SHS Group Research Articles

Dementia in patients with early cardiovascular complications following ischaemic stroke: A neglected complication of the stroke-heart syndrome

Abstract Background Early cardiovascular complications may occur in 20-30% of patients following following ischaemic stroke (stroke-heart-syndrome, SHS). The risk of dementia in patients with SHS remains unexplored. We aimed to quantify the risk of incident dementia in patients with SHS. Methods We conducted a retrospective analysis using a global federated health care network (TriNetX). We included patients who were discharged alive post-ischaemic stroke from 2000 to 2022. These individuals were classified into two cohorts based on the incidence of cardiovascular complications within 30 days post-stroke (acute heart failure [HF], acute myocardial infarction [AMI], ventricular fibrillation or flutter [VFF], or Takotsubo disease [TTS]), ie. those with SHS (Group 1) and those with stroke-only (without SHS; Group 2). The primary outcome was the five-year risk of dementia (vascular dementia [F01], dementia in other disease [F02], unspecified dementia [F03], Alzheimer’s disease [G30]). Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox regression analysis after 1:1 propensity score matching (PSM). Results We identified 70,113 patients with SHS (age 67.3±14.0; 42.2% females) and 1,092,540 patients with stroke-only (age 65.2±14.9, 48.1% females). Prior to PSM, patients with SHS were generally older and had a higher prevalence of cardiovascular treatments compared to those without SHS. Following PSM, 70,111 well-balanced patients were considered in each group, however, patients with SHS had a higher risk of dementia compared to patients with stroke-only (HR 1.25, 95%CI 1.20-1.30). Among the SHS complications, the highest dementia risks were associated with acute HF (HR 1.28, 95%CI 1.21-1.36) and AMI (HR 1.24, 95%CI 1.17-1.30), with no significant associations were found for TTS, and VFF. The increased risk of dementia in patients with SHS compared to patients with stroke-only was independent of oral anticoagulant (OAC) use, sex, and age (> or < 75 years) [Figure 1]. Conclusion Stroke-heart syndrome is associated with increased risk of dementia. Innovative strategies to identify and to prevent SHS complications would improve long-term prognosis in patients with recent stroke.

Folic Acid and Taurine Alleviate the Impairment of Redox Status, Immunity, Rumen Microbial Composition and Fermentation of Lambs under Heat Stress.

The aim of this study was to investigate if the supplementation of folic acid and taurine can relieve the adverse effects of different levels of heat stress (HS) on growth performance, physiological indices, antioxidative capacity, immunity, rumen fermentation and microbiota. A total of 24 Dorper × Hu crossbred lambs (27.51 ± 0.96 kg) were divided into four groups: control group (C, 25 °C), moderate HS group (MHS, 35 °C), severe HS group (SHS, 40 °C), and the treatment group, under severe HS (RHS, 40 °C, 4 and 40 mg/kg BW/d coated folic acid and taurine, respectively). Results showed that, compared with Group C, HS significantly decreased the ADG of lambs (p < 0.05), and the ADG in the RHS group was markedly higher than in the MHS and SHS group (p < 0.05). HS had significant detrimental effects on physiological indices, antioxidative indices and immune status on the 4th day (p < 0.05). The physiological indices, such as RR and ST, increased significantly (p < 0.05) with the HS level and were significantly decreased in the RHS group, compared to the SHS group (p < 0.05). HS induced the significant increase of MDA, TNF-α, and IL-β, and the decrease of T-AOC, SOD, GPx, IL-10, IL-13, IgA, IgG, and IgM (p < 0.05). However, there was a significant improvement in these indices after the supplementation of folic acid and taurine under HS. Moreover, there were a significant increase in Quinella and Succinivibrio, and an evident decrease of the genera Rikenellaceae_RC9_gut_group and Asteroleplasma under HS (p < 0.05). The LEfSe analysis showed that the genera Butyrivibrio, Eubacterium_ventriosum_group, and f_Bifidobacteriaceae were enriched in the MHS, SHS and RHS groups, respectively. Correlated analysis indicated that the genus Rikenellaceae_RC9_gut_group was positively associated with MDA, while it was negatively involved in IL-10, IgA, IgM, and SOD (p < 0.05); The genus Anaeroplasma was positively associated with the propionate and valerate, while the genus Succinivibrio was negatively involved in TNF-α (p < 0.05). In conclusion, folic acid and taurine may alleviate the adverse effects of HS on antioxidant capacity, immunomodulation, and rumen fermentation of lambs by inducing changes in the microbiome that improve animal growth performance.

The effect of subdiaphragmatic vagotomy on heart rate variability and lung inflammation in rats with severe hemorrhagic shock

BackgroundThe influence of cutting the sub-diaphragmatic branch of the vagus nerve on heart rate variability (HRV) and inflammatory reaction to severe hemorrhagic shock has not been determined prior to this study.MethodsMale Sprague–Dawley rats were divided into four groups of Sham, sub-diaphragmatic vagotomized (Vag), subacute (135 ± 2 min) hemorrhagic shock (SHS), and sub-diaphragmatic vagotomized with SHS (Vag + SHS). Hemodynamic parameters were recorded and HRV calculated during multiple phases in a conscious model of hemorrhagic shock. The expressions of TNF-α and iNOS were measured in the spleen and lung tissues at the conclusion of the protocol.ResultsDecreases in blood pressure during blood withdrawal were identical in the SHS and Vag + SHS groups. However, heart rate only decreased in the Nadir-1 phase of the SHS group. HRV indicated increased power in the very-low, low, and high (VLF, LF, and HF) frequency bands during the Nadir-1 phase of the SHS and Vag + SHS groups, albeit the values were higher in the SHS group. In the recovery phase, the HF bands were only lower in the SHS group. After hemorrhagic shock followed by resuscitation, the expression of TNF-α and iNOS increased in the spleen and lung of the SHS group, and the expression of these genes was significantly lower in the Vag + SHS group than in the SHS group.ConclusionParasympathetic activity increases during the hypotensive phase of hemorrhagic shock, whereas the cardiac vagal tone decreases in the recovery phase. Sub-diapragmatic vagotomy blunts the cardiac vagal tone during hemorrhagic shock, but its effect is reversed in the recovery phase. The vagus nerve plays a role in proinflammatory responses in the lungs and spleen in subacute hemorrhagic shock followed by resuscitation.

Movement patterns of the functional reach test do not reflect physical function in healthy young and older participants.

The relationship of the Functional Reach Test (FRT) value with the Center of Pressure Excursion (COPE) and physical function remains unclear, and would be influenced by different population characteristics and movement patterns used in the FRT. Therefore, we explored the relationship between the FRT value and the COPE and physical function in healthy young and older individuals classified according to movement patterns. In 21 healthy young participants (42 sides) and 20 older participants (40 sides), three-dimensional motion analysis was performed during the FRT and physical function assessments. The participants were assigned to two clusters after performing a motion analysis during the FRT. Kinematic and kinetic parameters during the FRT and physical function assessment results were compared between the clusters for both groups. Correlation analysis was performed to investigate the relationships of the FRT value with COPE and physical function parameters in each cluster, in young and older individuals separately. The results showed that the hip strategies could be divided into two groups according to the degree of use (Small Hip Strategy, SHS Group; Large Hip Strategy, LHS Group). In the older SHS group, the FRT values were significantly correlated with the COPE (r = 0.75), toe grip strength (r = 0.62), and the five-times sit-to-stand test time (r = -0.52). In the older LHS group and in both groups of young individuals, there were no significant correlations of the FRT value with any parameters. The FRT value reflects the COPE and physical function only in older individuals using the SHS. This could explain previous discrepant results. As there is no simple relationship between the FRT value and physical function, it is important to include movement strategy assessment when using the FRT in clinical evaluations.

Individuals with sub-health status have obviously unbalanced structure of the intestinal flora: analysis of 150 nursing staff members

To explore the difference in intestinal flora composition between individuals with sub-health status and healthy subjects. From November, 2020 to May, 2021, a total of 150 nursing staff members in Nanfang Hospital were selected for this study, including 75 participants with sub-health status (SHS group) and 75 healthy participants (control group). Fecal samples were collected from all the participants for analysis of the diversity and species composition of the intestinal flora using high-throughput sequencing for V3-V4 region of 16S rRNA gene. The results of α diversity analysis showed no significant difference in Chao1 index between the two groups (P=0.619), but the Shannon index was significantly higher in SHS group than in the control group (P < 0.001). The results of β diversity analysis showed significant differences in the community structure between the SHS group and the control group (R=0.227, P=0.001). At the phylum level, the intestinal flora in the two groups were composed mainly of Bacteroidota, Firmicutes and Actinobacteriata, and of Prevotella, Bacteroides, Blautia and Faecalibacterium at the genus level. Species difference analysis identified significant differences in the relative abundance between the two groups in 4 phyla, 3 classes, 3 orders, 3 families and 3 genera (P < 0.05). Compared with healthy subjects, the individuals with sub-health status have obviously unbalanced structure of the intestinal flora.

Changes in miRNA levels of sperm and small extracellular vesicles of seminal plasma are associated with transient scrotal heat stress in bulls

Scrotal heat stress affects spermatogenesis and impairs male fertility by increasing sperm morphological abnormalities, oxidative stress and DNA fragmentation. While sperm morpho-functional changes triggered by scrotal heat stress are well described, sperm molecular alterations remain unknown. Recently, spermatozoa were described as accumulating miRNAs during the last steps of spermatogenesis and through epididymis transit, mainly by communication with small extracellular vesicles (sEVs). Herein, the aim was to investigate the impact of scrotal heat stress in miRNAs profile of sperm, as well as, seminal plasma sEVs. Six Nelore bulls (Bos indicus) were divided into two groups: Control (CON; n = 3) and Scrotal Heat Stress (SHS; n = 3; scrotal heat stressed during 96 h by scrotal bags). The day that the scrotal bags were removed from SHS group was considered as D0 (Day zero). Seminal plasma sEVs were isolated from semen samples collected seven days after heat stress (D+7) to evaluate sEVs diameter, concentration, and 380 miRNA levels. Sperm morpho-functional features and profile of 380 miRNAs were evaluated from semen collected 21 days after heat stress (D+21). As a control, sEVs and sperm were analyzed seven days before heat stress (D-7). Only semen parameters that were not significantly different (P > 0.05) among bulls on D-7 were addressed on D+7 and D+21. While no alterations in diameter and concentration were detected in sEVs on D+7 between CON and SHS groups, three sEVs-miRNAs (miR-23b-5p, −489 and −1248) were down-regulated in SHS bulls compared to CON on D+7; other three (miR-126-5p, −656 and −1307) displayed a tendency (0.05 < P < 0.10) to be altered. Sperm oxidative stress was higher, and the level of 21 sperm miRNAs was altered (18 down-, 3 up-regulated) in SHS bulls compared to CON on D+21. Functional analysis indicated that target genes involved in transcription activation, as well as cell proliferation and differentiation were related to the 18 down-regulated sperm miRNAs (miR-9-5p, −15a, −18a, −20b, −30a-5p, −30b-5p, −30d, −30e-5p −34b, −34c, −106b, -126-5p, −146a, −191, −192, −200b, −335 and −449a). Thus, the scrotal heat stress probably impacted testicular and epididymis functions by reducing the levels of a substantial proportion of sEVs and sperm miRNAs. Our findings suggest that miR-126-5p was possibly trafficked between sEVs and sperm and provide new insights on the mechanism by which sperm acquire miRNAs in the last stages of spermatogenesis and sperm maturation in cattle.

A Pilot Study on Secondhand Smoke Exposure Among Pregnant Women in Chongqing, China: A Combined Questionnaire, Saliva Cotinine Test, and Ultrasound Flow Index Analysis.

Objective: The aim of the study was to gain updated data on SHS exposure among pregnant women in Chongqing city, one of the four municipalities of China.Study Design and Setting: Pregnant women attending routine ultrasound checks at an obstetrics and gynecology center voluntarily participated in the survey of SHS exposure. Some participants were also invited to have saliva cotinine tests using a NicAlert kit. The pulsatility index (PI) of the umbilical artery was compared between the SHS and non-SHS groups.Results: A total of 548 pregnant women (74.82 and 25.18% at 12 and 24 weeks' gestation, respectively) participated in the survey from July to November 2019. SHS exposure was reported by 29.44% of participants. “Workplace” was listed as the top location for SHS exposure. Twenty-three of the 31 participants who tested cotinine-negative in their saliva samples self-reported SHS exposure in the survey questionnaire. However, two of the eight participants who tested cotinine-positive in their saliva samples self-reported SHS-exposure negative. The mean PI in the SHS group is higher than that in the non-SHS group (1.10 vs. 1.02) in fetuses at 24 weeks' gestation. However, the PI may not be suitable as an index for SHS exposure at 12 weeks' gestation due to frequent absent or reversed diastolic flow.Conclusion: The first survey on SHS exposure in pregnant women that combines a questionnaire, saliva cotinine tests, and ultrasound flow index analysis has been performed in China and provided valuable data for ensuing studies.

Biomechanical Investigation of an Integrated 2-Screw Cephalomedullary Nail Versus a Sliding Hip Screw in Unstable Intertrochanteric Fractures.

To compare the efficacy of 2 intertrochanteric (IT) fracture fixation devices in conferring mechanical stability to unstable IT femur fractures. Nine pairs of cadaveric female femurs with a groupwise average bone quality indicative of osteopenia were used. An unstable IT fracture without calcar support (OTA/AO 31-A2) was created and stabilized with either a sliding hip screw and side plate (SHS) or a cephalomedullary nail using an integrated dual-screw fixation [InterTAN (ITN)]. Constructs were evaluated under stepwise and increasing cyclic loading up to 50,000 cycles (1500 N) or by failure in a test model that may best simulate hip joint contact forces at heel strike. Number of cycles to failure, failure load, and femoral head rotation about the screw axis were compared between groups. The average number of cycles in the ITN group was greater compared with that in the SHS group (48,383 vs. 31,403 cycles, P = 0.046). Similarly, the average maximum load survived by the ITN group was greater than that of the SHS group (1456 vs. 1113 N, P = 0.046). The number of constructs that survived up to the maximum applied load of 1500 N was greater in the ITN group (8/9, 89%) when compared with that of the SHS constructs (3/9, 33%) (P = 0.049). Finally, the ITN group conferred greater rotational control of the femoral head compared with the SHS constructs (1.5 vs. 5.5 degrees, P = 0.018), and reduced the amount of varus collapse (11.1 vs. 31.1 degrees, P = 0.038). The integrated dual-screw construct appeared to confer significantly greater fracture stability compared with a sliding hip screw and side plate using a worst-case model that simulates heel strike during gait. Study data provide biomechanical evidence that the ITN device may provide more stability and rotational resistance than a sliding hip screw in the elderly female patient population with an unstable IT fracture and compromised bone quality.

Second hand smoke exposure depresses neuronal excitability and enhances 4‐AP sensitive channel function of cardiac vagal neurons in the nucleus ambiguus

BACKGROUNDSecond hand smoke (SHS) is a significant risk factor for cardiac dysfunction including arrhythmias and sudden cardiac death. Previously we showed that environmentally relevant concentrations of SHS reduce heart rate variability (HRV), an index of autonomic function. We also showed that SHS exposure significantly reduces cardiac vagal neuronal excitability in the nucleus ambiguus (NA), the final vagal cardiac output regulating HRV. We further showed that SHS‐induced attenuation of SK channel activity that may serve as a partial compensatory mechanism to the reduction in overall neuronal excitability. Here, we sought to test the hypothesis that SHS exposure, at an environmentally relevant concentration that reduces HRV, depresses neuronal excitability of cardiac vagal neurons in the NA by enhancing 4‐AP sensitive potassium channel function.METHODSAdult male C57BL6/J mice underwent open chest surgeries to retrograde label cardiac vagal neurons by applying a fluorescent dye (DiI) to the sinoatrial node. After two weeks of recovery from surgery, mice were randomly assigned to either filtered air (FA) or SHS (3 mg/m3, 6 hr/d, 5 d/wk) for 4‐, 8‐ or 12‐weeks. Whole‐cell current clamp recordings in brainstem slices were performed on anatomically identified cardiac vagal neurons in the NA with fluorescent labeling.RESULTSSHS exposure significantly (p &lt; 0.05) reduced spiking response to depolarizing current injections after 4‐ and 12‐weeks – but not 8‐weeks – of exposure. Perfusion with 1 mM of 4‐AP, a voltage‐activated potassium channel blocker, similarly increased spiking response by 5–10 spikes/s across all time points. The 4‐AP induced changes in spiking responses were not different between SHS and FA (p &gt; 0.05). SHS exposure also significantly (p &lt; 0.05) increased voltage and current threshold for action potential generation for all time points tested (4‐, 8‐, and 12‐weeks). 4‐AP significantly lowered the voltage threshold; these effects were significantly (p &lt; 0.05) bigger in the SHS group (−1.2 ± 0.5 mV vs. −3.7 ± 0.4 mV, FA vs. SHS respectively). In contrast, 4‐AP similarly lowered current threshold for action potential generation in both FA and SHS groups (−80 ± 13 pA vs. −103 ± 12 pA, FA vs. SHS, respectively).CONCLUSIONSWe conclude that environmentally relevant SHS exposure induces time‐dependent changes in neuronal excitability of cardiac vagal neurons. Some of these changes may be the result of increased voltage‐activated potassium channel function.Support or Funding InformationR01 ES025229; T32 HL086350This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Summer season induced rhythmic alterations in metabolic activities to adapt to heat stress in three indigenous (Osmanabadi, Malabari and Salem Black) goat breeds

A study was conducted to assess the adaptive capability of three indigenous goat breeds to heat stress. Thirty six 10 months to one-year-old female goats of Osmanabadi, Malabari and Salem Black breeds were randomly divided into six groups, OC (n = 6; Osmanabadi control), OHS (n = 6; Osmanabadi heat stress), MC (n = 6; Malabari control), MHS (n = 6; Malabari heat stress), SBC (n = 6; Salem Black control) and SBHS (n = 6; Salem Black heat stress). Among the metabolic activity controlling hormones, the breed factor significantly (P < 0.05) influenced only plasma triiodothyronine (T3). However, heat stress significantly (P < 0.05) decreased thyroid stimulating hormone (TSH) in both MHS and SHS groups while significantly (P < 0.05) decreased the plasma T3 in MHS. The rumen metabolites such as acetate, propionate, butyrate and total volatile fatty acids (TVFAs) showed significant (P < 0.05) variation for both breed and treatment effect. The Salem Black breed did not show any significant variation for most of the rumen metabolites as compared to both Osmanabadi and Malabari breeds for the heat stress treatment. The study indicated the importance of the metabolic alterations in indigenous goat breeds to cope to the seasonal rhythms. The results indicated that on comparative basis, Salem Black breed adapted better to the heat stress challenges.

Four weeks of exposure to environmentally relevant levels of second hand smoke decreases heart rate variability—but not baroreflex sensitivity—in mice

BACKGROUNDSecond hand smoke (SHS), a source of environmental air pollution exposure, is a significant risk factor for cardiovascular morbidity and mortality. Impaired autonomic function, as indexed by decreased heart rate variability (HRV), has been implicated as one of the underlying mechanisms of increased arrhythmia susceptibility that often precedes sudden cardiac death. We previously showed, in mice, that short term (3 days) exposure to a high level of SHS (30 mg/m3, 6 hr/d) reduced HRV that persisted after this acute window of SHS exposure. However, we have limited information on the time course of SHS‐induced cardiovascular dysfunction at more environmentally relevant concentrations. Here, we sought to test the hypothesis that an environmentally relevant level of SHS decreases HRV and baroreflex sensitivity (BRS), while increasing blood pressure (BP) and BP variability (BPV).METHODSAdult male C57BL/6J mice were implanted with BP/ECG telemetry devices. Two weeks after recovering from surgery, mice were randomly assigned to either filtered air (FA, n=10 for HRV, n=5 for BPV and BRS) or SHS (n=6) groups. SHS exposure level was similar to that of a “smoky bar” (3 mg/m3) for 6hr/d, 5d/wk for 4wk. Weekly, 36 hours of continuous BP and ECG recordings were performed after five days of exposure. Data were divided into three 12‐hour periods: the dark cycle immediate after the 5th day of exposure and the following light and dark cycles. Standard time domain HRV parameters were determined from normal‐to‐normal R wave intervals (SDNN, CV% and rMSSD). BRS was determined with the sequence method using systolic BP.RESULTSSHS exposure for four weeks did not change BP and HR in either dark or light cycle. SHS significantly decreased short term HRV (rMSSD) during the light cycle in as few as two weeks of exposure (28% lower than FA group, p&lt;0.05). However, there was no significant change in overall HRV (SDNN and CV%) after four weeks of SHS exposure. These data suggest that the initial change in cardiac autonomic regulation is likely mediated by reduced vagal regulation. There was a trend, but not statistically significant effect, for an increase in BPV (12% higher than FA group) after four weeks of SHS exposure; however, no change in BRS was observed after four weeks of SHS exposure. These data suggest that changes in cardiac regulation precede changes in BP regulation, and that the cardiac vagal limb of the autonomic nervous system is particularly sensitive to SHS exposure.CONCLUSIONSWe conclude that this environmentally relevant dose of SHS can impair cardiovascular regulation in a time‐dependent manner, further emphasizing the importance of regulating and limiting exposure to SHS.Support or Funding InformationR01 ES025229; T32 HL086350

Increased Complication Rate Following Conversion Total Hip Arthroplasty After Cephalomedullary Fixation For Intertrochanteric Hip Fractures

Cephalomedullary devices (CMN) have become an increasingly popular for treatment of intertrochanteric hip fractures compared to sliding hip screw and side plate (SHS) devices. Failed fixation is often treated with conversion total hip arthroplasty (THA). We performed a multi-institutional study in which 60 patients with SHS devices and 31 patients with CMN devices were converted to THA. Harris Hip Score improved from 41.6 preoperatively to 83.6 at final follow-up in the SHS group and from 41.6 to 78.6 in the CMN group, with no significant difference between the groups (P=0.23). However, the complication rate in converted CMN patients was significantly higher at 41.9% compared with 11.7% (P=0.001) in converted SHS patients. Prior fixation with CMN may be associated with significantly higher complication rates during conversion.

Exposure to second‐hand smoke damages everyday prospective memory

Prospective memory (PM: remembering future intentions and activities) is critical to everyday remembering. This study compared a group of never-smokers who reported regular exposure to second-hand smoke (the SHS group) with a group of current smokers (the CS group) and a group of never-smokers who reported never having been exposed to SHS (the non-SHS group) on objective PM. An existing groups design was employed to compare the SHS, CS and non-SHS groups. Twenty-four SHS, 27 CS and 28 non-SHS were tested on objective PM. All participants were university undergraduates aged between 18-30 years. All participants were tested individually in a laboratory setting. The Cambridge Prospective Memory Test (CAMPROMPT) was used to assess objective PM. Age, other drug use, mood and IQ were also measured as covariates in the study. The non-SHS group recalled significantly more time-based PM tasks than the SHS group (means = 16.3 versus 13.7, P < 0.001) and significantly more than the CS group (CS mean = 11.6, P < 0.001); and the SHS group recalled significantly more time-based tasks than the CS group (P < 0.002). The non-SHS group recalled significantly more event-based PM tasks than the CS group (means = 15.2 versus 11.3, P < 0.002) with no significant difference between the non-SHS group and SHS group (SHS mean = 14.3, P = 0.234); and the SHS group recalled significantly more event-based tasks than the CS group (P < 0.001). Non-smokers exposed to second-hand smoke may suffer impairment in time-based prospective memory.

Development and evaluation of a Traditional Chinese Medicine syndrome questionnaire for measuring sub-optimal health status in China

ObjectiveSub-optimal health status (SHS), in which a person's mind and body exists in a low-quality state of being between disease and health, has become a public health problem that cannot be ignored in China. SHS measurement presents a challenge to the academic fields. We developed and evaluated a questionnaire from the perspective of traditional Chinese medicine (TCM) that embodies the features of TCM syndrome diagnosis for measuring SHS in China. MethodsThe construction of the theoretical framework of the questionnaire was based on a literature review, an expert questionnaire survey and group interviews. The subscales and questionnaire items were screened through a pilot study using statistical means and qualitative analysis. Reliability tests that were used included test-retest reliability, Cronbach's α coefficient, split-half reliability; validity tests included content validity, criterion validity, discrimination validity and construct validity. ResultsThe final questionnaire, the SHSQ-50, included 50 five-class quantifiable items that encompassed nine subscales: liver stagnation syndrome, liver-Qi deficiency syndrome, spleen-Qi deficiency syndrome, liver-fire syndrome, heart-fire syndrome, stomach-fire syndrome, heart-Qi deficiency syndrome, lung-Qi deficiency syndrome and dampness syndrome. Questionnaires were completed by 268 of the 288 SHS subjects (93.0%) and by 86 of the 94 healthy subjects (91.5%). The Cronbach α coefficients, split-half coefficients and stability coefficients ranged from 0.70 to 0.95, 0.67 to 0.87 and 0.88 to 0.98, respectively, for the overall scores and subscales. The Wilcoxon rank test showed statistically significant differences in the subscales and overall scores between the SHS group and the healthy group (P<0.01). Twelve factors with an eigenvalue greater than one were extracted by factor analysis and merged into nine factors, for which the cumulative contribution rate was 63.63%. The nine factors were corresponded to the overall structure of the questionnaire. ConclusionThe SHSQ-50 is a reliable and valid instrument for measuring TCM syndrome diagnosis of SHS in China.

Association between parental smoking behavior and children's respiratory morbidity: 5‐year study in an urban city of South Korea

After intensive tobacco control efforts in recent decades, the prevalence of active smoking has decreased. However, the hazardous effect of indirect exposure to cigarette smoke is often underestimated, especially in children. We aimed to investigate the effect of parental smoking on the respiratory morbidity of the children of parents who smoke by evaluating the relationship between parental smoking behavior and children's respiratory symptoms. We conducted a cross-sectional follow-up study of 31,584 children aged 6-11 in an urban community in Anyang City, Korea. The children's parents were asked about their smoking status and completed questionnaires regarding their children's symptoms related to asthma and other upper or lower respiratory illnesses. Our analysis focused on a comparison of the frequency of respiratory and ocular symptoms according to parental smoking status, whether it was non-smoking (Non-S), indirect passive smoking (third-hand smoking, THS) or direct passive smoking (second-hand smoking, SHS). The children with Non-S patients were 40.9%, THS group 40.6%, and SHS group 18.5%. THS group showed lower ORs for most respiratory symptoms when compared with those of SHS group, however, THS group revealed increased ORs compared with Non-S in cough-related symptoms. There was a linear trend in frequencies of cough and sputum-related symptoms according to the degree of exposure to cigarette smoke (P < 0.05). The prevalence of respiratory symptoms increased in children exposed to parental smoking including SHS and THS. To avoid the risk of respiratory and allergic disease by environmental tobacco smoke, absolute smoking cessation by parents is strongly recommended.

SIRT1 Transcription Is Decreased in Visceral Adipose Tissue of Morbidly Obese Patients with Severe Hepatic Steatosis

Visceral adipose tissue is known to release greater amounts of adipokines and free fatty acids into the portal vein, being one of the most predictive factors of nonalcoholic fatty liver disease (NAFLD). Our study has the purpose to evaluate sirtuin 1 (SIRT1), adiponectin, Forkhead/winged helix (FOXO1), peroxisome proliferator-activated receptor (PPAR)gamma1-3, and PPARbeta/delta mRNA expression in morbidly obese patients in three different lipid depots: visceral (VAT), subcutaneous (SAT), and retroperitoneal (RAT). Recent studies suggest that SIRT1, a NAD(+)-dependent deacetylase, protects rats from NAFLD. We divided the patients in two groups: those with slight or moderate steatosis (hepatic steatosis, HS) and other comprising individuals with severe steatosis associated or not with necroinflammation and fibrosis (severe hepatic steatosis, SHS). The adipose tissue depots were obtained during bariatric surgery. Total RNAs were extracted using TRIzol. The amount of genes of interest was determined by quantitative real-time polymerase chain reaction. When comparing the two groups of patients, a decrease in SIRT1 was observed in VAT of morbidly obese patients in SHS group (p = 0.006). The mRNA expression of the other genes showed no differences in VAT. No difference was found either in SAT or in RAT for all genes in the study. In addition, the homeostasis model assessment for insulin resistance (HOMA-IR) value was higher in SHS group compared to HS (p = 0.006). Also, our results show that the mRNA expression of SIRT1 and the value of HOMA-IR were positively correlated in VAT of SHS patients (r = 0.654; p = 0.048). Downregulation of SIRT1 mRNA expression in VAT of SHS could be possible impairing mitochondria biogenesis and fatty acid oxidation, promoting severe steatosis in obese patients. Our results provide a possible proof of SIRT1 protective potential in VAT against NAFLD in humans.

Performance of Hereford and two-breed rotational crosses of Hereford with Angus and Simmental cattle: II. Carcass traits of steers

Calf carcass traits were evaluated for Simmental (S) x Hereford (H) and Angus (A) x H crosses in two-breed rotations and for straightbred H. Data were grouped into seven dam breed categories: straightbred Hereford (H), F1 S x H cows (SH), S x H cows of low percentage H (SHS), S x H cows of high percentage H (HSH), F1 A x H cows (AH), A x H cows of low percentage H (AHA) and A x H cows of high percentage H (HAH). Straightbred H and crossbred SH, AH, SHS and AHA cows were mated to H bulls, HSH cows were mated to S bulls and HAH cows were mated to A bulls. Calves from the S x H rotation produced heavier carcasses with less fat, lower quality grade, larger longissimus area and increased estimated cutability compared to A x H calves. Some significant intergenerational differences were observed within rotations, particularly within S x H. Calves from HSH cows mated to S bulls produced carcasses with less fat cover, lower quality grade, larger longissimus muscle area and higher estimated cutability compared to calves from SHS dams mated to H bulls. Within both rotations, evaluation of carcass weight per day of age indicated that postweaning ADG was lower for generations for which H was the sire breed. Carcass traits of calves from SHS, HSH, AHA and HAH dam breed groups from the last 3 yr of the study when calves were fed under two different postweaning management systems were evaluated in a separate analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

Performance of Hereford and two-breed rotational crosses of Hereford with Angus and Simmental cattle: I. Calf production through weaning

Cow size, reproductive traits and calf performance through weaning were evaluated in a range environment for Simmental (S) x Hereford (H) and Angus (A) x H crosses in two-breed rotations and straightbred H. Data were grouped into seven dam breed categories: straightbred Hereford (H), crossbred F1 S x H cows (SH), S x H cows of low percentage H (SHS), S x H cows of high percentage H (HSH), F1 A x H cows (AH), A x H cows of low percentage H (AHA) and A x H cows of high percentage H (HAH). Straightbred H, SH, AH, SHS and AHA cows were mated to H bulls, HSH cows were mated to S bulls and HAH cows were mated to A bulls. Cows in the SHS and AHA groups ranged from 1/4 to 3/8 H and their calves from 5/8 to 11/16 H. Cows within the HSH and HAH groups ranged from 5/8 to 3/4 H and their calves from 5/16 to 3/8 H. Cow age ranged from 3 to 10 yr. Simmental-cross cows were heavier and taller and produced heavier calves at birth and weaning than A-cross. Pregnancy rate, calf birth date and percentage of difficult births did not vary significantly among dam breed groups. Within the A x H and S x H rotations, dam breed group rankings for calf birth weight were inverse to rankings for proportion of H in the breed makeup of the calf.(ABSTRACT TRUNCATED AT 250 WORDS)

Sexual concerns and counseling needs of normal men attending a university student health service.

Abstract The responses of 582 male university students attending the UCLA Student Health Service for medical evaluation are presented. Of these students, 37% (215) were freshmen and varsity athletes having pretraining physicals, and 63% (367) were students being evaluated in the SHS primary care clinics. A self-report questionnaire examined the frequency of sexual problems experienced by the respondents and their partners. The most common concerns expressed about themselves were orgasmic difficulties, feeling too interested in sex, and trouble getting and keeping erections. Forty-one percent of the SHS group and 33% of the athletes group had sexual concerns, and, of these, 55% and 40% respectively wanted help with their problems. Specific counseling needs of students were also evaluated.