS: Since 2002, GARD has collected anonymized data while responding to questions received via e-mail, website, telephone, fax, letter, or TTY. Between 2002 and 2016 GARD received a total of 60,106 inquiries. User satisfaction surveys were conducted in 2006 and 2014, in which users self-selected to participate. RESULTS: The annual number of inquiries has risen steadily since 2002. Inquiries are overwhelmingly from educated female patients, family, and friends seeking disease-specific information, treatment options, referrals, and research studies. Most users report satisfaction with the experience. CONCLUSIONS: Rare disease patients and their families face challenges in finding information about their symptoms or diagnosis, prognosis, treatment options, significance for family members, and research opportunities. Lack of available clinical expertise can leave patients, their family, and friends with little choice but to become knowledgeable on their own. GARD fills a critical need by providing the public with vetted, evidence-based information that empowers people to engage in their own health care and seek research studies of relevance.

Effects of hydrated lime on radionuclides stabilization of Hanford tank residual waste.

Chemical stabilization of tank residual waste is part of a Hanford Site tank closure strategy to reduce overall risk levels to human health and the environment. In this study, a set of column leaching experiments using tank C-104 residual waste were conducted to evaluate the leachability of uranium (U) and technetium (Tc) where grout and hydrated lime were applied as chemical stabilizing agents. The experiments were designed to simulate future scenarios where meteoric water infiltrates through the vadose zones into the interior of the tank filled with layers of grout or hydrated lime, and then contacts the residual waste. Effluent concentrations of U and Tc were monitored and compared among three different packing columns (waste only, waste + grout, and waste + grout + hydrated lime). Geochemical modeling of the effluent compositions was conducted to determine saturation indices of uranium solid phases that could control the solubility of uranium. The results indicate that addition of hydrated lime strongly stabilized the uranium through transforming uranium to a highly insoluble calcium uranate (CaUO4) or similar phase, whereas no significant stabilization effect of grout or hydrated lime was observed on Tc leachability. The result implies that hydrated lime could be a great candidate for stabilizing Hanford tank residual wastes where uranium is one of the main concerns.

Estimation of on-road NO2 concentrations, NO2/NOX ratios, and related roadway gradients from near-road monitoring data.

This paper describes a new regression modeling approach to estimate on-road nitrogen dioxide (NO2) and oxides of nitrogen (NOX) concentrations and near-road spatial gradients using data from a near-road monitoring network. Field data were collected in Las Vegas, NV at three monitors sited 20, 100, and 300 m from Interstate-15 between December, 2008 and January, 2010. Measurements of NO2 and NOX were integrated over 1-hour intervals and matched with meteorological data. Several mathematical transformations were tested for regressing pollutant concentrations against distance from the roadway. A logit-ln model was found to have the best fit (R2 = 94.7%) and also provided a physically realistic profile. The mathematical model used data from the near-road monitors to estimate on-road concentrations and the near-road gradient over which mobile source pollutants have concentrations elevated above background levels. Average and maximum on-road NO2 concentration estimates were 33 ppb and 105 ppb, respectively. Concentration gradients were steeper in the morning and late afternoon compared with overnight when stable conditions preclude mixing. Estimated on-road concentrations were also highest in the late afternoon. Median estimated on-road and gradient NO2 concentrations were lower during summer compared with winter, with a steeper gradient during the summer, when convective mixing occurs during a longer portion of the day On-road concentration estimates were higher for winds perpendicular to the road compared with parallel winds and for atmospheric stability with neutral-to-unstable atmospheric conditions. The concentration gradient with increasing distance from the road was estimated to be sharper for neutral-to-unstable conditions when compared with stable conditions and for parallel wind conditions compared with perpendicular winds. A regression of the NO2/NOX ratios yielded on-road ratios ranging from 0.25 to 0.35, substantially higher than the anticipated tail-pipe emissions ratios. The results from the ratios also showed that the diurnal cycle of the background NO2/NOX ratios were a driving factor in the on-road and downwind NO2/NOX ratios.

Circulating adipocyte-derived exosomal MicroRNAs associated with decreased insulin resistance after gastric bypass.

OBJECTIVE: Exosomes from obese adipose contain dysregulated microRNAs linked to insulin signaling, as compared with lean controls, providing a direct connection between adiposity and insulin resistance. This study tested the hypotheses that gastric bypass surgery and its subsequent weight loss would normalize adipocyte-derived exosomal microRNAs associated with insulin signaling and the associated metabolome related to glucose homeostasis. METHODS: African American female subjects with obesity (N = 6; age: 38.5 ± 6.8 years; BMI: 51.2 ± 8.8 kg/m2 ) were tested before and 1 year after surgery. Insulin resistance (HOMA), serum metabolomics, and global microRNA profiles of circulating adipocyte-derived exosomes were evaluated via ANCOVA and correlational analyses. RESULTS: One year postsurgery, patients showed decreased BMI (-18.6 ± 5.1 kg/m2 ; P < 0.001), ameliorated insulin resistance (HOMA: 1.94 ± 0.6 presurgery, 0.49 ± 0.1 postsurgery; P < 0.001), and altered metabolites including branched chain amino acids (BCAA). Biological pathway analysis of predicted mRNA targets of 168 surgery-responsive microRNAs (P < 0.05) identified the insulin signaling pathway (P = 1.27E-10; 52/138 elements), among others, in the data set. The insulin signaling pathway was also a target of 10 microRNAs correlated to changes in HOMA (P < 0.05; r > 0.4), and 48 microRNAs correlated to changes in BCAA levels. CONCLUSIONS: These data indicate that circulating adipocyte-derived exosomes are modified following gastric bypass surgery and correlate to improved postsurgery insulin resistance.

NO to NO2 Conversion Rate Analysis and Implications for Dispersion Model Chemistry Methods using Las Vegas, Nevada Near-Road Field Measurements.

The nitrogen dioxide/oxides of nitrogen (NO2/NOX) ratio is an important surrogate for NO to NO2 chemistry in dispersion models when estimating NOX impacts in a near-road environment. Existing dispersion models use different techniques and assumptions to represent NO to NO2 conversion and do not fully characterize all of the important atmospheric chemical and mechanical processes. Thus, "real-world" ambient measurements must be analyzed to assess the behavior of NO2/NOX ratios near roadways. An examination of NO2/NOX ratio data from a field study conducted in Las Vegas, Nevada (NV), from mid-December, 2008 through mid-December, 2009 provides insights into the appropriateness of assumptions about the NO2/NOX ratio included in dispersion models. Data analysis indicates multiple factors affect the downwind NO2/NOX ratio. These include spatial gradient, background ozone (O3), source emissions of NO and NO2, and background NO2/NOX ratio. Analysis of the NO2/NOX ratio spatial gradient indicates that under high O3 conditions, the change in the ratio is fairly constant once a certain O3 threshold (≥ 30 ppb) is reached. However, under low O3 conditions (< 30 ppb), there are differences between weekdays and weekends, most likely due to a decline in O3 concentrations during the weekday morning hours, reducing the O3 available to titrate the emitted NO, allowing lower NO2/NOX ratios. These results suggest that under high O3 conditions, NOX chemistry is driving the NO2/NOX ratios whereas under low O3 conditions, atmospheric mixing is the driving factor.

Effect of geocoding errors on traffic-related air pollutant exposure and concentration estimates.

Exposure to traffic-related air pollutants is highest very near roads, and thus exposure estimates are sensitive to positional errors. This study evaluates positional and PM2.5 concentration errors that result from the use of automated geocoding methods and from linearized approximations of roads in link-based emission inventories. Two automated geocoders (Bing Map and ArcGIS) along with handheld GPS instruments were used to geocode 160 home locations of children enrolled in an air pollution study investigating effects of traffic-related pollutants in Detroit, Michigan. The average and maximum positional errors using the automated geocoders were 35 and 196 m, respectively. Comparing road edge and road centerline, differences in house-to-highway distances averaged 23 m and reached 82 m. These differences were attributable to road curvature, road width and the presence of ramps, factors that should be considered in proximity measures used either directly as an exposure metric or as inputs to dispersion or other models. Effects of positional errors for the 160 homes on PM2.5 concentrations resulting from traffic-related emissions were predicted using a detailed road network and the RLINE dispersion model. Concentration errors averaged only 9%, but maximum errors reached 54% for annual averages and 87% for maximum 24-h averages. Whereas most geocoding errors appear modest in magnitude, 5% to 20% of residences are expected to have positional errors exceeding 100 m. Such errors can substantially alter exposure estimates near roads because of the dramatic spatial gradients of traffic-related pollutant concentrations. To ensure the accuracy of exposure estimates for traffic-related air pollutants, especially near roads, confirmation of geocoordinates is recommended.

Creating locally-resolved mobile-source emissions inputs for air quality modeling in support of an exposure study in Detroit, Michigan, USA.

This work describes a methodology for modeling the impact of traffic-generated air pollutants in an urban area. This methodology presented here utilizes road network geometry, traffic volume, temporal allocation factors, fleet mixes, and emission factors to provide critical modeling inputs. These inputs, assembled from a variety of sources, are combined with meteorological inputs to generate link-based emissions for use in dispersion modeling to estimate pollutant concentration levels due to traffic. A case study implementing this methodology for a large health study is presented, including a sensitivity analysis of the modeling results reinforcing the importance of model inputs and identify those having greater relative impact, such as fleet mix. In addition, an example use of local measurements of fleet activity to supplement model inputs is described, and its impacts to the model outputs are discussed. We conclude that with detailed model inputs supported by local traffic measurements and meteorology, it is possible to capture the spatial and temporal patterns needed to accurately estimate exposure from traffic-related pollutants.

Air quality modeling in support of the Near-Road Exposures and Effects of Urban Air Pollutants Study (NEXUS).

A major challenge in traffic-related air pollution exposure studies is the lack of information regarding pollutant exposure characterization. Air quality modeling can provide spatially and temporally varying exposure estimates for examining relationships between traffic-related air pollutants and adverse health outcomes. A hybrid air quality modeling approach was used to estimate exposure to traffic-related air pollutants in support of the Near-Road Exposures and Effects of Urban Air Pollutants Study (NEXUS) conducted in Detroit (Michigan, USA). Model-based exposure metrics, associated with local variations of emissions and meteorology, were estimated using a combination of the American Meteorological Society/Environmental Protection Agency Regulatory Model (AERMOD) and Research LINE-source dispersion model for near-surface releases (RLINE) dispersion models, local emission source information from the National Emissions Inventory, detailed road network locations and traffic activity, and meteorological data from the Detroit City Airport. The regional background contribution was estimated using a combination of the Community Multi-scale Air Quality (CMAQ) and the Space-Time Ordinary Kriging (STOK) models. To capture the near-road pollutant gradients, refined "mini-grids" of model receptors were placed around participant homes. Exposure metrics for CO, NOx, PM2.5 and its components (elemental and organic carbon) were predicted at each home location for multiple time periods including daily and rush hours. The exposure metrics were evaluated for their ability to characterize the spatial and temporal variations of multiple ambient air pollutants compared to measurements across the study area.

Prevalence of metabolic syndrome among Hispanics/Latinos of diverse background: the Hispanic Community Health Study/Study of Latinos.

OBJECTIVE: Approximately one-third of the adult U.S. population has the metabolic syndrome. Its prevalence is the highest among Hispanic adults, but variation by Hispanic/Latino background is unknown. Our objective was to quantify the prevalence of the metabolic syndrome among men and women 18-74 years of age of diverse Hispanic/Latino background. RESEARCH DESIGN AND METHODS: Two-stage area probability sample of households in four U.S. locales, yielding 16,319 adults (52% women) who self-identified as Cuban, Dominican, Mexican, Puerto Rican, Central American, or South American. The metabolic syndrome was defined according to the American Heart Association/National Heart, Lung, and Blood Institute 2009 Joint Scientific Statement. The main outcome measures were age-standardized prevalence of the metabolic syndrome per the harmonized American Heart Association/National Heart, Lung, and Blood Institute definition and its component abnormalities. RESULTS: The metabolic syndrome was present in 36% of women and 34% of men. Differences in the age-standardized prevalence were seen by age, sex, and Hispanic/Latino background. The prevalence of the metabolic syndrome among those 18-44, 45-64, and 65-74 years of age was 23%, 50%, and 62%, respectively, among women; and 25%, 43%, and 55%, respectively, among men. Among women, the metabolic syndrome prevalence ranged from 27% in South Americans to 41% in Puerto Ricans. Among men, prevalences ranged from 27% in South Americans to 35% in Cubans. In those with the metabolic syndrome, abdominal obesity was present in 96% of the women compared with 73% of the men; more men (73%) than women (62%) had hyperglycemia. CONCLUSIONS: The burden of cardiometabolic abnormalities is high in Hispanic/Latinos but varies by age, sex, and Hispanic/Latino background. Hispanics/Latinos are thus at increased, but modifiable, predicted lifetime risk of diabetes and its cardiovascular sequelae.

Short-term repeatability of electrocardiographic Tpeak-Tend and QT intervals.

BACKGROUND: The electrocardiographic (ECG) Tpeak-Tend interval (TpTe) is associated with arrhythmias and sudden cardiac death. TpTe offers a supplementary measure for the QT interval (QT), yet its repeatability has not been established. PURPOSE: Evaluate short-term repeatability of TpTe and QT. METHODS: Four ECGs were obtained on sixty participants. The sources of variation, intra-class correlation coefficient (ICC) - an index of reproducibility - and minimal detectable change (MDC) were estimated for TpTe and QT. The impact of repeated measurements on repeatability was estimated for a hypothetical clinical trial designed to detect drug-induced prolongation of TpTe and QT. RESULTS: We used heart rate-adjusted QT [(QT)a] but TpTe in the study group was rate-invariant. The ICC [95% confidence interval (CI)] was 0.77 (0.69, 0.85) for TpTe, 0.75 (0.65, 0.85) for QT and 0.60 (0.47, 0.73) for (QT)a. The MDC (ms) was 21, 32 and 26 for TpTe, QT and (QT)a respectively. CONCLUSION: TpTe has excellent repeatability supporting its use as a supplement to QT in observational and clinical studies.