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Policosanol contents and compositions of wheat varieties.

Policosanol (PC) is the common name for a mixture of high molecular weight (20-36 carbon) aliphatic primary alcohols, which are constituents of plant epicuticular waxes. Wheat germ oil has been reported to improve human physical fitness, and this effect is attributed to its high PC, specifically its high octacosanol (OC) content. Although the PC composition of wheat leaves has been studied extensively, information on PC content and composition of wheat grain fractions is scarce. The objective of this study was to examine the PC contents and compositions of wheat grain fractions of 31 varieties grown in Oklahoma. PC compositions of the samples were identified using a gas chromatograph coupled with a mass spectrometer. The PC content of wheat bran was higher than that of the germ, shorts, and flour. The Trego and Intrada varieties had the highest PC content among the 31 wheat varieties studied. Tetracosanol (C24), hexacosanol (C26), and OC (C28) were the major PC components in all varieties. This study showed that wheat varieties grown under identical growing conditions and management differ significantly in PC content and composition.

Fatty Alcohols↗

Aflatoxin contamination in supplemental and wild foods of northern bobwhite.

Esophagi were removed from northern bobwhite (Colinus virginianus) that were killed by hunters during the 1996-1997 (n = 39) and 1997-1998 (n = 27) hunting seasons in Wheeler County, Texas and Roger Mills County, Oklahoma to determine if they were exposed to aflatoxin (AF) by consuming either wild or supplemental food. Esophagi were segregated into three categories based upon their contents: all wild seeds (n = 11), all supplemental foods (n = 21), and mixed foods (n = 18). Contents of esophagi were then analyzed for AF concentration. Mean (+/- SE) AF concentration (ppb) of wild seeds was 2.44 +/- 0.54; supplemental foods, 0.12 +/- 0.41; and mixed foods, 0.53 +/- 0.40. Wild seeds had higher (P = 0.004) AF concentrations than either the supplemental or mixed categories, although these levels are below those found to cause damage to northern bobwhite. This information suggests that northern bobwhite may consume contaminated food much more often than previously thought.

Aflatoxins↗

Relationships of human disturbance, bird communities, and plant communities along the land-water interface of a large reservoir.

We examined the relationships of human activity, bird communities, and plant communities along the land-water interface of Lake Texoma, a large human-made reservoir on the Texas-Oklahoma border. Measurements of human activity, plant surveys, and bird surveys were performed at 40 paired transects, one with human disturbance, the other undisturbed. Both principal components and correspondence analyses of bird-survey data separated disturbed sites from paired undisturbed sites, and typical disturbance-tolerant species from those less tolerant of human activity. Compared to undisturbed sites, disturbed sites tended to have more individual birds per survey, pavement, and mowed lawns, and less canopy, vegetation volume, and vegetation vertical diversity. A principal components analysis of quantitative disturbance measurements revealed that most bird and plant measures were highly correlated with the first disturbance component. However, the correlation between birds and human activity was much stronger than that between birds and plants, or between plants and disturbance. Our data suggest that bird-species composition is regulated more by human activity than by plant-community composition. Also, in this system, bird communities are a better choice than plant communities to index the effect of human disturbance. To maintain regional diversity of both birds and plants, undisturbed areas should be maintained around reservoirs.

Animals↗

Effects of prior trauma and age on posttraumatic stress symptoms in Asian and Middle Eastern immigrants after terrorism in the community.

Forty-five adult Asian and Middle Eastern immigrants living in Oklahoma City at the time of the 1995 bombing were surveyed 114 to 2 years later as part of a disaster mental health outreach program. Demographic variables, physical and interpersonal exposure, initial physiologic and emotional responses to the bombing, and posttraumatic stress symptoms associated with this disaster and with earlier trauma were measured. Most participants had experienced prior trauma in their homeland. PTSD symptomatology from prior trauma was most predictive of initial physiologic and emotional response and of later bomb-related PTSD symptoms. Bomb-related PTSD symptoms increased with current age and were inversely related to age at the time of prior trauma. Results underscore the importance of providing long-term disaster assistance to immigrants with prior trauma.

Adult↗

Observational evidence of a change in radiative forcing due to the indirect aerosol effect.

Anthropogenic aerosols enhance cloud reflectivity by increasing the number concentration of cloud droplets, leading to a cooling effect on climate known as the indirect aerosol effect. Observational support for this effect is based mainly on evidence that aerosol number concentrations are connected with droplet concentrations, but it has been difficult to determine the impact of these indirect effects on radiative forcing. Here we provide observational evidence for a substantial alteration of radiative fluxes due to the indirect aerosol effect. We examine the effect of aerosols on cloud optical properties using measurements of aerosol and cloud properties at two North American sites that span polluted and clean conditions-a continental site in Oklahoma with high aerosol concentrations, and an Arctic site in Alaska with low aerosol concentrations. We determine the cloud optical depth required to fit the observed shortwave downward surface radiation. We then use a cloud parcel model to simulate the cloud optical depth from observed aerosol properties due to the indirect aerosol effect. From the good agreement between the simulated indirect aerosol effect and observed surface radiation, we conclude that the indirect aerosol effect has a significant influence on radiative fluxes.

Journal Article↗

Linkage analysis of factors underlying insulin resistance: Strong Heart Family Study.

In previous work in non-diabetic participants of the Strong Heart Family Study, we identified three heritable principal components of nine insulin resistance (IR) phenotypes: 1) a glucose/insulin/obesity factor, 2) a blood pressure factor, and 3) a dyslipidemia factor. To localize quantitative trait loci (QTL) potentially influencing these factors, we conducted a genome scan of factor scores in Strong Heart Family Study participants. Approximately 599 men and women, >or=18 years of age, in 32 extended families at three centers (in Arizona, Oklahoma, and North and South Dakota), were examined between 1997 and 1999. We used variance components linkage analysis to identify QTLs for the IR factors. With age, sex, and study center as covariates, we detected linkage of the glucose/insulin/obesity factor to chromosome 4 (robust logarithm of the odds (LOD) = 2.2), the dyslipidemia factor to chromosome 12 (robust LOD = 2.7), and the blood pressure factor to chromosome 1 (robust LOD = 1.6). The peak linkage signals identified for these IR factors support several positive findings from other studies and occur in regions harboring interesting candidate genes. The corroboration of existing QTLs will bring us closer to the identification of the functional genes that predispose to IR.

Aged↗

MedGem hand-held indirect calorimeter is valid for resting energy expenditure measurement in healthy children.

OBJECTIVE: To assess the validity of a new hand-held indirect calorimeter [MedGem (MG)] in the determination of resting energy expenditure (REE; kilocalories per day) in children. RESEARCH METHODS AND PROCEDURES: One hundred male (n = 54) and female (n = 46) children (10.6 +/- 3.2 years, 43.9 +/- 19.0 kg, 146.1 +/- 18.8 cm, 19.6 +/- 4.9 kg/m(2)) participated. Children arrived at the University of Oklahoma body composition laboratory between 5:30 am and 6:15 am after an overnight fast. On arrival, subjects voided and remained quietly in the supine position for 15 minutes before testing. REE was measured by indirect calorimetry (in random order), with both the MG (sitting upright) and the criterion Delta Trac II (DT) (supine). Data are reported as the mean +/- standard deviation. RESULTS: The mean MG REE (1452 +/- 355 kcal/d) was significantly higher than DT REE (1349 +/- 296 kcal/d, p < 0.001). Bland-Altman analysis revealed a mean bias (MG - DT) of 104 kcal/d, with limits of agreement of -241 to +449 kcal/d. To examine the difference in subject positioning, an independent sample of 38 subjects performed the MG in its normal position (sitting) and holding the MG in a supine position. REE by the MG in the sitting position (1475 +/- 350 kcal/d) was significantly (p < 0.05) higher than the MG in the supine position (1419 +/- 286 kcal/d). DISCUSSION: The mean difference in REE between MG and DT was relatively small (103 kcal/d) but significant; however, a portion of this difference may have been related to differences in subject positioning. These preliminary data indicate that the MG shows promise as a valid tool in the assessment of REE in children.

Adolescent↗

Relation of generalized and central obesity to cardiovascular risk factors and prevalent coronary heart disease in a sample of American Indians: the Strong Heart Study.

OBJECTIVE: To examine the hypothesis linking measures of obesity including body mass index (BMI), waist circumference (waist) and percentage body fat to coronary heart disease (CHD) prevalence and its risk factors in American Indians. DESIGN: The Strong Heart Study assesses the prevalence of CHD and its risk factors in American Indians in Arizona, Oklahoma and South/North Dakota. Participants underwent a physical examination and an electrocardiogram; anthropometric and blood pressure measurements were taken, as were measurements of glucose, lipoproteins, fibrinogen, insulin, hemoglobin A1c and urinary albumin. PARTICIPANTS: Data were available for 4549 men and women between 45 and 74 y of age. MEASUREMENTS: Obesity, measured using body mass index, waist circumference and percentage body fat, was correlated with prevalent CHD and its risk factors. RESULTS: More than 75% of participants were overweight (BMI>25 kg/m2). Measures of obesity were greater in women than in men, in younger than in older participants, and in participants with diabetes than in nondiabetic participants. CHD risk factors were associated with measures of obesity but, except for insulin concentration, changes in metabolic variables with increasing obesity were small. Associations were not stronger with waist than with BMI. The prevalence of CHD in those whose BMI and/or waist measurements lay in the lowest and highest quintiles, by gender and diabetic status, was similar. CONCLUSIONS: Although CHD risk factors are associated with obesity in American Indians, distribution of obesity (ie waist) is no more closely related to risk factors than is generalized obesity (ie BMI), and changes in CHD risk factors with obesity were small. Thus, the relations among obesity, body fat distribution and CHD risk may differ in this population.

Age Factors↗

Post-remediation evaluation of a LNAPL site using electrical resistivity imaging.

Present understanding of the earth's subsurface is most often derived from samples at discrete points (wells) and interpolations or models that interpret the space between these points. Electrical resistivity imaging techniques have produced an improved capability to map contaminants (especially NAPLs--NonAqueous Phase Liquids) away from traditional wells using actual field data. Electrical resistivity image data, confirmed by drilling, have demonstrated that LNAPL (Light NAPL--less dense than water, such as gasoline) contaminants exist outside of a delineated and remediated area in Golden, Oklahoma. The data also demonstrate that LNAPL exists between monitoring and remediation wells which indicate low contaminant levels when sampled. Additionally, the electrical images provided the drilling location with the highest concentration of hydrocarbon ever found on the site, even after two phases of remediation work had been performed, although the sampling protocols varied. The results indicate that current methods of post-remediation site characterization are inadequate for complete site characterization.

Electric Impedance↗

Fba, a novel fibronectin-binding protein from Streptococcus pyogenes, promotes bacterial entry into epithelial cells, and the fba gene is positively transcribed under the Mga regulator.

In infection by Streptococcus pyogenes, fibronectin (Fn)-binding proteins play important roles as adhesins and invasins. Here, we present a novel Fn-binding protein of S. pyogenes that exhibits a low similarity to other Fn-binding proteins reported. After searching the Oklahoma Streptococcal Genome Sequencing Database for open reading frames (ORFs) with an LPXTG motif, nine ORFs were found among those recognized as putative surface proteins, and one of them was designated as Fba. The fba gene was found in M types 1, 2, 4, 22, 28 and 49 of S. pyogenes, but not in other serotypes or groups of streptococci. Fba, a 37.8 kDa protein, possesses three or four proline-rich repeat domains and exhibits a high homology to FnBPA, the Fn-binding protein of Staphylococcus aureus. Recombinant Fba exhibited a strong binding ability to Fn. In addition, Fba-deficient mutants showed diminished invasive capabilities to HEp-2 cells and low mortality in mice following skin infection. The fba gene was located downstream of the mga regulon and analysis using an mga-inactivated mutant revealed that it was transcribed under the control of the Mga regulator. These results indicate that Fba is a novel protein and one of the important virulence factors of S. pyogenes.

Adhesins, Bacterial↗

Clinical and genetic heterogeneity in familial focal segmental glomerulosclerosis. International Collaborative Group for the Study of Familial Focal Segmental Glomerulosclerosis.

BACKGROUND: Familial forms of focal segmental glomerulosclerosis (FFSGS) that exhibit autosomal dominant or recessive patterns of inheritance have been described. The genetic basis of these hereditary forms of FSGS is unknown. One recent study of a kindred from Oklahoma with an autosomal dominant form of FSGS linked this disease to a region of chromosome 19q. In addition, polymorphisms in a gene in this region on chromosome 19q13 have been linked to congenital nephrotic syndrome of the Finnish type. We have ascertained and characterized a large family with autosomal dominant FFSGS (Duke 6530). METHODS: Families were compared for clinical and genetic heterogeneity. To test for linkage of our family to this portion of chromosome 19, genomic DNA was isolated from 102 family members, and polymerase chain reaction was performed using eight microsatellite markers that spanned the area of interest on chromosome 19. Data were evaluated using two-point linkage analysis, multipoint analysis, and an admixture test. RESULTS: Linkage was excluded at a distance of +/- 5 to 10 CM for all markers tested with two-point log10 of the odds of linkage (LOD) scores and from an approximate 60 CM interval in this area of chromosome 19q via multipoint analysis. CONCLUSIONS: FSGS has been called the "final common pathway" of glomerular injury, as it is a frequent pathological manifestation with diverse etiologies. This diversity likely correlates with the genetic heterogeneity that we have established. Thus, our data demonstrate that there are at least two genes responsible for this disease, and there is genetic as well as clinical heterogeneity in autosomal dominant FSGS.

Adolescent↗

Improving the pain management standard of care in a community hospital.

PURPOSE: The purpose of this article is to outline the development, implementation, and progress of one community hospital in improving the pain management standards of care and to describe why collaboration within the community and with a nationally recognized research facility, such as the City of Hope in California, is beneficial for the educational needs of a community-based hospital and for a framework-improvement model of pain management. OVERVIEW: Most patients with cancer receive care in community facilities. It is essential that optimal pain relief be provided to these patients. A model used by Mercy Health Center in Oklahoma demonstrates how community facilities can tap into national resources. The adaptation of research and educational information that was made available by the City of Hope National Medical Center has allowed multiple strategies to be implemented to target pain management education and clinical practice effectively to meet the American Pain Society quality improvement standards. Ongoing data collection and monitoring of pain management outcomes can provide direction and support for improved pain management patient satisfaction and other pain management outcomes. With continuous quality improvement monitoring, education, and administrative support, a pain management patient "safety net" can been developed to improve the standard of care for all patients within the organization. CLINICAL IMPLICATIONS: Effective pain management according to accepted national clinical standards can be implemented and improved on by adapting national resources to guide multidisciplinary strategic planning.

California↗

An evaluation of a low-intensity intervention to introduce medical students to healthy older people.

This is a report of a controlled, prospective, longitudinal trial of an intervention to affect medical students' attitudes toward aging. Members of the Class of 2002 at the University of Oklahoma College of Medicine were assigned a senior mentor (a community-dwelling older person) upon matriculation into medical school. Students were required to perform a structured interview with the mentor once per semester for the first 2 preclinical years and to discuss these interviews in small groups mediated by geriatrics faculty. Members of the Class of 2001 were controls. Attitudes toward aging were determined using the Aging Semantic Differential (ASD) attitude scale in August 1998 and again at the end of the second year of medical school. Initial mean ASD scores were not significantly different for the two groups. Although both classes experienced improvements in their ASD scores from Time 0 to Time 1, the improvement for the class of 2002 was significantly greater than that for the class of 2001 (2001 class mean = 0.17, 2002 class mean = 0.40, t = -3.09, degrees of freedom (df) = 219, P =.002). This difference held up under controls for sex, age, prior visits to a nursing home, prior work/volunteering in an old-age environment, and a prior course on aging (Model F = 3.00, df = 6/214, P =.008; class F = 9.70, df = 1, P =.002). It was concluded that a low-intensity intervention to introduce entering medical students to healthy older people might have a positive effect on attitudes toward aging.

Aged↗

Complications of plasma exchange in 71 consecutive patients treated for clinically suspected thrombotic thrombocytopenic purpura-hemolytic-uremic syndrome.

BACKGROUND: With the increased frequency of diagnosis and improved survival of thrombotic thrombocytopenic purpura-hemolytic-uremic syndrome (TTP-HUS), the morbidity of plasma exchange (PE) treatment has become more important. STUDY DESIGN AND METHODS: Data were prospectively collected on 71 consecutive patients referred to the Oklahoma Blood Institute (OBI) for PE treatment for clinically suspected TTP-HUS from mid-1996 to mid-1999. Complications were defined as major or minor, and distinguished between those related to central venous catheter access or to the plasma. RESULTS: Twenty-one patients (30%) had 27 major complications, which caused two deaths. The major complications included 2 episodes of hemorrhage after subclavian line insertion (1 death), 1 pneumothorax requiring a chest tube, 12 systemic infections (1 death), 7 episodes of catheter thrombosis requiring removal of the central venous catheter, 2 episodes of venous thrombosis requiring anticoagulant treatment, 2 episodes of hypoxemia and hypotension, and 1 episode of serum sickness. Minor complications occurred in 22 additional patients (31%). Twenty-eight patients (39%) had no complications. CONCLUSIONS: The morbidity and mortality of catheter placement and PE are important considerations when PE treatment for clinically suspected TTP-HUS is anticipated.

Bacteremia↗

Prevalence of gallbladder disease in American Indian populations: findings from the Strong Heart Study.

American Indians are believed to be at high risk of gallbladder disease (GBD), but there has been no systematic evaluation of its prevalence among diverse groups of American Indians. Therefore, we determined the prevalence of GBD and associated risk factors among specified American Indian populations using ultrasonography of the gallbladder and standardized diagnostic criteria. Enrolled members, aged 47 years and older, of 13 American Indian tribes or communities in Arizona, Oklahoma, and South and North Dakota who participated in the Strong Heart Study were analyzed. GBD was the sum of gallstones (determined by ultrasound examination) and cholecystectomy (determined by ultrasound and self-report). The proportion of American Indian heritage was based on the heritage of the grandparents of participants. GBD prevalence was determined among 3,296 participants at the 3 sites. Among women, 17.8% had gallstones, and 46.3% had evidence of a cholecystectomy, for a total of 64.1% with GBD. Among men, 17.4% had gallstones, and 12.1% had evidence of a cholecystectomy, for a total of 29.5% with GBD. When figures were adjusted for age and Indian heritage, there was no significant difference in GBD prevalence across the 3 geographical areas. In multivariate logistic regression analysis, age, American Indian heritage, and waist circumference were associated with GBD among men, and age, American Indian heritage, diabetes, and parity were associated with GBD among women. Body mass index was not independently associated with GBD in either sex. In conclusion, GBD was found in epidemic proportions in diverse American Indian populations.

Age Distribution↗

Epidemiology of the American Indians' burden and its likely genetic origins.

It was not known until recently whether the endemic of cholesterol gallstones among certain southwestern American Indian tribes was unique among this ethnic group. With use of ultrasonography of the gallbladder and standard diagnostic criteria, gallstones are now found in epidemic proportions in 13 diverse American Indian tribes and communities living in Arizona, Oklahoma, and the Dakotas. We speculate that this predisposition is polygenic involving "thrifty" genes that conferred survival advantages when Paleo-Indians migrated from present-day Siberia to the Americas during the last Great Ice Age approximately 50,000 to 10,000 years ago. A reasonable hypothesis is that functioning of these genes promoted more efficient calorie utilization and storage in the form of adipose tissue. Beneficial results would have been operative during the isolation of Paleo-Indians in the Bering Strait land bridge (Beringia) when thrifty genes would have ensured sufficient fat reserves for survival of prolonged winters, successful pregnancy outcomes, and extended lactation periods. The authors' conjoint work on genetics of experimental cholesterol cholelithiasis in inbred mice promises help in pinpointing orthologous genetic loci (LITH genes) in the human genome. Moreover, the shared environments and homogeneity of American Indian tribes and communities should facilitate discovery of the ensembles of their common and rarer cholesterol gallstone genes. It is anticipated that knowledge of expression, polymorphisms, and functionality of LITH genes will help resolve the molecular mechanisms of this complex heterogeneous trait and thereby provide targets for novel therapies to prevent cholesterol cholelithiasis worldwide.

Cholelithiasis↗

An outbreak of multidrug-resistant pneumococcal pneumonia and bacteremia among unvaccinated nursing home residents.

BACKGROUND: Outbreaks of pneumococcal disease are uncommon and have occurred mainly in institutional settings. Epidemic, invasive, drug-resistant pneumococcal disease has not been seen among adults in the United States. In February 1996, there was an outbreak of multidrug-resistant pneumococcal pneumonia among the residents of a nursing home in rural Oklahoma. METHODS: We obtained nasopharyngeal swabs for culture from residents and employees. Streptococcus pneumoniae isolates were serotyped and compared by pulsed-field gel electrophoresis. A retrospective cohort study was conducted to identify factors associated with colonization and disease. RESULTS: Pneumonia developed in 11 of 84 residents (13 percent), 3 of whom died. Multidrug-resistant S. pneumoniae, serotype 23F, was isolated from blood and sputum from 7 of the 11 residents with pneumonia (64 percent) and from nasopharygeal specimens from 17 of the 74 residents tested (23 percent) and 2 of the 69 employees tested (3 percent). All the serotype 23F isolates were identical according to pulsed-field gel electrophoresis. Recent use of antibiotics was associated with both colonization (relative risk, 2.3; 95 percent confidence interval, 1.3 to 4.2) and disease (relative risk, 3.6; 95 percent confidence interval, 1.2 to 10.8). Only three residents (4 percent) had undergone pneumococcal vaccination. After residents received pneumococcal vaccine and prophylactic antibiotics, there were no additional cases of pneumonia, and the rates of carriage decreased substantially. CONCLUSIONS: In this outbreak a single pneumococcal strain was disseminated among the residents and employees of a nursing home. The high prevalence of colonization with a virulent organism in an unvaccinated population contributed to the high attack rate. Clusters of pneumococcal disease may be underrecognized in nursing homes, and wider use of pneumococcal vaccine is important to prevent institutional outbreaks of drug-resistant S. pneumoniae infection.

Adult↗

Effectiveness of a selected bedding system on quality of sleep, low back pain, shoulder pain, and spine stiffness.

OBJECTIVE: To determine whether clinical and statistically significant changes in back pain, shoulder pain, spine stiffness, and quality of sleep may be documented after use of a prescribed bedding system. DESIGN: Quasi-experimental field study of single group pretest-posttest design with subjects serving as their own controls. SETTING: Two chiropractic clinics and the Oklahoma State University Program of Health and Human Performance. SUBJECTS: Convenience sample of 22 subjects (women, n = 13; men, n = 9) between the ages of 25 and 75 years with documented disturbed sleep, shoulder pain, low back pain, and spine stiffness of a chronic nature. OUTCOME MEASURES: Pretest and posttest 28-day Visual Analog Scales for pain, spine stiffness, and quality of sleep. MAIN RESULTS: The experimental bedding system reduced back pain by 57.21% (P =.000001), reduced shoulder pain by 60.83% (P =.000005), reduced back stiffness by 59.12% (P =.000004), and improved quality of sleep by 60.73% (P =.000001). CONCLUSIONS: Results suggest that subjects obtain significant improvement in shoulder and back pain, back stiffness, and quality of sleep after 28 days of prescribed bedding system use as compared with 28 days of personal bedding use. Female subjects and those with lower body weight were more likely to significantly improve than heavier and more obese subjects.

Adult↗