Cardiovascular disease (CVD) continues to be one of the leading causes of death for women. New approaches need to be identified that will enable women to recognize modifiable risk factors and target their efforts toward prevention. The objectives of this study were to (1) determine if women would access Vivametrica™ to assess CVD risk, (2) identify whether women would increase their physical activity as measured by their daily step counts, and (3) elicit women's opinions about using the system, prospective observational study design. Thirty-six English-speaking women aged 45-64 years of age, without physical disability, were recruited. Participants attended two clinic visits and were asked to wear a sensor-based activity monitor (Garmin Vivosmart® HR Wrist Tracker) for 12 weeks. Twenty-six (72%) of participants accessed Vivametrica for the course of the study. The median number of steps at baseline and at study completion was 9329 (range 5406-18,228) and 10,181 (range 5398-21,401), respectively. There was no significant change in number of steps taken by the participants for the study period (Z = -1.086, p = 0.278). The women's responses to the three statements (related to using Vivametrica) are represented on bar graphs. Women's opinions were important to provide an understanding about how they realized the technology. Women did access Vivametrica. Women did not significantly increase their step count. However, these women were achieving beyond sedentary levels of activity (>5000 steps/day). Although the change in steps was not statistically significant, it represents a median increase in daily steps of 9%, which is clinically important.
The survival rate of women after breast cancer has improved significantly worldwide. More attention should be paid to the rehabilitation intervention after surgery. Cancer rehabilitation helps breast cancer survivors maintain the highest possible physical, social, psychological, and vocational function in the limits that are imposed by the cancer and its treatments. The aim of our research was to determine the rehabilitative setting that promotes greater efficacy of the rehabilitation. A double-blind, randomized controlled trial with 45 patients enrolled was conducted. All participants were randomized into two groups: single rehabilitative training (N = 22) and group rehabilitative training (N = 23). Outcomes were assessed for each group before treatment (T0), after first 6 weeks of rehabilitative treatment (T1), and after 3 months (T2). All patients underwent the same rehabilitation treatment, but the setting differed between single and group rehabilitative training, which included four to five patients each and evaluated using Minnesota Multiphasic Personality Inventory (MMPI-2), Working Alliance Inventory Patient form (WAIP), Disabilities of Arm, Shoulder and Hand Questionnaire (DASH), and visual analog scale (VAS). Two patients dropped out in the single treatment group. In the within-group analysis at the three evaluation times, on the VAS, a significant reduction in pain was reported and maintained at the follow-up, as was observed for the DASH and WAIP scales. In the between-group analysis WAIP and Bond scale scores differed significantly in favor of the single treatment. In the group treatment, the Psychopathic Deviate, Masculine/Feminine, and Social Discomfort scales of the MMPI-2 correlated with WAIP Tot at T1. There was an association between the Correction, Hysteria, Paranoid, and Schizophrenia MMPI-2 scales and Δ VAS T0T1 in the total sample. Proposing the same rehabilitative intervention in both breast cancer groups, our results showed significant reduction in pain and good functional recovery of the upper limb, which did not depend on the setting (single or group). However, with single rehabilitation treatment, patients developed a better therapeutic alliance and experienced a more comfortable environment.
High-risk stains of human papillomavirus (HPV) is linked to causing cancer, is highly prevalent, and has increased incidence among adolescents and young adults. However, vaccination rates are low. Health care provider recommendation is the biggest influencer toward vaccine uptake. Since more health care providers are using digital health technologies in their medical practices, this study investigated the feasibility of technology to increase informed decision making. A convenience sample of 210 students completed an online survey. Participants were 18-25 years of age (88%), female (85%), Caucasian (60%), and never been diagnosed with HPV (92.9%). Overwhelmingly, participants owned a smartphone (98.9%) and used mobile apps for health/health tracking (65.5%). However, only 29.3% indicated that they received text messages from their health care provider. Digital health technology can be a cost-effective way for increasing HPV knowledge, removing barriers, and increasing vaccine uptake. Health care providers should explore using various platforms to empower their health care decision making.
It is known that culture media composition can affect cell behavior, morphology, and gene expression. However, in the case of corneal epithelial cells, the combined role of calcium and glucose concentration in media has not previously been examined. In this study, a human immortalized corneal epithelial cell line was used to examine the effect of glucose and calcium concentrations on these cells. Cell metabolic activity, cell growth curve analysis, and relative gene and protein expression of proliferative marker extracellular related kinase (ERK) were used to study proliferation. Corneal epithelial stem cell marker NP63 and mature epithelial marker cytokeratin 3 (CK3) were analyzed by using reverse transcription polymerase chain reaction (RT-PCR) and immunocytochemistry. Focal adhesions were examined by using immunocytochemistry. Cells cultured in both low-glucose, high-calcium (LG-HC) media and high-glucose, low-calcium (HG-LC) media showed similar results in both RT-PCR and immunocytochemistry analysis. NP63 expression was significantly lower and CK3 expression was higher in these groups compared with cells cultured in commercial media. NP63 and CK3 expression was also analyzed by using immunocytochemistry, which confirmed these findings. The high-glucose, high-calcium-fed cells showed the lowest expression of all markers and no gene expression of CK3. This was deemed the most unsuitable media formulation for this cell line. Focal adhesion expression was the lowest in the high-calcium, high-glucose-fed cells, with the most even distribution of this among the commercial media group. Overall, this study showed that varying glucose and calcium concentrations can have significant effects on differentiation, proliferation, focal adhesions, and metabolic activity of this cell line. It seems that an LG-HC and HG-LC formulation were interchangeable with similar proliferative and differentiation effects.
As human papillomavirus (HPV) self-sampling continues to emerge as a potential cervical cancer screening strategy in the United States, it is necessary to examine women's acceptability of this screening approach. Furthermore, since several HPV self-sampling devices exist, it is important to determine if women's preferences differ by device type. We conducted an online survey in Fall 2017 with a national sample of women (n = 605) ages 21-65 years (the recommended age range for cervical cancer screening). Multivariable linear regression identified correlates of women's willingness to use an HPV self-sample at home. We used repeated measures analysis of variance to determine if preferences differed across four self-sampling devices: Evalyn® Brush (Device A), HerSwab® (Device B), Catch-All® Swab (Device C), and Qvintip® (Device D). Most women were willing to use an HPV self-sample at home (mean = 4.03 [possible range: 1-5], standard deviation = 1.09, 72.7% indicated "probably willing" or "definitely willing"). The most common concerns about self-sampling were related to test accuracy (53.1%) and obtaining the sample incorrectly (51.1%). Women were more willing to use an HPV self-sample at home if they reported greater perceived severity of cervical cancer (β = 0.16), reported an annual income less than $50,000 (β = 0.13), or were a former smoker (β = 0.11). Women were more willing to use Device A (mean = 3.72, 67.6% indicated "agree" or "strongly agree"), Device C (mean = 3.86, 73.9% indicated "agree" or "strongly agree"), and Device D (mean = 3.81, 72.1% indicated "agree" or "strongly agree") than Device B (mean = 3.36, 49.4% indicated "agree" or "strongly agree"; all p < 0.05). Acceptability of HPV self-sampling as a cervical cancer screening strategy is generally high among women. Future efforts should consider the potential impact that device type may have on women's use of an HPV self-sample at home.
Human mesenchymal stem cells derived from adipose tissue (AD-hMSCs) represent a promising source for tissue engineering and are already widely used in cell therapeutic clinical trials. Until today, an efficient and sustainable cell labeling system for cell tracking does not exist. We evaluated transient transfection through electroporation for cell labeling and compared it with lentiviral transduction for AD-hMSCs. In addition, we tested whether nonsense DNA or a reporter gene such as enhanced green fluorescent protein (EGFP) is the more suitable label for AD-hMSCs. Using electroporation, the transfection efficiency reached a maximal level of 44.6 ± 1.1% EGFP-positive cells after selective and expansive cultivation of the mixed MSC population, and was 44.5 ± 1.4% after gene transfer with Cyanin3-marked nonsense-label DNA, which remained stable during 2 weeks of nonselective cultivation (37.2 ± 4.7% positive AD-hMSCs). Electroporation with both nonsense DNA and pEGFP-N1 led to a slight growth retardation of 45.2% and 59.1%, respectively. EGFP-transfected or transduced AD-hMSCs showed a limited adipogenic and osteogenic differentiation capacity, whereas it was almost unaffected in cells electroporated with the nonsense-label DNA. The nonsense DNA was detectable through quantitative real-time polymerase chain reaction for at least 5 weeks/10 passages and in differentiated AD-hMSCs. EGFP-labeled cells were trackable for 24 h in vitro and served as testing cells with new materials for dental implants for 7 days. In contrast, lentivirally transduced AD-hMSCs showed an altered natural immune phenotype of the AD-hMSCs with lowered expression of two cell type defining surface markers (CD44 and CD73) and a relevantly decreased cell growth by 71.8% as assessed by the number of colony-forming units. We suggest electroporation with nonsense DNA as an efficient and long-lasting labeling method for AD-hMSCs with the comparably lowest negative impact on the phenotype or the differentiation capacity of the cells, which may, therefore, be suitable for tissue engineering. In contrast, EGFP transfection by electroporation is efficient but may be more suitable for cell tracking within cell therapies without MSC differentiation procedures. Since current protocols of lentiviral gene transduction include the risk of cell biological alterations, electroporation seems advantageous and sustainable enough for hMSC labeling.
The contribution of pregnancy interval after gestational diabetes (GDM) to type 2 diabetes (T2DM) onset is a poorly understood but potentially modifiable factor for T2DM prevention. The purpose of this study was to assess the impact of GDM recurrence and/or delivery interval on follow-up care and T2DM onset in a sample of continuously insured women with a term livebirth within 3 years of a GDM-affected delivery. This is a secondary analysis of a cohort of 12,622 women with GDM, 2006-2012, drawn from a national administrative data system (OptumLabs Data Warehouse). We followed 1091 women with GDM who had a subsequent delivery within 3 years of their index delivery. GDM recurred in 49.3% of subsequent pregnancies regardless of the interval to the next conception. Recurrence tripled the odds of early T2DM onset within 3 years of the second delivery. Women with GDM recurrence had greater likelihood of glucose testing in that 3-year interval, but not transition to primary care for continued monitoring, as required by both American Congress of Obstetricians and Gynecologists (ACOG) and the American Diabetes Association (ADA) guidelines. In multivariable analysis, we found a trend toward increased likelihood of T2DM onset for short interpregnancy intervals (≤1 year vs. 3 year, 0.08). Pregnancy interval may play a previously unrecognized role in progression to T2DM. T2DM onset after GDM can be prevented or mitigated, but many women in even this insured sample did not receive recommended follow-up monitoring and preventive care, even after a GDM recurrence. The postpartum visit may be an ideal time to inform patients about T2DM prevention opportunities, and discuss potential benefits of optimal spacing of future pregnancies.
Patent application trends were investigated for induced pluripotent stem cell (iPSC) technologies, particularly disease-specific cell technologies related to iPSCs, in the U.S., Japanese, and European applications during 2017. The number of patent applications for iPSC technologies was 1516 in the United States, 895 in Japan, and 420 in Europe, with 5% of applications for disease-specific cell technologies. In contrast, the percentages of patent applications for iPSC preparation and differentiation technologies were 17% and 23%, respectively. Patent applications for disease-specific cell technologies were classified into four technical fields and 14 disorder groups. In the technical fields, patent applications for genetically engineered cell technologies were prominent, accounting for 63%, 50%, and 65% of the U.S., Japanese, and European applications for 11, 8, and 7 disorder groups, respectively. In the disorder groups, the percentages of patent applications for neurological disorders were 40%, 32%, and 40% of the U.S., Japanese, and European applications, respectively, which were filed in four technical fields in the U.S. and Japanese applications. The U.S. patent applications for disease-specific cell technologies were filed by applicants in the United States, Japan, France, Belgium, Italy, Korea, and Canada; however, patent applications filed by those in Belgium, Italy, and Canada were not found in the Japanese and European applications. The percentages of patent applications filed by the U.S. applicants were 72%, 55%, and 65% of the U.S., Japanese, and European applications, respectively. Most patent applications filed by the U.S. applicants were in the field of genetically engineered cells for 11 disorder groups, which mostly included neurological and blood disorders. Japanese applicants mainly filed patent applications for drug screening technologies; subjects included five disorder groups, particularly neurological and bone/articular disorders. French applicants filed patent applications for neurological disorders in the field of genetically engineered cells and drug screening technologies. Korean applicants filed patent applications for patient-derived cell technologies for neurological, metabolic, and chromosomal/genetic disorders. In conclusion, more than half of patent applications were for genetically engineered cells for 11 disorders, most of which were filed by U.S. applicants.