Living alone and cancer mortality by race/ethnicity and socioeconomic status among US working-age adults.

BACKGROUND: Previous studies have shown an association between living alone and cancer mortality; however, findings by sex and race/ethnicity have generally been inconsistent, and data by socioeconomic status are sparse. The association between living alone and cancer mortality by sex, race/ethnicity, and socioeconomic status in a nationally representative US cohort was examined. METHODS: Pooled 1998-2019 data for adults aged 18-64 years at enrollment from the National Health Interview Survey linked to the National Death Index (N = 473,648) with up to 22 years of follow-up were used to calculate hazard ratios (HRs) for the association between living alone and cancer mortality. RESULTS: Compared to adults living with others, adults living alone were at a higher risk of cancer death in the age-adjusted model (HR, 1.32; 95% CI, 1.25-1.39) and after additional adjustments for multiple sociodemographic characteristics and cancer risk factors (HR, 1.10; 95% CI, 1.04-1.16). Age-adjusted models stratified by sex, poverty level, and educational attainment showed similar associations between living alone and cancer mortality, but the association was stronger among non-Hispanic White adults (HR, 1.33; 95% CI, 1.25-1.42) than non-Hispanic Black adults (HR, 1.18; 95% CI, 1.05-1.32; p value for difference < .05) and did not exist in other racial/ethnic groups. These associations were attenuated but persisted in fully adjusted models among men (HR, 1.13; 95% CI, 1.05-1.23), women (HR, 1.09; 95% CI, 1.01-1.18), non-Hispanic White adults (HR, 1.13; 95% CI, 1.05-1.20), and adults with a college degree (HR, 1.22; 95% CI, 1.07-1.39). CONCLUSIONS: In this nationally representative study in the United States, adults living alone were at a higher risk of cancer death in several sociodemographic groups.

The rationale for bladder washouts in children with neurogenic bladder.

Children with a neurogenic bladder are at risk of developing recurrent urinary tract infections and long-term kidney failure. Due to an altered lower urinary tract, children may be overtreated for simple bacteriuria or undertreated for a potentially severe urinary tract infection. This group of patients represent high users of healthcare, and are at risk of colonization and development of antibiotic resistance. Bladder washouts with non-antibiotic electrochemically activated solutions are a potential new prophylactic option for patients with bladder dysfunction when clean intermittent catheterization has resulted in chronic bacteriuria.

Racial and ethnic disparities in monthly trends in alcohol-induced mortality among US adults from January 2018 through December 2021.

Background: Historically, American Indians/Alaska Natives (AIANs), Blacks, and Hispanics have experienced higher alcohol-induced mortality rates. Given a disproportionate surge in unemployment rate and financial strain among racial and ethnic minorities and limited access to alcohol use disorder treatment during the COVID-19 pandemic, it is essential to examine monthly trends in alcohol-induced mortality in the United States during the pandemic.Objectives: This study estimates changes in monthly alcohol-induced mortality among US adults by age, sex, and race/ethnicity.Methods: Using monthly deaths from 2018-2021 national mortality files (N = 178,201 deaths, 71.5% male, 28.5% female) and census-based monthly population estimates, we calculated age-specific monthly alcohol-induced death rates and performed log-linear regression to derive monthly percent increases in mortality rates.Results: Alcohol-induced deaths among adults aged ≥25 years increased by 25.7% between 2019 (38,868 deaths) and 2020 (48,872 deaths). During 2018-2021, the estimated monthly percent change was higher for females (1.1% per month) than males (1.0%), and highest for AIANs (1.4%), followed by Blacks (1.2%), Hispanics (1.0%), non-Hispanic Whites (1.0%), and Asians (0.8%). In particular, between February 2020 and January 2021, alcohol-induced mortality increased by 43% for males, 53% for females, 107% for AIANs, the largest increase, followed by Blacks (58%), Hispanics (56%), Asians (44%), and non-Hispanic Whites (39%).Conclusions: During the peak months of the pandemic, the rising trends in alcohol-induced mortality differed substantially by race and ethnicity. Our findings indicate that behavioral and policy interventions and future investigation on underlying mechanisms should be considered to reduce alcohol-induced mortality among Blacks and AIANs.

Double transplantation as a climate resilient and sustainable resource management strategy for rice production in eastern Uttar Pradesh, north India.

-Enhancing the productivity of rainfed crops, especially rice, while coping with climate adversities and saving critical natural resources is essential for ensuring the food and nutrition security of a growing population. With this context, the present study was undertaken to validate promising farm innovation and adaptation practices used by small-medium landholding farmers for rice cultivation in eastern Uttar Pradesh (UP), north India, as well as to examine the sustainability of innovative practices for large-scale adoption. For this, a 3-year study comprising extensive field surveys and experiments was undertaken to compare single transplantation (ST) and double transplantation (DT) in rice along with organic addition (farm-yard manure, FYM) on crop growth, yield, climate resilience, soil quality, and overall sustainability i.e., social (women involvements and labour productivity), environmental (water productivity and nutrient use efficiency), and economic (benefit:cost ratio) dimensions of sustainability. Field experiments were conducted in triplicate using two local rice varieties (MotiNP-360 and Sampurna Kaveri) in two agroclimatic zones, namely the middle Gangetic plains and the Vindhyan zone, in the Mirzapur district of eastern Uttar Pradesh. The DT practices of rice with and without farm yard manure (FYM) (replacing at a dose of 25% NPK) were evaluated over conventional methods of rice cultivation (i.e., ST, as control) and analysis was done periodically. The DT practice improved growth (p < 0.05), percent fertile tiller and grain (p < 0.05), and rice yield (15-20% higher than ST), while also improving soil quality, yield indices, water and labour productivity, and the benefit-cost ratio. The DT practice also resulted in early maturity (10-15 days earlier than ST), created more labour days for women, decreased lodging and pest/disease incidence, as well as a subsequent reduction in the use of synthetic chemical pesticides and associated environmental costs. Importantly, the residual effects of FYM application significantly improved (p < 0.05) the grain yield in subsequent years of cropping. Optimizing DT cultivation practices, preferably with FYM input for various agro-climatic regions, is essential for large-scale sustainable rice production under changing climatic conditions.

Socio-ecological Challenges and Adaptation Strategies of Farmers Towards Changing Climate in Vindhyan highlands, India.

The Indian agriculture is highly vulnerable to climate change which adversely affects crop production and livelihood of farmers. The effect is more intensified in Vindhyan highlands, where prolong drought and high rate of poverty exist in depredation environment. In this context, present study conducted to explore farmers' perception, attitude about climate change and adaptive capabilities. We undertook an interview schedules survey through structured questionnaire in Duddhi block of Sonbhadra district. A total of 400 households were selected in which 347 (86.75%) male and 53 (13.25%) female respondents have participated. The perception of farmers on climate change is presented in SI (severity index) which varies from 36% to 68.63%. The statement 'rainy season decreases' ranked first with SI (68.63%) followed by 'temperature increases' SI (66.06%). This investigation identified 17 types of adaptive practices which are frequently performed in the Vindhyan highlands. Based on the WAI (Weighted Average Index) score, crop diversification (2.0), cultivation of drought-adapted crop varieties (1.99), changing plantation calendar (1.95) were the most adopted practices. Multiple regression analysis between the socio-economic status of farmers and the adaptation practices, recorded a significant positive relationship with age (P < 0.01), family size (P < 0.05), education (P < 0.01), caste categories (P < 0.05) and livestock ownership (P < 0.01) of farmer. This study will be helpful in developing drought resilience farming practices for sustaining the livelihood of farmers and inform policy making.

The Impact of Telemedicine Parity Requirements on Telehealth Utilization in the United States During the COVID-19 Pandemic.

BACKGROUND: Research has shown a dramatic increase in telehealth utilization during the COVID-19 pandemic and marked socioeconomic disparities in telehealth utilization. However, previous studies have shown discrepant findings on the association between the state's telehealth payment parity laws and telehealth utilization, and dearth of differential impact studies by subgroups. METHODS: Using a nationally representative Household Pulse Survey from April 2021 to August 2022 and the logistic regression modeling, we estimated the impact of parity payment laws on overall, video, and phone telehealth utilization and related disparities by race and ethncity during the pandemic. RESULTS: We found that adults in parity states had 23% higher odds of telehealth utilization (odds ratio [OR] = 1.23; 95% confidence interval [CI], 1.14-1.33) and 124% higher odds of video telehealth utilization (OR = 2.24; 95% CI, 1.95-2.57) than their counterparts in nonparity states. In parity states, non-Hispanic White adults had 24% higher odds of telehealth utilization (OR = 1.24; 95% CI: 1.14, 1.35) and non-Hispanic Black adults had 31% higher odds of telehealth utilization (OR = 1.31; 95% CI: 1.03, 1.65), compared with those in nonparity states. For Hispanics, non-Hispanic Asians, and non-Hispanic other races, there was not a statistically significant effect of parity act on overall telehealth utilization. CONCLUSIONS: Given inequalities in telehealth utilization, increased state policy efforts are needed to reduce access disparities during the ongoing pandemic and beyond.

The Differential Impact of the COVID-19 Pandemic on Prenatal Care Utilization Among US Women by Medicaid Expansion and Race and Ethnicity.

BACKGROUND: The 2014 Medicaid expansion improved racial and ethnic equity in insurance coverage and access to maternal care among women of reproductive age. This study examines differential effects of the COVID-19 pandemic on prenatal care utilization by Medicaid expansion and by race and ethnicity. METHODS: Using the pooled 2019-2020 National Natality file (N = 7 361 190), logistic regression was used to estimate the effect of COVID-19 on prenatal care utilization among US women aged 10 to 54 years after controlling for maternal age, race, ethnicity, marital status, parity, nativity/immigrant status, education, payment type, and smoking during pregnancy. Outcome measures were having no care and delayed prenatal care (third trimester or no care). Stratified models by race/ethnicity and Medicaid expansion status yielded the differential effects of COVID-19 on prenatal care utilization. RESULTS: During the COVID-19 pandemic, the adjusted odds of having no prenatal care decreased by 4% (adjusted odds ratio [AOR] = 0.96; 95% confidence interval [CI], 0.94-0.97) in expansion states but increased by 13% (AOR = 1.13; 95% CI, 1.11-1.15) in nonexpansion states. While most racial and ethnic groups in expansion states experienced a decrease in having no prenatal care, the adjusted odds of having no prenatal care increased by 15% for non-Hispanic Whites, 9% for non-Hispanic Blacks, 33% for American Indians/Alaska Natives, 25% for Asian/Pacific Islanders, and 13% for Hispanics in nonexpansion states. Women in expansion states experienced no change in delayed prenatal care during the pandemic, but women in nonexpansion states experienced an increase in delayed care. CONCLUSIONS: Prenatal care utilization decreased during the pandemic among women in nonexpansion states, particularly for American Indians/Alaska Natives and Asian/Pacific Islanders, compared with expansion states.

Adding complexity to complexity: The role of concomitant cardiac surgery in lung transplantation.

Outcomes of lung transplantation have greatly improved over recent years. While patients with concomitant cardiac pathology used to be excluded from lung transplant, today, most of these cardiac conditions can be addressed safely and effectively. Interventional techniques should be preferred. Lung transplant performed by cardiac surgeons allows for concomitant interventions.

Spatial Genomic Resource Reveals Molecular Insights into Key Bioactive-Metabolite Biosynthesis in Endangered Angelica glauca Edgew.

Angelica glauca Edgew, which is an endangered medicinal and aromatic herb, is a rich source of numerous industrially important bioactive metabolites, including terpenoids, phenolics, and phthalides. Nevertheless, genomic interventions for the sustainable utilization and restoration of its genetic resources are greatly offset due to the scarcity of the genomic resources and key regulators of the underlying specialized metabolism. To unravel the global atlas of the specialized metabolism, the first spatial transcriptome sequencing of the leaf, stem, and root generated 109 million high-quality paired-end reads, assembled de novo into 81,162 unigenes, which exhibit a 61.53% significant homology with the six public protein databases. The organ-specific clustering grouped 1136 differentially expressed unigenes into four subclusters differentially enriched in the leaf, stem, and root tissues. The prediction of the transcriptional-interactome network by integrating enriched gene ontology (GO) and the KEGG metabolic pathways identified the key regulatory unigenes that correspond to terpenoid, flavonoid, and carotenoid biosynthesis in the leaf tissue, followed by the stem and root tissues. Furthermore, the stem and root-specific significant enrichments of phenylalanine ammonia lyase (PAL), cinnamate-4-hydroxylase (C4H), and caffeic acid 3-O-methyltransferase (COMT) indicate that phenylalanine mediated the ferulic acid biosynthesis in the stem and root. However, the root-specific expressions of NADPH-dependent alkenal/one oxidoreductase (NADPH-AOR), S-adenosyl-L-methionine-dependent methyltransferases (SDMs), polyketide cyclase (PKC), and CYP72A15 suggest the "root" as the primary site of phthalide biosynthesis. Additionally, the GC-MS and UPLC analyses corresponded to the organ-specific gene expressions, with higher contents of limonene and phthalide compounds in the roots, while there was a higher accumulation of ferulic acid in the stem, followed by in the root and leaf tissues. The first comprehensive genomic resource with an array of candidate genes of the key metabolic pathways can be potentially utilized for the targeted upscaling of aromatic and pharmaceutically important bioactive metabolites. This will also expedite genomic-assisted conservation and breeding strategies for the revival of the endangered A. glauca.

An Integrative Transcriptional Network Revealed Spatial Molecular Interplay Underlying Alantolactone and Inulin Biosynthesis in Inula racemosa Hook f.

Inula racemosa Hook. f. (Pushkarmula), a perennial Himalayan herb known for its aromatic and phytopharmaceutical attributes, is not yet explored at genomic/transcriptomic scale. In this study, efforts were made to unveil the global transcriptional atlas underlying organ-specific specialized metabolite biosynthesis by integrating RNA-Seq analysis of 433 million sequenced reads with the phytochemical analysis of leaf, stem, and root tissues. Overall, 7242 of 83,772 assembled nonredundant unigenes were identified exhibiting spatial expression in leaf (3761), root (2748), and stem (733). Subsequently, integration of the predicted transcriptional interactome network of 2541 unigenes (71,841 edges) with gene ontology and KEGG pathway enrichment analysis revealed isoprenoid, terpenoid, diterpenoid, and gibberellin biosynthesis with antimicrobial activities in root tissue. Interestingly, the root-specific expression of germacrene-mediated alantolactone biosynthesis (GAS, GAO, G8H, IPP, DMAP, and KAO) and antimicrobial activities (BZR1, DEFL, LTP) well-supported with both quantitative expression profiling and phytochemical accumulation of alantolactones (726.08 µg/10 mg) and isoalantolactones (988.59 µg/10 mg), which suggests "roots" as the site of alantolactone biosynthesis. A significant interaction of leaf-specific carbohydrate metabolism with root-specific inulin biosynthesis indicates source (leaf) to sink (root) regulation of inulin. Our findings comprehensively demonstrate the source-sink transcriptional regulation of alantolactone and inulin biosynthesis, which can be further extended for upscaling the targeted specialized metabolites. Nevertheless, the genomic resource created in this study can also be utilized for development of genome-wide functionally relevant molecular markers to expedite the breeding strategies for genetic improvement of I. racemosa.

The Association Between Psychological Distress and Cancer Mortality in the United States: Results from the 1997-2014 NHIS-NDI Record Linkage Study.

BACKGROUND/PURPOSE: Psychological distress can influence cancer mortality through socioeconomic disadvantage, health-risk behaviors, or reduced access to care. These disadvantages can result in higher risks of cancer occurrence, a delayed cancer diagnosis, hamper adherence to treatment, and provoke inflammatory responses leading to cancer. Previous studies have linked psychological distress to cancer mortality. However, studies are lacking for the U.S. population. METHODS: This study examines the Kessler six-item psychological distress scale as a risk factor for U.S. cancer mortality using the pooled 1997-2014 data from the National Health Interview Survey (NHIS) linked to National Death Index (NDI) (N = 513,012). Cox proportional hazards regression was used to model survival time as a function of psychological distress and sociodemographic and behavioral covariates. RESULTS: In Cox models with 18 years of mortality follow-up, the cancer mortality risk was 80% higher (hazard ratio [HR] = 1.80; 95% CI = 1.64, 1.97) controlling for age; 61% higher (HR = 1.61; 95% CI = 1.46, 1.76) in the SES-adjusted model, and 33% higher (HR = 1.33; 95% CI = 1.21, 1.46) in the fully-adjusted model among adults with serious psychological distress (SPD), compared with adults without psychological distress. Males, non-Hispanic Whites, and adults with incomes at or above 400% of the federal poverty level had greater cancer mortality risk associated with SPD. Using an 8 years of mortality follow-up, those with SPD had 108% increased adjusted risks of mortality from breast cancer. CONCLUSION: Our study findings underscore the significance of addressing psychological well-being in the population as a strategy for reducing cancer mortality.

Exposure to anti-PD-1 causes functional differences in tumor-infiltrating lymphocytes in rare solid tumors.

The pervasive use of therapeutic antibodies targeting programmed cell death protein 1 (PD-1) to boost anti-tumor immunity has positioned this approach to become the standard-of-care for some solid tumor malignancies. However, little is known as to how blockade of PD-1 may alter the function or phenotype of tumor-infiltrating lymphocytes (TIL). We used our ongoing Phase II clinical trial of pembrolizumab for patients with rare solid tumors from various types (NCT02721732) with matched core biopsies taken at baseline and after initial dose of anti-PD-1 (15-21 days post-dose) to elucidate this question. One fresh core needle biopsy was used to propagate TIL ex vivo to analyze phenotype and function using flow cytometry in both CD8+ and CD4+ TIL populations. An enriched CTLA-4 expression in the CD4+ TIL population was observed in TIL expanded from the on-treatment samples compared to TIL expanded from the matched baseline (n = 22, p = 0.0007) but was not observed in patients who experienced tumor regression. Impact on functionality was evaluated by measuring secretion of 65 soluble factors by expanded TIL from 26 patients at baseline and on-treatment. The CD8+ TIL population demonstrated a diminished cytokine secretion profile post-pembrolizumab. Overall, our study assesses the ramifications of one dose of anti-PD-1 on TIL in rare solid tumor types.

Reducing Cardiovascular Disparities Through Community-Engaged Implementation Research: A National Heart, Lung, and Blood Institute Workshop Report.

Cardiovascular disparities remain pervasive in the United States. Unequal disease burden is evident among population groups based on sex, race, ethnicity, socioeconomic status, educational attainment, nativity, or geography. Despite the significant declines in cardiovascular disease mortality rates in all demographic groups during the last 50 years, large disparities remain by sex, race, ethnicity, and geography. Recent data from modeling studies, linked micromap plots, and small-area analyses also demonstrate prominent variation in cardiovascular disease mortality rates across states and counties, with an especially high disease burden in the southeastern United States and Appalachia. Despite these continued disparities, few large-scale intervention studies have been conducted in these high-burden populations to examine the feasibility of reducing or eliminating cardiovascular disparities. To address this challenge, on June 22 and 23, 2017, the National Heart, Lung, and Blood Institute convened experts from a broad range of biomedical, behavioral, environmental, implementation, and social science backgrounds to summarize the current state of knowledge of cardiovascular disease disparities and propose intervention strategies aligned with the National Heart, Lung, and Blood Institute mission. This report presents the themes, challenges, opportunities, available resources, and recommended actions discussed at the workshop.

Earthworms and vermicompost: an eco-friendly approach for repaying nature's debt.

The steady increase in the world's population has intensified the need for crop productivity, but the majority of the agricultural practices are associated with adverse effects on the environment. Such undesired environmental outcomes may be mitigated by utilizing biological agents as part of farming practice. The present review article summarizes the analyses of the current status of global agriculture and soil scenarios; a description of the role of earthworms and their products as better biofertilizer; and suggestions for the rejuvenation of such technology despite significant lapses and gaps in research and extension programs. By maintaining a close collaboration with farmers, we have recognized a shift in their attitude and renewed optimism toward nature-based green technology. Based on these relations, it is inferred that the application of earthworm-mediated vermitechnology increases sustainable development by strengthening the underlying economic, social and ecological framework.

Muscle-strengthening physical activity is associated with cancer mortality: results from the 1998-2011 National Health Interview Surveys, National Death Index record linkage.

PURPOSE: To examine the association of muscle-strengthening activities (MSA) and cancer mortality. METHODS: We pooled data from the 1998 to 2009 National Health Interview Survey (NHIS), which were linked to records in the National Death Index. Mortality follow-up was through 31 December 2011. Based on U.S. federal guidelines for physical activity, we dichotomized MSA and compared those who performed MSA twice a week or more to others with lower MSA. We also examined dose-response relationship of MSA frequency with cancer mortality. Hazard ratios (HR) from Cox regression were computed to estimate the association of MSA with the risk of cancer mortality. Mean follow-up was 7.9 years and the analysis sample size was 310,282. RESULTS: Covariate-adjusted results showed that meeting the MSA guideline was associated with a 19% lower risk of cancer mortality (HR 0.81, 95% CI 0.73, 0.90). We found no evidence of a dose-response relationship between the frequency of performing MSA and cancer mortality. CONCLUSION: Adhering to the U.S. federal guideline for MSA is associated with lower cancer mortality. Public health programs and policy for cancer prevention and control should promote MSA to further reduce cancer mortality.

Women from racial or ethnic minority and low socioeconomic backgrounds receive more prenatal education: Results from the 2012 to 2014 Pregnancy Risk Assessment Monitoring System.

BACKGROUND: Racial or ethnic and socioeconomic disparities in adverse birth outcomes are well known, but few studies have examined disparities in the receipt of prenatal health education. The objectives of this study were to examine racial or ethnic and socioeconomic variations in receiving (1) comprehensive prenatal health education and (2) education about human immunodeficiency virus (HIV) testing, breastfeeding, alcohol, and smoking cessation from health care practitioners. METHODS: Data were drawn from the 2012 to 2014 Pregnancy Risk Assessment Monitoring System (PRAMS). Twenty-seven states were included with an analysis sample size of 68 025 participants. Receiving counseling on all listed health topics during prenatal care visits was denoted as comprehensive prenatal health education. Logistic regression was used to examine the association of racial or ethnic and socioeconomic variables with receiving comprehensive prenatal health education, and HIV testing, breastfeeding, alcohol, and smoking cessation advice separately. RESULTS: Multivariable results showed that racial or ethnic minorities and women with a high school degree or less; receiving Women, Infant, and Children (WIC) assistance; and on Medicaid during pregnancy have higher odds of receiving comprehensive prenatal health education (all P  ≤0 .001). Results were similar for receiving HIV testing, breastfeeding, alcohol, and smoking counseling. Low household income was associated with receiving counseling on HIV testing, alcohol, and smoking (all P ≤ 0.001). CONCLUSION: Despite reporting higher levels of prenatal health education on a variety of health-related topics, disadvantaged women continue to experience disparities in adverse birth outcomes suggesting that education is insufficient in promoting positive behaviors and birth outcomes.

Agricultural growth and land use land cover change in peri-urban India.

Varanasi district is comprised of eight administrative blocks. Owing to economic development, it has shown an increase in urban activities. Analysis of remotely sensed data for a period of two decades reveals that the built-up area increased by about 345% while vegetation decreased by 86% during 1993-2013. Contrary to other observations, land use changes, due to urban growth, increased not only the built area but also the agriculture class. Agricultural area increased by 39% in the two decades. Population density increased from 1217 to 1806 person/km2 and household density grew from 152 to 273 households/km2 during 1991-2011. Land absorption coefficient (LAC) and land consumption ratio (LCR) were calculated as demographic indices of land use land cover change (LULC). Vegetation delineation shows that sparse vegetation increased from 40.2 to 90.1 km2 while dense vegetation decreased from 28.4 to 1.7 km2 in 1993-2013. There was a distinct shift from agriculture, as a primary economic activity, towards non-agricultural pursuits. In order to frame better strategies for sustainable development and food security, this phenomenon of increasing urbanization around cities needs to be studied. This micro scale study can be helpful in formulating policy for urban areas in developing countries like India which heavily depend on agriculture to sustain their population and economy.

Adipose Gene Expression Profile Changes With Lung Allograft Reperfusion.

Obesity is a risk factor for primary graft dysfunction (PGD), a form of lung injury resulting from ischemia-reperfusion after lung transplantation, but the impact of ischemia-reperfusion on adipose tissue is unknown. We evaluated differential gene expression in thoracic visceral adipose tissue (VAT) before and after lung reperfusion. Total RNA was isolated from thoracic VAT sampled from six subjects enrolled in the Lung Transplant Body Composition study before and after allograft reperfusion and quantified using the Human Gene 2.0 ST array. Kyoto Encyclopedia of Genes and Genomes pathway analysis revealed enrichment for genes involved in complement and coagulation cascades and Jak-STAT signaling pathways. Overall, 72 genes were upregulated and 56 genes were downregulated in the postreperfusion time compared with baseline. Long pentraxin-3, a gene and plasma protein previously associated with PGD, was the most upregulated gene (19.5-fold increase, p = 0.04). Fibronectin leucine-rich transmembrane protein-3, a gene associated with cell adhesion and receptor signaling, was the most downregulated gene (4.3-fold decrease, p = 0.04). Ischemia-reperfusion has a demonstrable impact on gene expression in visceral adipose tissue in our pilot study of nonobese, non-PGD lung transplant recipients. Future evaluation will focus on differential adipose tissue gene expression and the development of PGD after transplant.

Point-of-sale cigarette marketing and smoking-induced deprivation in smokers: results from a population-based survey.

BACKGROUND: Strict restrictions on outdoor cigarette marketing have resulted in increasing concentration of cigarette marketing at the point-of-sale (POS). The association between POS cigarette marketing and smoking-induced deprivation (SID) has never been studied. The aim of this study was to examine this association and how it is mediated by cravings to smoke, urges to buy cigarettes, and unplanned purchases of cigarettes. METHODS: Data from a telephone survey of 939 smokers were collected in Omaha, Nebraska. POS cigarette marketing was measured by asking respondents three questions about noticing pack displays, advertisements, and promotions such as cigarette price discounts within their respective neighborhoods. SID was measured with the following question: "In the last six months, has there been a time when the money you spent on cigarettes resulted in not having enough money for household essentials such as food? [yes/no]" We used structural equation modeling to examine the study aim. RESULTS: There was overwhelming evidence for an association between higher levels of POS cigarette marketing and a higher probability of SID (p < 0.001). This association was partly mediated by cravings to smoke, urges to buy cigarettes, and unplanned purchases of cigarettes during a visit to a neighborhood store (p < 0.001). CONCLUSION: Given that POS cigarette marketing is associated with a higher probability of experiencing SID, policies that ban POS cigarette marketing might help some smokers afford essentials household items such as food more easily and thus have better standards of living.

Educational outcomes associated with childhood obesity in the United States: cross-sectional results from the 2011-2012 National Survey of Children's Health.

BACKGROUND: Past research examining the effects of childhood obesity has largely focused on its projected effects into adulthood. However, there is emerging evidence that childhood obesity may have more immediate effects on school-related outcomes. We examine a range of educational attainment indicators to examine the possible pathway between obesity status and academic performance, while investigating the proximal effects of childhood obesity on health and utilization of health services, and whether these variables attenuate the relationship between obesity status and educational outcomes. METHODS: Data for the current study come from the 2011-2012 National Survey of Children's Health, which details the impacts of childhood obesity on a range of outcomes among a nationally representative sample of children and adolescents aged 10-17 years (N=45,255). Educational outcomes (school absences, school problems, repeating a grade and school engagement) were modeled by logistic regression as a function of BMI, overall health status, health care utilization, and a range of sociodemographic variables. RESULTS: BMI status was significantly associated with all educational outcomes (p<0.001 for all), overall health status (p<0.001), and health care utilization (p=0.016). Prior to adjustment for covariates, obese children were significantly more likely to have school absences and school problems, to repeat a grade, and to have lower school engagement than non-overweight children. After adjustment for sociodemographic and health/healthcare variables, these outcomes remained significant for all but repeating a grade. The odds of having school problems, repeating a grade, and low school engagement that were associated with obesity were attenuated by the addition of sociodemographic variables into the model, while the addition of health and health care variables in the model decreased the odds of school absences. CONCLUSIONS: This study provides evidence that increased weight status in children is associated with poorer educational outcomes. While recognizing that these are cross-sectional data, we suggest that 1) health-related and sociodemographic factors should be a focus point of intervention, and 2) a socio-structural approach including Coordinated School Health intervention is crucial to reducing childhood obesity and improving educational outcomes in this population.