Search

This study explored preschooler feeding practices and beliefs among Spanish- and English-speaking WIC participants in Texas. The Preschooler Feeding Questionnaire examined 9 dimensions of the parent-child feeding interaction among 235 caregivers. Results from ANOVA and post hoc analyses demonstrated significant differences in reported preschooler feeding practices and beliefs among Spanish-speaking Hispanics in comparison with English-speaking Hispanics and non-Hispanics. No significant differences were found between English-speaking Hispanics and non-Hispanics. Results indicated that acculturation may impact behaviors apart from ethnicity. Nutrition professionals should understand and acknowledge the cultural context of the parent-child feeding interaction when developing programs. [ABSTRACT FROM AUTHOR]

The specific aim for this pilot study was to evaluate the effectiveness of a nutrition and media literacy intervention targeting elementary students and their parents. The purpose of the intervention was to increase child fruit and vegetables (FV) consumption and change the home nutrition environment (measured with FV availability and accessibility and parental social support). During the intervention, students learned about nutrition, the role media plays in shaping values concerning nutrition, and developed a media campaign for their parents. A quasi-experimental research design was used to evaluate the effectiveness of the intervention. The media intervention was effective in changing the home environment. [ABSTRACT FROM AUTHOR]

To better understand outcome expectations, barriers, and strategies for healthful eating, 5 structured focus groups were conducted with adolescents from low-income families (n = 48; 83% Black students; 10-14 years old). The focus group questions dealt with healthful eating in different settings: home, school, and other eating establishments. Results suggested that healthful eating is important to this population, but perceived barriers prevent the consistent consumption of healthful foods. Strategies suggested by participants to increase healthful eating (eg, parents and schools making healthy foods that look and taste good more available) should be considered when developing nutrition interventions for adolescents from low-income families. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To examine the relationship between an aggregate risk score (smoking, drinking, and number of sex partners) and measures of youth assets in a sample of 3439 youth aged 14-18 years. METHODS: Linear regression models for African American and white males and females predicted an aggregate risk score. RESULTS: After adjustments, the youth asset most predictive of risk was self/peer values regarding risk behaviors. Perceived school support was also predictive. CONCLUSIONS: Taking an ecological approach to the measurement of adolescent health behaviors contributes to our understanding of these risk behaviors. [ABSTRACT FROM AUTHOR]

Background: Despite the widespread prevalence and serious clinical sequelae of infection with Helicobacter pylori, there have been few large population-based studies, using randomly selected subjects, examining the epidemiology of this infection.Aim: To examine the distribution and determinants of H. pylori infection in a developed country.Subjects and Setting: Overall 4742 subjects, aged 12-64, from Northern Ireland were randomly selected.Methods: Helicobacter pylori specific IgG antibodies were measured by enzyme linked immunosorbent assay, using an acid-glycine extract antigen, in stored serum from subjects who had participated in three linked population-based surveys of cardiovascular risk factors performed in 1986 and 1987.Results: The overall prevalence of H. pylori infection was 50.5%. Prevalence increased with age from 23.4% in 12-14 year olds to 72.7% in 60-64 year olds: chi 2 for trend 518, P < 10(-4). In subjects aged > or = 25, infection was more common in males (60.9%) than females (55.2%): chi 2 = 9.53, P < 0.01. This relation remained significant after adjusting for age, and measures of socioeconomic class: odds ratio (OR) for infection, male versus female was 1.19 (95% confidence interval [CI]: 1.02-1.40). Infection was associated with social class: the adjusted OR of infection in subjects from manual social classes relative to those from non-manual classes was 1.7 (95% CI: 1.47-1.98). Infection was significantly more common in current smokers and ex-smokers than in subjects who had never smoked: adjusted OR for infection, ex-smokers versus never smoked was 1.22 (95% CI: 1.01-1.49); for smokers of > or = 20/day versus never smoked OR = 1.33 (95% CI: 1.05-1.67). Infection was not associated with height in adult males but mean height in infected women was lower than in uninfected women after adjusting for age and socioeconomic status: difference in mean height (SE), -0.85 cm (0.32), P < 0.01. There was no demonstrable relationship between H. pylori infection and current alcohol intake.Conclusions: This study demonstrated a high prevalence of infection in a population from a developed country. Previously reported associations between H. pylori infection, age, sex, social class, and reduced height in females were confirmed and smoking was identified as a possible risk factor for H. pylori infection. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To explore demographic differences in individual, social, and environmental factors potentially related to fruit and vegetable intake. DESIGN: Self-report questionnaires administered to a convenience sample of middle school students during regular classes. PARTICIPANTS: Black and white adolescents, 11 to 15 years of age (N = 736). VARIABLES MEASURED: Measures included self-efficacy, family dinner frequency, normative beliefs, outcome expectations, modeling, availability, preferences, snack choice, and demographics. ANALYSIS: Chi-square, general linear models, and Poisson and linear regressions as appropriate. RESULTS: Black participants reported greater social influences than did white participants, whereas white adolescents reported greater family environmental influences on fruit and vegetable intake. The oldest adolescents reported lower self-efficacy, peer modeling, family dinner frequency, and fruit and vegetable preferences compared with younger adolescents. White participants and females reported a higher preference for vegetables than did black participants and males. Regression models for self-efficacy and snack choice explained 41% and 34% of the variance, respectively. Preferences for vegetables and parental modeling were the strongest correlates of self-efficacy. Self-efficacy was the strongest correlate of snack choice. CONCLUSIONS AND IMPLICATIONS: Decreases in several factors with age highlight the importance of intervention for this age group. Future research is needed for a better understanding of the formation and modification of self-efficacy and snack choice. [ABSTRACT FROM AUTHOR]

Abstract: Both the clinical management and study of recurrent acute pancreatitis (RAP) and chronic pancreatitis (CP) is complicated by significant heterogeneity in the etiology, mechanisms, symptoms, and complications of pancreatitis. The National Institutes of Diabetes and Digestive and Kidney Disease (NIDDK) recently convened a workshop to address current knowledge and knowledge gaps in the field. Preclinical models that better replicate human disease are important for development of new therapies. Pain is often the most common and most difficult symptom to treat, as the causes are multifactorial and effective treatment may vary depending on whether pain is neuropathic or nociceptive in origin, and the placebo effect can complicate evaluation of the efficacy of medical and procedural interventions. Novel technologies like functional MRI and virtual reality may offer novel means for assessing and treating pain, respectively. Clinical trial designs will need to consider best approaches to addressing the heterogeneity of CP, including careful attention to designing eligibility criteria, and establishing accepted and validated core outcomes criteria for the field. The latter may be informed by consensus in pain research. Recruitment of participants into clinical trials has been challenging, often requiring multiple centers. Establishment of a clinical trials network would facilitate greater opportunities for therapeutic trials in pancreatitis., Competing Interests: Conflict of Interest: DY is a consultant for Pfizer, Inc. and has received research support from Abbvie Pharmaceuticals., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Autophagy is a cellular recycling process that is associated with tumor growth, anti-tumor immune responses, and therapy resistance in colorectal cancer (CRC). In this report, we identify the small GTPase Rab27B to control the autophagy process in CRC. Depletion of Rab27B showed an abnormal accumulation of autophagy vesicles and increased autophagy markers in CRC cells, indicating autophagy dysregulation. Image analysis indicated that autophagy flux is blocked at the autophagosome/lysosome fusion step when Rab27B is lost. While Rab27B deficient cells are proficient at growth under 2D in vitro conditions, cell growth was significantly impacted in both in vitro 3D growth and in vivo tumorigenesis studies. Together, these results demonstrate a new role of Rab27B in the autophagy trafficking process in CRC and identify Rab27B as a potential therapeutic target for CRC., Competing Interests: Declaration of Competing Interest The authors declare no competing interests., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The rapid diversification of terminology associated with invasion ecology is a known barrier to effective communication and management. These challenges are magnified by the addition of terms and concepts related to climate-induced range-shifting taxa and/or changes to impacts. Further, institutional policies and terminologies for invasive species introduce new ambiguities when considering climate change. To alleviate communication and application challenges, we introduce a conceptual framework that organizes climate-related invasion terms, revealing ambiguities and gaps. Additionally, we illustrate how these ambiguities can affect management with four case studies and consider situations where resolution can improve policy and management outcomes. The framework can help users avoid inconsistent use of terminology, and prioritize when to address management and policy consequences related to associated terminological ambiguity., Competing Interests: Declaration of interests No interests are declared., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Dietary fat malabsorption contributes to poor nutritional status in patients with cystic fibrosis (CF) and exocrine pancreatic insufficiency (EPI). Prescribing gastric acid-reducing agents such as proton-pump inhibitors (PPI) as an adjunct to pancreatic enzyme replacement therapy (PERT) to improve dietary fat absorption has been accepted in clinical practice despite limited evidence., Aims: This was a pilot randomized, double-blind, placebo-controlled crossover trial of subjects aged 12 and older with CF and EPI assessed on placebo and omeprazole to determine if PPI improved the efficacy of PERT as indicated by measures of dietary fat absorption., Methods: Fat malabsorption via stool coefficient of fat absorption (CFA) and malabsorption blood test (MBT), gastrointestinal pH (wireless motility capsule [WMC]), and quality of life (QOL) were assessed after 14 days on both placebo or PPI (omeprazole)., Results: Total 19 subjects enrolled, 13 were randomized, and 9 provided paired results on placebo and PPI. The 3 subject results for CFA were as follows: 1 increased, 1 decreased, and 1 was within the reference range in both tests for fat absorption. For 9 MBT subjects, 7 decreased and 2 increased fat absorption. For the 4 WMC studies, no change in transit times, nor in pH profiles were noted. No differences were seen in the domains of the two QOL questionnaires comparing placebo and PPI., Conclusions: These limited descriptive pilot study results in participants with CF and EPI on PERT evaluated by stool, blood, and QOL tests did not suggest improvement in fat absorption attributable to PPI., Competing Interests: Declarations Conflict of interest All authors disclose they have no conflicts of interest related to this project and manuscript. The funding sources had no role in study design, analysis, or drafting of the manuscript., (© 2024. The Author(s).)

Objectives: Pain is the foremost complication of chronic pancreatitis (CP), affecting about 70% of patients. However, the pathophysiological understanding and management of CP-related pain are complex, likely as patients have diverse "pain phenotypes" responding differently to treatment. This study aims to develop a bedside test panel to identify distinct pain phenotypes, investigate the temporal evolution, and determine whether they can be used to predict treatment response., Methods: The INPAIN study is an international, multicenter, observational, longitudinal cohort study consisted of 4 substudies. The studies will prospectively enroll 400 CP patients (50 without pain and 350 with pain) and 50 control subjects, conducting biannual observations for 4 years. The test panel is consisted of comprehensive subjective and objective assessment parameters. Statistical analysis strategies differ across the substudies. A model to predict treatment efficacy will be developed using various machine learning techniques, including an artificial intelligence approach, with internal cross-validation. Trajectories in pain parameters will be characterized by graphical analysis and mixed effect models., Discussion: The INPAIN study aims to comprehensively understand pain in CP through a test panel developed for routine clinical use. This tool has the potential to personalize treatments, improve clinical practice, enhance patient care, improve quality of life, and minimize treatment side effects., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Spontaneous pancreatic portal vein fistula (PPVF) - a rare complication of pancreatic inflammation - varies widely in presentation and means of diagnosis but has been previously associated with bleeding complications and mortality. A systematic review of published literature was performed to assess the frequency of outcomes., Methods: A search of electronic databases (PubMed, Ovid MEDLINE, Scopus, EMBASE, gray literature) resulted in 1667 relevant unique manuscripts; 52 met inclusion criteria., Results: A total of 74 unique (male n = 47, 63.5 %) patients were included. Mean age was 53.5 (±11.9) years. History of alcohol use was reported in 55 (74.3 %). Underlying chronic pancreatitis (CP) was present in 49 (66.2 %). In cases where presenting symptoms were reported (n = 57, 77.4 %), the most frequent were abdominal pain (63.5 %), weight loss (14.9 %), rash (12.2 %), nausea/vomiting (12.2 %), and polyarthritis (9.5 %). Computed tomography was the most common imaging modality used to confirm the diagnosis (n = 20, 27.0 %), followed by magnetic resonance cholangiopancreatography (n = 14, 18.9 %). Portal vein thrombosis was reported in 57 (77.0 %), and bleeding events (luminal, variceal, or intra-pseudocyst) were reported in 13(17.6 %) patients. Younger age was associated with higher risk of bleeding events. Mortality was reported in 12 (16.2 %) patients at any time during follow up. Older age and polyarthritis at presentation were associated with mortality., Conclusions: PPVF is a rare and potentially fatal condition, though rates of bleeding complication and death were relatively low in this population. High-quality observational studies are needed to better understand the pathophysiology and natural history of this diagnosis., Competing Interests: Declaration of competing interest AEP: Board Member, National Pancreas Foundation. All other authors declare no relevant conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Exocrine Pancreatic insufficiency (EPI) occurs following acute pancreatitis (AP) at variably reported rates and with unclear recovery timeline. The aim of this study was to establish the prevalence and predictors of EPI at 12 months after AP in a prospective cohort., Methods: In this prospective, multicentre, longitudinal cohort study, adult participants (≥18 years) admitted to the hospital with an AP attack (defined by Revised Atlanta Classification) were enrolled in a United States multi-centre longitudinal cohort (Sites: The Ohio State University, University of Pittsburgh, and Johns Hopkins University). Patients were excluded if they had pancreatic cancer, chronic pancreatitis, or malabsorptive disease (including previously diagnosed EPI). Participant data was obtained by interview and by review of the electronic medical record. EPI was assessed by stool fecal elastase (FE-1) levels collected at baseline, 3 months, and 12 months (primary endpoint). EPI was defined by FE-1 <200 μg/g; severe FE-1 level ≤100 μg/g; mild FE-1 101-200 μg/g. Multivariable logistic regression was used to identify predictors of EPI at 12 months. This study is registered with ClinicalTrials.gov, NCT03063398., Findings: EPI was observed in 29 (34.1%) of the 85 participants [44 (51.8%) male, mean age 54.7 ± 14.1 years] who provided stool samples at 12 months. For the study overall, participants were recruited between June 22, 2017 and October 18, 2021. A total of 5794 individuals were screened, 311 of whom were eligible for the study. 112 participants provided stool samples at baseline, 79 completed stool samples at 3 months, and 85 completed samples at 12 months. 64 participants included samples at all 3 timepoints. In univariable analysis, factors significantly associated with EPI at 12 months included recurrent (versus index) AP, pre-existing diabetes, alcohol, and idiopathic etiologies, and increasing severity of AP. In multivariable analysis, the odds of having EPI at 12 months increased 4-fold with idiopathic AP etiology (Odds Ratio 4.095, 95% Confidence Interval [CI] 1.418, 11.826), and 3-fold with moderately severe or severe AP (Odds Ratio 3.166, 95% CI 1.156, 8.670), and baseline diabetes mellitus (Odds Ratio 3.217, 95% CI 1.113, 9.298). Even individuals with an index mild attack of AP (n = 39) developed severe EPI at 12 months (prevalence 12.8%)., Interpretation: EPI as diagnosed by FE-1 is present in over one third of prospectively assessed patients at 12 months post-AP. Since EPI develops in patients with mild AP, investigations are needed to understand the mechanisms of injury and identify methods for tailored screening., Funding: This study was supported by an Investigator Initiated Research Grant from AbbVie, Inc., Competing Interests: VKS declares being a Consultant to Ariel Precision Medicine, Panafina, and Horizon Therapeutics; a Scientific Advisory Board Member of and equity holder in Kyttaro, Origin Endoscopy and Solv Endotherapy. SC declares funding for research, including salary, paid to her institution by Abbvie. MLR declares support from the Cystic Fibrosis Foundation and the American Society for Parenteral and Enteral Nutrition, and position as Chair for the Young Trainees Committee for the Collaborative Alliance for Pancreatic Education and Research (CAPER). PJL declares the Investigator Initiated Research funding from Abbvie for the project execution and administration. GIP declares the Investigator Initiated Research funding that supported this study from Abbvie. All other authors declare no financial or other conflicts of interest., (© 2024 The Authors.)

Colorectal cancer (CRC) is the third most prevalent cancer worldwide. Current studies have demonstrated that tumor-derived extracellular vesicles (EVs) from different cancer cell types modulate the fibroblast microenvironment to contribute to cancer development and progression. Here, we isolated and characterized circulating large EVs (LEVs), small EVs (SEVs) and non-EV entities released in the plasma from wild-type (WT) mice and the APC Min/+ CRC mice model. Our results showed that human colon fibroblasts exposed from APC-EVs, but not from WT-EVs, exhibited the phenotypes of cancer-associated fibroblasts (CAFs) through EV-mediated NF-κB pathway activation. Cytokine array analysis on secreted proteins revealed elevated levels of inflammatory cytokine implicated in cancer growth and metastasis. Finally, non-activated cells co-cultured with supernatant from fibroblasts treated with APC-EVs showed increased mRNA expressions of CAFs markers, the ECM, inflammatory cytokines, as well as the expression of genes controlled by NF-κB. Altogether, our work suggests that EVs and non-EV components from APC Min/+ mice are endowed with pro-tumorigenic activities and promoted inflammation and a CAF-like state by triggering NF-κB signaling in fibroblasts to support CRC growth and progression. These findings provide insight into the interaction between plasma-derived EVs and human cells and can be used to design new CRC diagnosis and prognosis tools.

Exocrine pancreatic dysfunction (EPD) is a malabsorptive complication of pancreatic disorders that can lead to a host of symptoms ranging from flatulence to diarrhea and contribute to weight loss and metabolic bone disease. It is increasingly recognized to occur after acute pancreatitis (AP), including episodes with mild severity. The risk of developing EPD after AP is influenced by a range of factors, including the degree of acinar cell destruction and inflammation during AP, and persistent structural derangements following AP. In this article, we discuss the epidemiology, pathophysiology, and clinical management of EPD after AP while highlighting key knowledge gaps., Competing Interests: Declaration of competing interest No conflicts of interest exist., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Introduction: Gastrointestinal hospitalisations in the USA cause over US$130 billion in expenditures, and acute pancreatitis is a leading cause of these hospitalisations. Adequate pain control is one of the primary treatment goals for acute pancreatitis. Though opioids are commonly used for analgesia in these patients, there have been concerns about short-term and long-term side effects of using opioids. Recently, non-opioid medications have been studied to treat pain in patients with acute pancreatitis. This systematic review and network meta-analysis aims to assess the comparative efficacy of analgesic medication for non-severe, acute pancreatitis., Methods and Analysis: We will search multiple electronic databases for randomised controlled trials that study pain management in patients with non-severe, acute pancreatitis. The intervention will be any analgesic for acute pancreatitis in the hospital setting. The comparison group will be patients who received a placebo or other active interventions for pain management. The primary outcomes of interest include pain scores and the need for supplementary analgesia. The secondary outcomes will be serious adverse events, local complications, progression to severe pancreatitis, transfer to the intensive care unit, length of hospitalisation, time to start enteral feeds, 30-day all-cause mortality and Quality of Life Scale scores. If sufficient homogeneity exists among included studies, the findings will be pooled using a traditional pairwise and network meta-analysis. The risk of bias in randomised control trials will be evaluated using the Cochrane Risk of Bias Tool 2.0. The Grading of Recommendations, Assessment, Development, and Evaluation approach will be used to report the certainty of evidence., Ethics and Dissemination: This systematic review will not involve direct contact with human subjects. The findings of this review will be published in a peer-reviewed journal. They will give healthcare providers a better awareness of the optimal analgesic medication for pain treatment in non-severe, acute pancreatitis., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Psychiatric comorbidity measured by screening instruments is common in patients with chronic pancreatitis (CP) but whether this accurately reflects clinical diagnosis of psychiatric comorbidity is unknown and the prevalence of psychotropic medication prescription in CP remains largely unexplored., Methods: Adult patients (≥18 years) with definite CP were enrolled and completed the Hospital Anxiety and Depression Scale (HADS). Demographics, clinical characteristics and medications were retrieved from case report forms and the electronic health record (EHR). Clinical diagnosis of depression or anxiety was determined by presence of ICD-10 code or inclusion in the patient's EHR problem list or treatment plan. Comparisons were made between patients with and without clinical psychiatric comorbidity., Results: Total of 81 patients (48, 59.3% male; mean age 57.6 ± 14.3 years) were included. Clinical diagnoses of anxiety and depression were each noted in 47 (58%) patients, with overlap in 42 (51.9%). Compared to clinical diagnoses, the sensitivity and specificity of a positive screen for anxiety (HADS >7) were 76.6% and 91.2%; for depression 55.3% and 88.2%. Patients with anxiety and/or depression were more frequently female (51.9% v 20.7%), younger (53.6 v 64.9 years), and had alcohol etiology (51.9% v 27.6%) (all p < 0.01). In those with psychiatric comorbidity, 42 (80.8%) were prescribed psychotropic medication, most commonly gabapentinoid (24, 57.1%), selective serotonin reuptake inhibitor (n = 22, 52.4%) or benzodiazepine (n = 20, 47.6%)., Conclusions: Psychiatric comorbidities are common among CP patients and many receive psychotropic medications. Further studies are needed to evaluate the impact of these medications on CP symptoms., Competing Interests: Declaration of competing interest The authors report that they have no relevant conflicts of interest., (Copyright © 2024 IAP and EPC. Published by Elsevier B.V. All rights reserved.)