While there are increasing empirical findings on general health literacy (HL), there is a lack of evidence on digital HL in adolescence and its association with health behavior.
A cross-sectional ...study of 490 students from grade eight and nine from the federal state of Hesse was conducted from October 2019 to February 2020. Digital HL was assessed using five subscales of the Digital Health Literacy Instrument (DHLI), while consumption of fruits, vegetables, and soft drinks as well as weekly physical activity were used as indicators of health behavior. In addition to gender and grade level, subjective social status (SSS) was used as a social characteristic. Univariate, bivariate, and multivariate analyses were performed, with binary-logistic regression adjusted for gender and SSS.
Across all items, 15.3 to 37.5% of adolescents reported difficulties in acquiring and dealing with digital health information. Stratified by social characteristics, gender and socioeconomic differences were found with girls and respondents reporting a lower SSS more often showed a limited digital HL. Adolescents with moderate and low digital HL reported higher levels of low physical activity and non-daily fruit and daily soft drink consumption.
The findings suggest a need for interventions to promote digital HL among adolescents, particularly for those of low SSS. In this context, the differential relationship patterns with health behaviors provide an avenue for the development of specific interventions. The school as a place of teaching and learning is a suitable setting because, among other things, of its fit with the mandatory strategy of media literacy education in schools.
Prospective analyses of biomarkers of inflammation and distal sensorimotor polyneuropathy (DSPN) are scarce and limited to innate immunity. We therefore aimed to assess associations between ...biomarkers reflecting multiple aspects of immune activation and DSPN. The study was based on 127 case subjects with incident DSPN and 386 noncase subjects from the population-based Cooperative Health Research in the Region of Augsburg (KORA) F4/FF4 cohort (follow-up 6.5 years). Proximity extension assay technology was used to measure serum levels of biomarkers of inflammation. Of 71 biomarkers assessed, 26 were associated with incident DSPN. After adjustment for multiple testing, higher levels of six biomarkers remained related to incident DSPN. Three of these proteins (MCP-3/CCL7, MIG/CXCL9, IP-10/CXCL10) were chemokines, and the other three (DNER, CD40, TNFRSF9) were soluble forms of transmembrane receptors. The chemokines had neurotoxic effects on neuroblastoma cells in vitro. Addition of all six biomarkers improved the C statistic of a clinical risk model from 0.748 to 0.783 (
= 0.011). Pathway analyses indicated that multiple cell types from innate and adaptive immunity are involved in the development of DSPN. We thus identified novel associations between biomarkers of inflammation and incident DSPN pointing to a complex cross talk between innate and adaptive immunity in the pathogenesis of the disease.
Abstract Objectives Complex longitudinal sampling and the observational structure of patient registers in health services research are associated with methodological challenges regarding data ...management and statistical evaluation. We exemplify common pitfalls and want to stimulate discussions on the design, development, and deployment of future longitudinal patient registers and register-based studies. Study Design and Setting For illustrative purposes, we use data from the prospective, observational, German DIabetes Versorgungs-Evaluation register. One aim was to explore predictors for the initiation of a basal insulin supported therapy in patients with type 2 diabetes initially prescribed to glucose-lowering drugs alone. Results Major challenges are missing mortality information, time-dependent outcomes, delayed study entries, different follow-up times, and competing events. We show that time-to-event methodology is a valuable tool for improved statistical evaluation of register data and should be preferred to simple case–control approaches. Conclusion Patient registers provide rich data sources for health services research. Analyses are accompanied with the trade-off between data availability, clinical plausibility, and statistical feasibility. Cox' proportional hazards model allows for the evaluation of the outcome-specific hazards, but prediction of outcome probabilities is compromised by missing mortality information.
Left ventricular (LV) hypertrophy and changes in LV geometry are associated with increased cardiovascular mortality. Subjects with type 2 diabetes have an increased risk of such alterations in ...cardiac morphology. We sought to assess the association of glycemic status and LV wall thickness measured by cardiac magnetic resonance (CMR), and potential interactions of hypertension and diabetes.
CMR was performed on 359 participants from a cross-sectional study nested in a population-based cohort (KORA FF4) free of overt cardiovascular disease. Participants were classified according to their glycemic status as either control (normal glucose metabolism), prediabetes or type 2 diabetes. Segmentation of the left ventricle was defined according to the American Heart Association (AHA) 16-segment model. Measurements of wall thickness were obtained at end-diastole and analyzed by linear regression models adjusted for traditional cardiovascular risk factors.
LV wall thickness gradually increased from normoglycemic controls to subjects with prediabetes and subjects with diabetes (8.8 ± 1.4 vs 9.9 ± 1.4 vs 10.5 ± 1.6 mm, respectively). The association was independent of hypertension and traditional cardiovascular risk factors (β-coefficient: 0.44 mm for prediabetes and 0.70 mm for diabetes, p-values compared to controls: p = 0.007 and p = 0.004, respectively). Whereas the association of glycemic status was strongest for the mid-cavity segments, the association of hypertension was strongest for the basal segments.
Abnormal glucose metabolism, including pre-diabetes, is associated with increased LV wall thickness independent of hypertension.
Application of mixed meal tolerance tests (MMTT) to measure beta-cell function in long-term studies is limited by modification of the commercial products occurring over time. This study assessed the ...intra-individual reliability of MMTTs and compared the effects of liquid meals differing in macronutrient composition on the estimation of beta-cell function in type 2 diabetes (T2DM).
To test the reliability of MMTTs, 10 people with T2DM (age 58 ± 11 years, body mass index 30.0 ± 4.9 kg/m
) received Boost® high Protein 20 g protein three times. For comparing different meals, another 10 persons with T2DM (58 ± 5 years, 31.9 ± 5.3 kg/m
) ingested either Boost® high Protein 20 g protein or the isocaloric Boost® high Protein 15 g protein containing 35% less protein and 18% more carbohydrates. C-peptide, insulin and glucose release were assessed from the incremental area under the concentration time curve (iAUC) and the intra- and inter-individual variation of these parameters from the coefficients of variations (CV).
Repetitive ingestion of one meal revealed intra-individual CVs for the iAUCs of C-peptide, insulin and glucose, which were at least 3-times lower than the inter-individual variation of these parameters (18.2%, 19.7% and 18.9% vs. 74.2%, 70.5% and 207.7%) indicating a good reliability. Ingestion of two different meals resulted in comparable intra-individual CVs of the iAUCs of C-peptide and insulin (16.9%, 20.5%).
MMTTs provide reliable estimation of beta-cell function in people with T2DM. Furthermore, moderate differences in the protein and carbohydrate contents in a standardized liquid meal do not result in relevant changes of C-peptide and insulin responses.
Clinicaltrials.gov, Identifier number: NCT01055093. Registered 22 January 2010 - Retrospectively registered, https://www.clinicaltrials.gov/ct2/show/study/NCT01055093.
Filopodia are dynamic, finger-like cellular protrusions associated with migration and cell-cell communication. In order to better understand the complex signaling mechanisms underlying filopodial ...initiation, elongation and subsequent stabilization or retraction, it is crucial to determine the spatio-temporal protein activity in these dynamic structures. To analyze protein function in filopodia, we recently developed a semi-automated tracking algorithm that adapts to filopodial shape-changes, thus allowing parallel analysis of protrusion dynamics and relative protein concentration along the whole filopodial length. Here, we present a detailed step-by-step protocol for optimized cell handling, image acquisition and software analysis. We further provide instructions for the use of optional features during image analysis and data representation, as well as troubleshooting guidelines for all critical steps along the way. Finally, we also include a comparison of the described image analysis software with other programs available for filopodia quantification. Together, the presented protocol provides a framework for accurate analysis of protein dynamics in filopodial protrusions using image analysis software.
Parents of small deaf children need guidance on constructing home and school environments that affect normal language acquisition. They often turn to physicians and spiritual leaders and, ...increasingly, the internet. These sources can be underinformed about crucial issues, such as matters of brain plasticity connected to the risk of linguistic deprivation, and delay or disruption in the development of cognitive skills interwoven with linguistic ability. We have formed a team of specialists in education, linguistics, pediatric medicine, and psychology, and at times specialists in theology and in law have joined our group. We argue that deaf children should be taught a sign language in the early years. This does not preclude oral-aural training and assistive technology. With a strong first language (a sign language), the child can become bilingual (with the written form of the ambient spoken language and, perhaps, the spoken form), accruing the benefits of bilingualism. We have published in medical journals, addressing primary care physicians, in a journal with a spiritual-leader readership, and in a health-law journal. Articles in progress address medical educators and practitioners. Team members present findings at conferences, work on lobbying and legislative efforts with the National Association of the Deaf, and spread the word at conferences of target audiences. We share our work in Word format, so that anyone can easily appropriate it for our common interests. One of our articles has been downloaded over 27,000 times (as of April 2014), and we are asked to consult with committees in other countries as they draft national policies.
Preselected carcasses (n = 112) from feedlot steers fed zilpaterol hydrochloride (ZH; 8.33 mg/kg, DM basis) in a serial slaughter experiment were evaluated to determine the effects of ZH upon carcass ...cutability, composition, and tenderness. A 4 x 4 factorial arrangement of treatments in a completely random design was used with days on ZH (0, 20, 30, and 40 d before slaughter with a 3-d withdrawal) and days on the finishing diet (DOF; 136, 157, 177, and 198 d). No relevant ZH duration x slaughter group interactions were detected (P > 0.05) for carcass cutability, composition, or tenderness data. Exposure to ZH increased the lean yield of 22 of the 33 subprimals evaluated with every subprimal within the round showing increased cutability (P < or = 0.04). Carcass fat was decreased, whereas carcass protein and moisture were increased due to ZH (P < 0.01). Lengthening the ZH feeding period did not result in additive gains in subprimal yield or chemical composition (P > 0.05). Warner-Bratzler shear force analysis of the LM indicated that ZH caused a toughening effect (P < 0.01) regardless of the length of the aging period (7, 14, or 21 d). Extending the ZH dose duration caused a linear increase in Warner-Bratzler shear force at 7 (P = 0.06) and 21 d (P < 0.01) of aging. Within 10 min postmortem, samples (n = 48) were collected from the semimembranosus muscle for RNA isolation from 4 randomly selected steers from each treatment within the 157, 177, and 198 d slaughter groups. Feeding ZH did not alter beta1- or beta2-adrenergic receptor (AR), calpastatin (CAL), IGF-I, or myosin heavy chain (MHC) isoform I mRNA abundance (P > 0.10). There was a ZH duration x DOF interaction (P < 0.01) for the expression of MHC-IIa and -IIx. Expression of MHC-IIa was decreased in every ZH treatment within the 177 and 198 DOF groups (P < 0.02). Expression of MHC-IIx was increased in the 20-d ZH group in the 157 DOF group (P = 0.03), and the 40-d ZH group in the 177 (P = 0.10) and 198 (P = 0.03) DOF groups. There was a tendency for a linear decrease in CAL mRNA abundance as ZH duration increased (P = 0.07), and there was a linear increase in beta2-AR (P = 0.03) and CAL (P < 0.01) mRNA abundance as DOF increased. Collectively, the data indicate that ZH may influence net protein turnover by decreasing MHC-IIa mRNA transcription and possibly increasing MHC-IIx. Furthermore, a ZH feeding duration of 20 d appeared to be adequate for capturing lean yield benefits while limiting tenderness losses.
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