Medicine and Health Sciences Commons^™

Dried Whole Plant Artemisia Annua As An Antimalarial Therapy, Mostafa Elfawal, Melissa Towler, Nicholas Reich, Douglas Golenbock, Pamela Weathers, Stephen Rich

Nicholas G Reich

Drugs are primary weapons for reducing malaria in human populations. However emergence of resistant parasites has repeatedly curtailed the lifespan of each drug that is developed and deployed. Currently the most effective anti-malarial is artemisinin, which is extracted from the leaves of Artemisia annua. Due to poor pharmacokinetic properties and prudent efforts to curtail resistance to monotherapies, artemisinin is prescribed only in combination with other anti-malarials composing an Artemisinin Combination Therapy (ACT). Low yield in the plant, and the added cost of secondary anti-malarials in the ACT, make artemisinin costly for the developing world. As an alternative, we compared the …

Ready To Use Therapeutic Foods (Rutf) Improves Undernutrition Among Art-Treated, Hiv-Positive Children In Dar Es Salaam, Tanzania, Bruno Sunguya, Krishna C. Poudel, Linda B. Mlunde, Keiko Otsuka, Junko Yasuoka, David P. Urassa, Namala P. Mkopi

Krishna C. Poudel

Background: HIV/AIDS is associated with an increased burden of undernutrition among children even under antiretroviral therapy (ART). To treat undernutrition, WHO endorsed the use of Ready to Use Therapeutic Foods (RUTF) that can reduce case fatality and undernutrition among ART-naïve HIV-positive children. However, its effects are not studied among ART-treated, HIV-positive children. Therefore, we examined the association between RUTF use with underweight, wasting, and stunting statuses among ART-treated HIV-positive children in Dar es Salaam, Tanzania. Methods: This cross-sectional study was conducted from September-October 2010. The target population was 219 ART-treated, HIV-positive children and the same number of their caregivers. We …

Caregiving Associated With Selected Cancer Risk Behaviors And Screening Utilization Among Women: Cross-Sectional Results Of The 2009 Brfss, Katherine Reeves, Kathryn Bacon, Lisa Fredman

Katherine Reeves

Background Informal caregiving is increasingly common as the U.S. population ages, and there is concern that caregivers are less likely than non-caregivers to practice health-promoting behaviors, including cancer screening. We examined caregiving effects on cancer risk behaviors and breast and cervical cancer screening in the 2009 Behavioral Risk Factor Surveillance System. Methods Women age ≥41 with data on breast and cervical cancer screening were included (weighted frequency 3,478,000 women). Cancer screening was classified according to American Cancer Society guidelines. We evaluated the association of caregiving with cancer risk behaviors (obesity, physical activity, alcohol intake, smoking status, and fruit/vegetable consumption) and …

Genetic Variability In Igf-1 And Igfbp-3 And Body Size In Early Life, Elizabeth Poole, Shelley Tworoger, Susan Hankinson, Heather Baer

Susan E. Hankinson

Background Early life body size and circulating levels of IGF-1 and IGFBP-3 have been linked to increased risks of breast and other cancers, but it is unclear whether these exposures act through a common mechanism. Previous studies have examined the role of IGF-1 and IGFBP-3 genetic variation in relation to adult height and body size, but few studies have examined associations with birthweight and childhood size. Methods We examined whether htSNPs in IGF-1 and the IGFBP-1/IGFBP-3 gene region are associated with the self-reported outcomes of birthweight, body fatness at ages 5 and 10, and body mass index (BMI) at age …

Uptake Of Interventions For Preventing Mother-To-Child Hiv Transmission In 11 Operational Districts In Cambodia, Krishna C. Poudel

Krishna C. Poudel

INTRODUCTION: To achieve the global goal of eliminating mother-to-child transmission of HIV, retention of HIV-positive women and their babies throughout the cascade of prevention of mother-to-child transmission of HIV (PMTCT) services is necessary. Little evidence has been published on coverage of the cascade in resource-limited settings. Along with PMTCT service expansion in Cambodia, a national routine reporting system was developed. This study examines coverage of six PMTCT interventions to improve our understanding of retention throughout the cascade. METHOD: WE DEVELOPED INDICATORS TO MONITOR COVERAGE OF THE SIX KEY INTERVENTIONS: (1) maternal antiretroviral treatment or prophylaxis; (2) delivery in a health …

Influence Of Prenatal Arsenic Exposure And Newborn Sex On Global Methylation Of Cord Blood Dna, Richard Pilsner, Megan Hall, Xinhua Liu, Vesna Ilievski, Vesna Slavkovich, Diane Levy, Pam Factor-Litvak, Mahammad Yunus, Mahfuzar Rahman, Joseph Graziano, Mary Gamble

J. Richard Pilsner

Background

An emerging body of evidence indicates that early-life arsenic (As) exposure may influence the trajectory of health outcomes later in life. However, the mechanisms underlying these observations are unknown.

Objective

The objective of this study was to investigate the influence of prenatal As exposure on global methylation of cord blood DNA in a study of mother/newborn pairs in Matlab, Bangladesh.

Design

Maternal and cord blood DNA were available from a convenience sample of 101 mother/newborn pairs. Measures of As exposure included maternal urinary As (uAs), maternal blood As (mbAs) and cord blood As (cbAs). Several measures of global DNA …

Empirical Power And Sample Size Calculations For Cluster-Randomized And Cluster-Randomized Crossover Studies, Nicholas Reich, Jessica Myers, Daniel Obeng, Aaron Milstone, Trish Perl

Nicholas G Reich

In recent years, the number of studies using a cluster-randomized design has grown dramatically. In addition, the cluster-randomized crossover design has been touted as a methodological advance that can increase efficiency of cluster-randomized studies in certain situations. While the cluster-randomized crossover trial has become a popular tool, standards of design, analysis, reporting and implementation have not been established for this emergent design. We address one particular aspect of cluster-randomized and cluster-randomized crossover trial design: estimating statistical power. We present a general framework for estimating power via simulation in cluster-randomized studies with or without one or more crossover periods. We have …

Hormones And Endocrine-Disrupting Chemicals: Low-Dose Effects And Nonmonotonic Dose Responses, Laura Vandenberg, Theo Colborn, Tyrone Hayes, Jerrold Heindel, David Jacobs Jr., Duk-Hee Lee, Toshi Shioda, Ana Soto, Frederick Vom Saal, Wade Welshons, R. Zoeller, John Myers

Laura Vandenberg

For decades, studies of endocrine-disrupting chemicals (EDCs) have challenged traditional concepts in toxicology, in particular the dogma of “the dose makes the poison,” because EDCs can have effects at low doses that are not predicted by effects at higher doses. Here, we review two major concepts in EDC studies: low dose and nonmonotonicity. Low-dose effects were defined by the National Toxicology Program as those that occur in the range of human exposures or effects observed at doses below those used for traditional toxicological studies. We review the mechanistic data for low-dose effects and use a weight-of-evidence approach to analyze five …

A Call For Parental Monitoring To Improve Condom Use Among Secondary School Students In Dar Es Salaam, Tanzania, Linda B. Mlunde, Krishna C. Poudel, Bruno F. Sunguya, Jessie K. K. Mbwambo, Junko Yasuoka, Keiko Otsuka, Omary Ubuguyu, Masamine Jimba

Krishna C. Poudel

Background: The number of people newly infected with human immunodeficiency virus (HIV) has been decreasing in sub-Saharan Africa, but prevalence of the infection remains unacceptably high among young people. Despite the alarming pervasiveness of the virus, young people in this region continue to engage in risky sexual behaviors including unprotected sexual intercourse. In developed countries, parents can play important roles in protecting young people from such behaviors, but evidence regarding the impact of parental involvement is still limited in sub-Saharan Africa. Therefore, we conducted this study to examine the magnitude of risky sexual behaviors and the association of parental monitoring …

Hormesis And The Salk Polio Vaccine, Edward Calabrese

Edward Calabrese

The production of the Salk vaccine polio virus by monkey kidney cells was generated using the synthetic tissue culture medium, Mixture 199. In this paper’s retrospective assessment of this process, it was discovered that Mixture 199 was modified by the addition of ethanol to optimize animal cell survival based on experimentation that revealed a hormetic-like biphasic response relationship. This hormesis-based optimization procedure was then applied to all uses of Mixture 199 and modifications of it, including its application to the Salk polio vaccine during preliminary testing and in its subsequent major societal treatment programs.

Weight Gain Prevention Among Black Women In The Rural Community Health Center Setting: The Shape Program, Perry Foley, Erica Levine, Sandy Askew, Elaine Puleo, Jessica Whiteley, Bryan Batch, Daniel Heil, Daniel Dix, Veronica Lett, Michele Lanpher, Jade Miller, Karen Emmons, Gary Bennett

Elaine M. Puleo

Background: Nearly 60% of black women are obese. Despite their increased risk of obesity and associated chronic diseases, black women have been underrepresented in clinical trials of weight loss interventions, particularly those conducted in the primary care setting. Further, existing obesity treatments are less effective for this population. The promotion of weight maintenance can be achieved at lower treatment intensity than can weight loss and holds promise in reducing obesity-associated chronic disease risk. Weight gain prevention may also be more consistent with the obesity-related sociocultural perspectives of black women than are traditional weight loss approaches.

Methods/Design: We conducted an 18-month …