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Lin T, Mao H, Huang S, Chen J. Association between aromatic amines and serum neurofilament light chain as a biomarker of neural damage: a cross-sectional study from NHANES. Front Public Health 2024; 12:1344087. [PMID: 39381758 PMCID: PMC11458512 DOI: 10.3389/fpubh.2024.1344087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 09/09/2024] [Indexed: 10/10/2024] Open
Abstract
Background Aromatic amines (AAs) are a group of compounds widely found in chemical industry, tobacco smoke, and during food processing, with established carcinogenic properties. To date, there have been no reports on the potential neurotoxic effects of adult exposure to AAs. Serum neurofilament light chain (sNfL) is a protein released into the bloodstream following nerve axon injury and has been validated as a reliable biomarker for various neurological diseases. However, there has been no research to investigate the relationship between AAs exposure and sNfL. Methods In this study, we selected adults (aged ≥20 years) with data on both AAs and sNfL from the National Health and Nutrition Examination Survey (NHANES) conducted in 2013-2014. We used multivariable linear regression models to explore the correlation between urinary AAs and sNfL. Results In total, 510 adult participants with an average age of 43.58 ± 14.74 years were included in the study. Our findings indicate that, based on univariate linear regression and between-group comparative analyses, 1-Aminonaphthalene (1-AN), 2-Aminonaphthalene (2-AN), 4-Aminobiphenyl (4-AN) and o-Anisidine (o-ANI) showed a positive correlation with serum neurofilament light chain (P < 0.05). However, multiple linear regression analysis revealed that only 2-AN exhibited a positive correlation with serum neurofilament light chain (P < 0.05), while the correlations of other compounds with serum neurofilament light chain became non-significant. Conclusion Although our cross-sectional study fails to establish causal relationships or determine clinical significance, the findings indicate a potential association between adult exposure to AAs, notably 2-AN, and nerve damage. Consequently, further research is needed to explore the connection between AAs exposure, sNfL, and neurological conditions in adults.
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Affiliation(s)
- Tong Lin
- Department of Critical Medicine, Ningbo Medical Center Lihuili Hospital, Ningbo, China
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Sun Y, Wang D, Yi Y, Chen H, Zhou Y, Huang G, Zhao F. Outdoor secondhand smoke exposure in public places frequented by minors in the urban area of Hangzhou City, China: A cross-sectional study. Tob Induc Dis 2024; 22:TID-22-152. [PMID: 39239104 PMCID: PMC11375629 DOI: 10.18332/tid/192129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2024] [Revised: 08/07/2024] [Accepted: 08/10/2024] [Indexed: 09/07/2024] Open
Abstract
INTRODUCTION Hangzhou Public Places Smoking Control Regulations (2019) have been gradually adopted, which explicitly stipulate that smoking is strictly prohibited in the outdoor areas of educational and healthcare institutions for minors. However, there are few studies reporting the exposure to secondhand smoke (SHS) in outdoor public places for minors in the urban area of Hangzhou City. METHODS We aimed to assess the exposure to SHS in public spaces frequented by minors using on-site observations and questionnaires. In this cross-sectional study, the area was divided into core and non-core areas based on the spatial distribution and development process of the city. The core areas included the West Lake commercial district, extending to the Qiantang River, while non-core areas were located beyond this radius. Using stratified random sampling, 30 public places in each area were selected as observation sites. On-site observations measured SHS exposure and smoking control, and questionnaires were administered to 6 individuals at each site. The results were compared between the two investigation methods. RESULTS Among the 57 valid observation points, 24.6% (14/57) did not display any no-smoking signs. Outdoor SHS exposure rate from on-site observation P1 (observing someone smoking or smelling tobacco smoke), on-site observation P2 (observing someone smoking or smelling tobacco smoke or seeing cigarette butts) and questionnaire survey P3, were 59.6% (95% CI: 45.7-72.2), 91.1% (95% CI: 79.7-96.7) and 41.0% (95% CI: 35.5-46.7), respectively. CONCLUSIONS The outdoor SHS exposure in areas frequented by minors in the urban district of Hangzhou City remains high, coupled with a lack of awareness of SHS risks among underage individuals. Therefore, controlling outdoor SHS exposure in these key areas is a critical public health issue in Hangzhou, requiring further tobacco control efforts. On-site observation is an important and supplementary research method to investigate outdoor SHS exposure, especially to describe the SHS exposure of focus areas.
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Affiliation(s)
- Yuhuan Sun
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Dahui Wang
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Yang Yi
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Hongkun Chen
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Yuchen Zhou
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Geyao Huang
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Falin Zhao
- School of Public Health, Hangzhou Normal University, Hangzhou, China
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3
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Sun S, Zhang T, Yu H, Xia T, Yao Y, Sun M, Liang H, Huang Q, Wang W, Yang H, Hong X. Time trends in Alzheimer's disease mortality attributable to metabolic risks and smoking in China from 1990 to 2019: an age-period-cohort analysis. Front Aging Neurosci 2024; 16:1425577. [PMID: 39026988 PMCID: PMC11256009 DOI: 10.3389/fnagi.2024.1425577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 06/18/2024] [Indexed: 07/20/2024] Open
Abstract
Background With the increase in the aging population worldwide, Alzheimer's disease has become a rapidly increasing public health concern. In the Global Burden of Disease Study 2019, there are three risk factors judged to have evidence for a causal link to Alzheimer's disease and other dementias: smoking, high body-mass index (HBMI), and high fasting plasma glucose (HFPG). Objective This study aimed to analyze trends in AD mortality and the relevant burden across China from 1990 to 2019, as well as their correlation with age, period, and birth cohort. Methods The data were extracted from the GBD 2019. Trends in AD mortality attributable to metabolic risks (HFPG and HBMI) and smoking were analyzed using Joinpoint regression. The age-period-cohort (APC) model was used to evaluate cohort and period effects. Results From 1990 to 2019, the overall age-standardized mortality rate of AD increased, especially in women. There was an increase in AD mortality due to smoking in the net drift, and it was more significant in women (0.46, 95%CI = [0.09, 0.82]) than men (-0.03, 95%CI = [-0.11, 0.05]). For the cause of HFPG, the net drift values for men and women were 0.82% and 0.43%. For HBMI, the values were 3.14% and 2.76%, respectively, reflecting substantial increases in AD mortality. Conclusion Time trends in AD mortality caused by metabolic risks and smoking in China from 1990 to 2019 have consistently increased. Therefore, it is necessary to prevent excessive weight gain and obesity during the later stages of life, especially for females.
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Affiliation(s)
- Simeng Sun
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Ting Zhang
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Hao Yu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Ting Xia
- Monash Addiction Research Centre, Monash University, Clayton, VIC, Australia
| | - Yunan Yao
- Nantong Center for Disease Control and Prevention, Nantong, Jiangsu, China
| | - Mengting Sun
- Nanjing Drum Tower Hospital, Nanjing, Jiangsu, China
| | - Hongmei Liang
- Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiaoyu Huang
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Weiwei Wang
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Huafeng Yang
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Xin Hong
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu, China
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Shen YX, Lee PS, Teng MC, Huang JH, Wang CC, Fan HF. Influence of Cigarette Aerosol in Alpha-Synuclein Oligomerization and Cell Viability in SH-SY5Y: Implications for Parkinson's Disease. ACS Chem Neurosci 2024; 15:1484-1500. [PMID: 38483468 PMCID: PMC10995954 DOI: 10.1021/acschemneuro.3c00771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 03/17/2024] Open
Abstract
Although cigarette aerosol exposure is associated with various adverse health issues, its impact on Parkinson's disease (PD) remains elusive. Here, we investigated the effect of cigarette aerosol extract (CAE) on SH-SY5Y cells for the first time, both with and without α-synuclein (α-Syn) overexpression. We found that α-Syn aggravates CAE-induced cell death, oxidative stress, and mitochondrial dysfunction. Fluorescence cross-correlation spectroscopy (FCCS) revealed a dual distribution of α-Syn within the cells, with homogeneous regions indicative of monomeric α-Syn and punctated regions, suggesting the formation of oligomers. Moreover, we observed colocalization of α-Syn oligomers with lysosomes along with a reduction in autophagy activity. These findings suggest that α-Syn overexpression exacerbates CAE-induced intracellular cytotoxicity, mitochondrial dysfunction, and autophagy dysregulation, leading to elevated cell mortality. Our findings provide new insights into the pathogenic mechanisms linking exposure to cigarette aerosols with neurodegenerative diseases.
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Affiliation(s)
- Yu-Xin Shen
- Institute
of Medical Science and Technology, National
Sun Yat-sen University, Kaohsiung 804, Taiwan
- Department
of Chemistry, National Sun Yat-sen University, Kaohsiung 804, Taiwan
- Aerosol
Science Research Center, National Sun Yat-sen
University, Kaohsiung 804, Taiwan
| | - Pe-Shuen Lee
- Institute
of Medical Science and Technology, National
Sun Yat-sen University, Kaohsiung 804, Taiwan
- Department
of Chemistry, National Sun Yat-sen University, Kaohsiung 804, Taiwan
- Aerosol
Science Research Center, National Sun Yat-sen
University, Kaohsiung 804, Taiwan
| | - Ming-Chu Teng
- Institute
of Medical Science and Technology, National
Sun Yat-sen University, Kaohsiung 804, Taiwan
- Department
of Chemistry, National Sun Yat-sen University, Kaohsiung 804, Taiwan
- Aerosol
Science Research Center, National Sun Yat-sen
University, Kaohsiung 804, Taiwan
| | - Jhih-Hong Huang
- Department
of Chemistry, National Sun Yat-sen University, Kaohsiung 804, Taiwan
- Aerosol
Science Research Center, National Sun Yat-sen
University, Kaohsiung 804, Taiwan
| | - Chia C. Wang
- Department
of Chemistry, National Sun Yat-sen University, Kaohsiung 804, Taiwan
- Aerosol
Science Research Center, National Sun Yat-sen
University, Kaohsiung 804, Taiwan
| | - Hsiu-Fang Fan
- Institute
of Medical Science and Technology, National
Sun Yat-sen University, Kaohsiung 804, Taiwan
- Department
of Chemistry, National Sun Yat-sen University, Kaohsiung 804, Taiwan
- Aerosol
Science Research Center, National Sun Yat-sen
University, Kaohsiung 804, Taiwan
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Wan Z, Zhang X, He H, Zhang Y, Chen GC, Qin LQ, Zhang N, Li FR. Secondhand Smoke Exposure and Risk of Dementia in Nonsmokers: A Population-Based Cohort Study. Neuroepidemiology 2024; 58:166-173. [PMID: 38417408 DOI: 10.1159/000535828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 12/06/2023] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND Large population-based prospective studies are necessary to provide clarification on the associations of panoramic secondhand smoking burden, including prenatal and postnatal secondhand smoke (SHS) exposure, with the risk of developing dementia. METHODS Our study comprised a sample of 353,756 dementia-free individuals from the UK Biobank who were nonsmokers had data on the exposure of maternal smoking as well as SHS exposure in daily life, which was quantified in terms of hours per week (h/week) and whether they lived with household smokers. Multivariable Cox regression models were utilized to analyze the independent and joint associations of maternal smoking and daily life SHS exposure with dementia risk. RESULTS During a median follow-up of 11.8 years, 4,113 participants developed dementia. Compared with those who lived in the environment without smokers, multivariable-adjusted hazard ratios (HRs) (95% CIs) were 1.11 (1.02, 1.20) and 1.31 (1.13, 1.52) for those who exposed to SHS for >0 but ≤4 h/week and >4 h/week, respectively, and was 1.25 (1.13, 1.39) for those who lived with smokers in the household. A positive history of maternal smoking was associated with a modestly higher risk of dementia (HR = 1.07; 95% CI: 1.01, 1.15). Furthermore, compared with participants with neither history of maternal smoking nor exposure to SHS, a particularly higher risk of dementia was observed among those with both exposures (HR = 1.48; 95% CI: 1.18, 1.86). Additionally, the HR (95% CI) was 1.32 (1.10, 1.59) when comparing participants with a history of maternal smoking who lived with smokers in their households with those who had neither exposures. CONCLUSIONS Having a history of maternal smoking, longer exposure to SHS, and living with smokers in the household were each associated with an increased risk of developing dementia. Individuals who were simultaneously exposed to maternal smoking and SHS or lived with household smokers had a particularly higher dementia risk.
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Affiliation(s)
- Zhongxiao Wan
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - Xiaohui Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - Huanying He
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - Yebing Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - Guo-Chong Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - Li-Qiang Qin
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - Na Zhang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fu-Rong Li
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
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Martin SS, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Barone Gibbs B, Beaton AZ, Boehme AK, Commodore-Mensah Y, Currie ME, Elkind MSV, Evenson KR, Generoso G, Heard DG, Hiremath S, Johansen MC, Kalani R, Kazi DS, Ko D, Liu J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Perman SM, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Tsao CW, Urbut SM, Van Spall HGC, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Palaniappan LP. 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association. Circulation 2024; 149:e347-e913. [PMID: 38264914 DOI: 10.1161/cir.0000000000001209] [Citation(s) in RCA: 182] [Impact Index Per Article: 182.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
BACKGROUND The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2024 AHA Statistical Update is the product of a full year's worth of effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. The AHA strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional global data, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Tsao CW, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Beaton AZ, Boehme AK, Buxton AE, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Fugar S, Generoso G, Heard DG, Hiremath S, Ho JE, Kalani R, Kazi DS, Ko D, Levine DA, Liu J, Ma J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Virani SS, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association. Circulation 2023; 147:e93-e621. [PMID: 36695182 DOI: 10.1161/cir.0000000000001123] [Citation(s) in RCA: 1560] [Impact Index Per Article: 1560.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year's worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Santiago JA, Quinn JP, Potashkin JA. Sex-specific transcriptional rewiring in the brain of Alzheimer’s disease patients. Front Aging Neurosci 2022; 14:1009368. [PMID: 36389068 PMCID: PMC9659968 DOI: 10.3389/fnagi.2022.1009368] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 10/11/2022] [Indexed: 11/28/2022] Open
Abstract
Sex-specific differences may contribute to Alzheimer’s disease (AD) development. AD is more prevalent in women worldwide, and female sex has been suggested as a disease risk factor. Nevertheless, the molecular mechanisms underlying sex-biased differences in AD remain poorly characterized. To this end, we analyzed the transcriptional changes in the entorhinal cortex of symptomatic and asymptomatic AD patients stratified by sex. Co-expression network analysis implemented by SWItchMiner software identified sex-specific signatures of switch genes responsible for drastic transcriptional changes in the brain of AD and asymptomatic AD individuals. Pathway analysis of the switch genes revealed that morphine addiction, retrograde endocannabinoid signaling, and autophagy are associated with both females with AD (F-AD) and males with (M-AD). In contrast, nicotine addiction, cell adhesion molecules, oxytocin signaling, adipocytokine signaling, prolactin signaling, and alcoholism are uniquely associated with M-AD. Similarly, some of the unique pathways associated with F-AD switch genes are viral myocarditis, Hippo signaling pathway, endometrial cancer, insulin signaling, and PI3K-AKT signaling. Together these results reveal that there are many sex-specific pathways that may lead to AD. Approximately 20–30% of the elderly have an accumulation of amyloid beta in the brain, but show no cognitive deficit. Asymptomatic females (F-asymAD) and males (M-asymAD) both shared dysregulation of endocytosis. In contrast, pathways uniquely associated with F-asymAD switch genes are insulin secretion, progesterone-mediated oocyte maturation, axon guidance, renal cell carcinoma, and ErbB signaling pathway. Similarly, pathways uniquely associated with M-asymAD switch genes are fluid shear stress and atherosclerosis, FcγR mediated phagocytosis, and proteoglycans in cancer. These results reveal for the first time unique pathways associated with either disease progression or cognitive resilience in asymptomatic individuals. Additionally, we identified numerous sex-specific transcription factors and potential neurotoxic chemicals that may be involved in the pathogenesis of AD. Together these results reveal likely molecular drivers of sex differences in the brain of AD patients. Future molecular studies dissecting the functional role of these switch genes in driving sex differences in AD are warranted.
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Affiliation(s)
| | | | - Judith A. Potashkin
- Cellular and Molecular Pharmacology Department, Center for Neurodegenerative Diseases and Therapeutics, The Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States
- *Correspondence: Judith A. Potashkin,
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