Dietary patterns, insulin sensitivity and inflammation in older adults

Background/Objectives

Several studies have linked dietary patterns to insulin sensitivity and systemic inflammation, which affect risk of multiple chronic diseases. The purpose of this study was to investigate the dietary patterns of a cohort of older adults, and examine relationships of dietary patterns with markers of insulin sensitivity and systemic inflammation.

Subjects/Methods

The Health, Aging and Body Composition (Health ABC) Study is a prospective cohort study of 3075 older adults. In Health ABC, multiple indicators of glucose metabolism and systemic inflammation were assessed. Food intake was estimated with a modified Block food frequency questionnaire (FFQ). In this study, dietary patterns of 1751 participants with complete data were derived by cluster analysis.

Results

Six clusters were identified, including a ‘Healthy foods’ cluster, characterized by higher intake of lowfat dairy products, fruit, whole grains, poultry, fish and vegetables. In the main analysis, the ‘Healthy foods’ cluster had significantly lower fasting insulin and HOMA-IR than the ‘Breakfast cereal’ and ‘High-fat dairy products’ clusters, and lower fasting glucose than the ‘High-fat dairy products’ cluster (P ≤ 0.05). No differences were found in 2-hour glucose. With respect to inflammation, the ‘Healthy foods’ cluster had lower IL-6 than the ‘Sweets and desserts’ and ‘High-fat dairy products’ clusters, and no differences were seen in CRP or TNF-α.

Conclusions

A dietary pattern high in lowfat dairy products, fruit, whole grains, poultry, fish and vegetables may be associated with greater insulin sensitivity and lower systemic inflammation in older adults.

The Bacillus subtilis DivIVA protein has a sporulation-specific proximity to Spo0J

The Bacillus subtilis DivIVA protein controls the positioning of the division site and the relocation of the chromosome during sporulation. By performing coimmunoprecipitation experiments, we demonstrated that a myc-DivIVA protein is in proximity to FtsZ and MinD during vegetative growth and Spo0J during the first 120 min of sporulation.

Identification of a polar targeting determinant for Bacillus subtilis DivIVA

The Bacillus subtilis protein DivIVA controls both the positioning of the vegetative cell division site and the polar attachment of the chromosome during sporulation. In vegetative growth DivIVA attracts the bipartite cell division inhibitor MinCD away from the cell centre and towards the cell pole. This process ensures the inactivation of old polar division sites and leaves the cell centre free for the assembly of a new cell division complex. During sporulation MinCD and DivIVA levels fall, but DivIVA remains at the cell poles and becomes involved in the migration of the chromosomes to the pole. In order to investigate polar targeting of DivIVA, we undertook a mutational analysis of the 164-amino-acid protein. These studies identified one mutant (divIVA(R18C)) that could not localize to the cell pole but which retained the ability to support both vegetative growth and 50% sporulation efficiency. Further analysis revealed that, in the absence of polar targeting, DivIVA(R18C) localized to the nucleoid during vegetative growth in a Spo0J/Soj-dependent manner and required Spo0J/Soj and MinD to orientate the chromosomes correctly during sporulation. We demonstrate that polar targeting of DivIVA(R18C) is not essential during vegetative growth because the mutant can recognize the cell division site and influences the localization of MinD. Similarly we show that DivIVA(R18C) can function during sporulation because it can support the Spo0J/Soj orientation of the chromosome. In addition, we establish that both residues 18 and 19 constitute a DivIVA polar targeting determinant.

You Can Make a Difference

Inaccuracies, injustices, bad advice, and insensitivity are irritating. Most of us feel powerless to do anything about such situations or don't have the time or energy to try to make changes. A strategy is described that allows the author to address her concerns. Examples are given of changes that occurred because of her efforts through writing letters. Childbirth educators become aware of policies and situations that need change; as advocates, they are encouraged to take the risk and enjoy the challenge of creating change.

The embryo MADS domain factor AGL15 acts postembryonically. Inhibition of perianth senescence and abscission via constitutive expression

AGL15 (AGAMOUS-like 15), a member of the MADS domain family of regulatory factors, accumulates preferentially throughout the early stages of the plant life cycle. In this study, we investigated the expression pattern and possible roles of postembryonic accumulation of AGL15. Using a combination of reporter genes, RNA gel blot analysis, and immunochemistry, we found that the AGL15 protein accumulates transiently in the shoot apex in young Arabidopsis and Brassica seedlings and that promoter activity is associated with the shoot apex and the base of leaf petioles throughout the vegetative phase. During the reproductive phase, AGL15 accumulates transiently in floral buds. When AGL15 was expressed in Arabidopsis under the control of a strong constitutive promoter, we noted a striking increase in the longevity of the sepals and petals as well as delays in a selected set of age-dependent developmental processes, including the transition to flowering and fruit maturation. Although ethylene has been implicated in many of these same processes, the effects of AGL15 could be clearly distinguished from the effects of the ethylene resistant1-1 mutation, which confers dominant insensitivity to ethylene. By comparing the petal breakstrength (the force needed to remove petals) for flowers of different ages, we determined that ectopic AGL15 had a novel effect: the breakstrength of petals initially declined, as occurs in the wild type, but was then maintained at an intermediate value over a prolonged period. Abscission-associated gene expression and structural changes were also altered in the presence of ectopic AGL15.

The MADS-domain protein AGAMOUS-like 15 accumulates in embryonic tissues with diverse origins

AGL15 (AGAMOUS-like 15), a member of the MADS-domain family of regulatory factors, accumulates preferentially in the organs and tissues derived from double fertilization in flowering plants (i.e. the embryo, suspensor, and endosperm). The developmental role of AGL15 is still undefined. If it is involved in embryogenesis rather than some other aspect of seed biology, then AGL15 protein should accumulate whenever development proceeds in the embryonic mode, regardless of the origin of those embryos or their developmental context. To test this, we used AGL15-specific antibodies to analyze apomictic embryogenesis in dandelion (Taraxacum officinale), microspore embryogenesis in oilseed rape (Brassica napus), and somatic embryogenesis in alfalfa (Medicago sativa). In every case, AGL15 accumulated to relatively high levels in the nuclei of the embryos. AGL15 also accumulated in cotyledon-like organs produced by the xtc2 (extra cotyledon2) mutant of Arabidopsis and during precocious germination in oilseed rape. Furthermore, the subcellular localization of AGL15 appeared to be developmentally regulated in all embryogenic situations. AGL15 was initially present in the cytoplasm of cells and became nuclear localized before or soon after embryogenic cell divisions began. These results support the hypothesis that AGL15 participates in the regulation of programs active during the early stages of embryo development.

The MADS domain protein AGL15 localizes to the nucleus during early stages of seed development

Little is known about regulatory factors that act during the earliest stages of plant embryogenesis. The MADS domain protein AGL15 (for AGAMOUS-like) is expressed preferentially during embryogenesis and accumulates during early seed development in monocotyledonous and dicotyledonous flowering plants. AGL15-specific antibodies and immunohistochemistry were used to demonstrate that AGL15 accumulates before fertilization in the cytoplasm in the cells of the egg apparatus and moves into the nucleus during early stages of development in the suspensor, embryo, and endosperms. Relatively high levels of AGL15 are present in the nuclei during embryo morphogenesis and until the seeds start to dry in Brassica, maize, and Arabidopsis. AGL15 is associated with the chromosomes during mitosis, and gel mobility shift assays were used to demonstrate that AGL15 binds DNA in a sequence-specific manner. To assess whether AGL15 is likely to play a role in specifying the seed or embryonic phase of development, AGL15 accumulation was examined in Arabidopsis mutants that prematurely exit embryogenesis. lec1-2 mutants show an embryo-specific loss of AGL15 at the transition stage, suggesting that AGL15 interacts with regulators in the leafy cotyledons pathway.

AGL15, a MADS domain protein expressed in developing embryos

To extend our knowledge of genes expressed during early embryogenesis, the differential display technique was used to identify and isolate mRNA sequences that accumulate preferentially in young Brassica napus embryos. One of these genes encodes a new member of the MADS domain family of regulatory proteins; it has been designated AGL15 (for AGAMOUS-like). AGL15 shows a novel pattern of expression that is distinct from those of previously characterized family members. RNA gel blot analyses and in situ hybridization techniques were used to demonstrate that AGL15 mRNA accumulated primarily in the embryo and was present in all embryonic tissues, beginning at least as early as late globular stage in B. napus. Genomic and cDNA clones corresponding to two AGL15 genes from B. napus and the homologous single-copy gene from Arabidopsis, which is located on chromosome 5, were isolated and analyzed. Antibodies prepared against overexpressed Brassica AGL15 lacking the conserved MADS domain were used to probe immunoblots, and AGL15-related proteins were found in embryos of a variety of angiosperms, including plants as distantly related as maize. Based on these data, we suggest that AGL15 is likely to be an important component of the regulatory circuitry directing seed-specific processes in the developing embryo.

Envelope membrane proteins that interact with chloroplastic precursor proteins

The post-translational transport of cytoplasmically synthesized precursor proteins into chloroplasts requires proteins in the envelope membranes. To identify some of these proteins, label transfer cross-linking was performed using precursor to the small subunit of ribulose-1,5-bisphosphate carboxylase (prSSU) that was blocked at an early stage of the transport process. Two envelope proteins were identified: an 86-kD protein and a 75-kD protein, both present in the outer membrane. Labeling of both proteins required prSSU and could not be accomplished with SSU lacking a transit peptide. Labeling of the 75-kD protein occurred only when low levels of ATP were present, whereas labeling of the 86-kD protein occurred in the absence of exogenous ATP. Although both labeled proteins were identified as proteins of the outer envelope membrane, the labeled form of the 75-kD protein could only be detected in fractions containing mixed envelope membranes. Based on these observations, we propose that prSSU first binds in an ATP-independent fashion to the 86-kD protein. The energy-requiring step is association with the 75-kD protein and assembly of a translocation contact site between the inner and outer membrane of the chloroplastic envelope.

The business of being an expert witness and legal consultant

Nurses serve as expert witnesses and provide legal and other consultation for which they receive compensation. Although numerous articles describe the process of serving as an expert witness and providing consultation, the business aspects of such consultation is seldom addressed. Most nurses have little experience in managing the business and financial aspects of such consultation. To be a successful consultant, clinical expertise and business acumen are necessary. Suggestions are given for creating a system of record keeping, keeping track of expenses, billing for services, reporting expenses and income for tax purposes, and marketing services.

Inbreeding avoidance in rhesus macaques: whose choice?

Whether nonhuman primates avoid copulating with close kin living in their social group is controversial. If sexual aversion to relatives occurs, it should be stronger in females than in males because of females' greater investment in each offspring and hence greater costs resulting from less viable offspring. Data presented here show that adult male rhesus macaques breeding in their natal groups at Cayo Santiago experienced high copulatory success, but copulated less with females of their own matrilineages than with females of other matrilineages. Adult females were never observed to copulate with males of their own matrilineage during their fertile periods. Although natal males sometimes courted their relatives, examination of two measures of female mate choice showed that females chose unrelated natal males over male kin. Female aversion to male kin was specific to the sexual context; during the birth season, females did not discriminate against their male relatives in distributing grooming. Evolved inbreeding avoidance mechanisms probably produce different outcomes at Cayo Santiago than in wild rhesus macaque populations. Gender differences in sexual aversion to relatives may be partly responsible for differences between studies in reported frequency of copulations by related pairs.

The neuroscience nurse as an expert witness

Serving as an expert witness in cases alleging nursing negligence is an interesting, rewarding and stressful role. Having knowledge about qualifications of an expert, what is expected of the expert, how to assess adequacy of nursing care, and how to bill for services may lower the stress. If after careful consideration you choose to serve as an expert witness, you should experience satisfaction knowing you are fulfilling a professional responsibility to maintain standards of care and to protect nurses accused unjustly of negligence.

The clinical nurse specialist as expert witness

A clinical nurse specialist is an ideal expert witness in cases alleging nursing negligence. Nurses choose to serve in this capacity for a variety of reasons. As an expert witness, a clinical nurse specialist may act as a consultant, review medical records, give depositions, translate medical jargon, testify in court, educate attorneys, suggest questions for attorneys to ask of witnesses, and provide opinions about the standard of care a client received. Guidelines for qualifications of an expert, reviewing medical records, preparing opinions, and testifying are given. Reactions to serving as an expert are discussed.

Dopamine beta-hydroxylase deficiency. A genetic disorder of cardiovascular regulation

Dopamine beta-hydroxylase (DBH) deficiency is a genetic disorder in which affected patients cannot synthesize norepinephrine, epinephrine, and octopamine in either the central nervous system or the peripheral autonomic neurons. Dopamine acts as a false neurotransmitter in their noradrenergic neurons. Neonates with DBH deficiency have had episodic hypothermia, hypoglycemia, and hypotension, but survivors sometimes cope relatively well until late childhood when overwhelming orthostatic hypotension profoundly limits their activities. The hypotension may be so severe that clonic seizures supervene. Most currently recognized patients are young or middle-aged adults. The diagnosis is established by the observation of severe orthostatic hypotension in a patient whose plasma norepinephrine/dopamine ratio is much less than one.

Synthetic analogues of a transit peptide inhibit binding or translocation of chloroplastic precursor proteins

Although amino-terminal transit peptides of chloroplastic precursor proteins are known to be necessary and sufficient for import into chloroplasts, the mechanism by which they mediate this process is not understood. Another important question is whether different precursors share a common transport apparatus. We used 20-residue synthetic peptides corresponding to regions of the transit peptide of the precursor to the small subunit of ribulose bisphosphate carboxylase (prSS) as competitive inhibitors for the binding and translocation of precursor proteins into chloroplasts. Synthetic peptides with sequences corresponding to either end of the transit peptide had little to no effect on binding of prSS to chloroplasts, but significantly inhibited its translocation. Synthetic peptides corresponding to the central region of the transit peptide inhibited binding of prSS to chloroplasts. Each of the peptides inhibited binding or translocation of precursors to light-harvesting chlorophyll a/b protein, ferredoxin, and plastocyanin in the same manner and to a similar extent as prSS transport was inhibited. The results presented in this paper suggest that the central regions of the transit peptide of prSS mediate binding to the chloroplastic surface, whereas the ends of this transit peptide are more important for translocation across the envelope. Furthermore, all of the precursors tested appear to share components in the transport apparatus even though they are sorted to different chloroplastic compartments.

Linkage analysis of the human dopamine beta-hydroxylase gene

The human gene for dopamine beta-hydroxylase (D beta H) has been mapped to chromosome 9q34. Using polymerase chain reaction amplification of exon 11 of the D beta H gene followed by digestion of the reaction products with FnuDII (BstUI), we detected a low-frequency restriction fragment length polymorphism (RFLP). The CEPH panel of family DNAs was genotyped for this RFLP, enabling us to determine the linkage relationships between D beta H and four other loci previously mapped to human chromosome 9q. We obtained two-point recombination frequencies (theta) between D beta H and arginosuccinate synthetase (theta = 0, LOD = 7.37), the ABO blood group locus (theta = 0, LOD = 4.5), CRI-P111 (theta = 0, LOD = 2.1), and D9S31 (theta = .06, LOD = 2.81).

Molecular cloning and characterization of the spaB gene of Streptococcus sobrinus

A gene of Streptococcus sobrinus 6715 (serotype g) designated spaB and encoding a surface protein antigen was isolated from a cosmid gene bank. A 5.4 kb HindIII/AvaI DNA fragment containing the gene was inserted into plasmid pBR322 to yield plasmid pXI404. Analysis of plasmid-encoded gene products showed that the 5.4 kb fragment of pXI404 encoded a 195 kDa protein. Southern blot experiments revealed that the 5.4 kb chromosomal insert DNA had sequence similarity with genomic DNA of S. sobrinus 6715, S. sobrinus B13 (serotype d) and Streptococcus cricetus HS6 (serotype a). The recombinant SpaB protein (rSpaB) was purified and monospecific antiserum was prepared. With immunological techniques and the anti-rSpaB serum, we have shown: (1) that the rSpaB protein has physico-chemical and antigenic identity with the S. sobrinus SpaB protein, (2) the presence of cross-reactive proteins in the extracellular protein of serotypes a and d of the mutans group of streptococci and (3) that the SpaB protein is expressed on the surface of mutans streptococcal serotypes a, d and g.

In vitro and ex vivo evaluation of cyclic aminoalkyl benzilates as potential emission tomography ligands for the muscarinic receptor

A series of muscarinic antagonists were screened as potential receptor imaging agents. (+)2 alpha-tropanyl benzilate (TRB), N-methyl-4-piperidyl benzilate (NMPB) and several analogs amenable to labeling with positron emitting isotopes were evaluated for muscarinic binding to mouse brain tissue in vitro and ex vivo using [3H]quinuclidinyl benzilate as the probe. The in vitro assay directly compared the innate binding affinities of the compounds. The rank order of binding (IC50) was TRB (0.7 nm), QNB (0.8 nm), scopolamine (1.3 nm) and NMPB (1.6 nm). The ex vivo assay was used to gain information regarding the pharmacokinetics and brain penetration of the compounds in live animals. Ex vivo results demonstrated that TRB was rapidly taken up into the brain and was equipotent with QNB in occupying muscarinic binding sites at early time points, but TRB binding decreased twice as fast over time as QNB binding. The results suggest TRB would be a good candidate for radiolabeling and further study.

Teaching tools made by peers: a novel approach to medical preparation

Materials created by patients who have undergone medical procedures and surgery are being used by the health team at Miller Children's Hospital to help prepare other children for their hospital experiences. The materials include booklets written by children about their tests and surgeries, drawings illustrating their hospital experiences, and photographs of treatment rooms and equipment. These booklets are compiled, along with supplies associated with the tests and surgeries, into attractively decorated boxes. Case studies have shown that the input from peers who have created the preparation materials is well received by patients and has added credibility to the teaching sessions. The creators of the preparation boxes have also benefitted by helping other children and by putting their own hospital experiences into perspective.

Fetal surgery for congenital hydronephrosis

Fetal surgery is a treatment approach to anatomic lesions which, if left untreated, may be incompatible with life. Diagnosis of conditions amenable to surgical treatment has become possible because of recent advances in ultrasonography. Correction of such lesions may interrupt the pathologic process and enable the infant to live a normal life. Currently, fetal surgical treatment at the University of California, San Francisco, is limited to correction of posterior urethral valve obstruction and ureteropelvic junction obstruction. Two procedures have been used at the university for surgical correction of anomalies of the urinary tract of the fetus: an open technique and a closed technique. The procedures, parental responses to the treatment, and the role of the clinical specialist in the care of patients having this experimental surgery are described.

Calcium, sodium, and the calcium paradox

The effect of "sodium loading," of verapamil and of nifedipine on the gain in calcium and sodium, and on the loss of myoglobin, during the calcium paradox in adult rat hearts was examined. Raising cell sodium from 56.5 +/- 2.6 to 129.5 +/- 10.2 mumol sodium/gram dry weight did not alter the degree or rate of calcium gain or myoglobin release during calcium repletion after long periods (greater than 2 minutes) of calcium-free perfusion; under these conditions, and in the presence of 10 micrograms/liter verapamil, calcium gain was enhanced. However, after shorter periods (0.5-1.5 minutes), of calcium-free perfusion, calcium gain was enhanced in "sodium-loaded" hearts, even in the absence of verapamil, and particularly during the early stages of repletion. The presence of 1 and 10 mumol/liter dl-verapamil and 1 mumol/liter nifedipine before, during, and after 10 minutes of calcium-free perfusion significantly (P less than 0.01) slowed the early (up to 1 minute for verapamil and 2 minutes for nifedipine) but not the late gain in calcium. When verapamil was present, the late gain in calcium was actually enhanced. These agents also abolished the early (45 seconds) but not the late (greater than 2 minutes) gain in sodium that occurs during repletion. We propose that the gain in calcium that occurs during calcium repletion after a period of calcium-free perfusion can be divided into at least two phases (early and late), and that the early phase contains a verapamil/nifedipine-sensitive component and a verapamil/nifedipine-insensitive component, the latter probably involving sodium-calcium exchange.

The biochemistry of uncontrolled calcium entry

The Ca2+ paradox is characterized by a rapid and uncontrolled entry of Ca2+. Whilst the consequence of the resultant gain in Ca2+ are relatively well defined, uncertainty exists concerning the route of entry. Possible routes include passive diffusion across damaged sarcolemma and intercalated discs, active transport in exchange for K+, or Na+, and entry through the voltage-activated, Ca2+-selective slow channels. The following experiments were designed to differentiate between these possibilities. Isolated spontaneously beating Sprague-Dawley rat hearts were perfused at 37 degrees C with Ca2+-free perfusion buffer for greater than 1 min before starting Ca2+ repletion. Adding 2-4 mmol l-1 Co2+ or Mn2+ before, during but not coincident with Ca2+ repletion protected against the paradox as indicated by an absence of myoglobin release and Ca2+ overload. Despite this protection marked distortion of the glycocalyx occurred, with splitting of the basement coat and blebbing. The intercalated discs, however, remained intact. It seems unlikely therefore that splitting of the basement coat necessarily results in an uncontrolled entry of Ca2+. Since Mn2+ and Co2+ block Ca2+ entry through the slow channels their failure to prevent the uncontrolled entry of Ca2+ when added at the time of Ca2+ repletion favours the view that Ca2+ entry during the paradox does not depend upon entry of Ca2+ through the slow channels. In other experiments hearts were preloaded with Na+, to alter intracellular Na+ before Ca2+ repletion. This procedure did not markedly affect the gain in Ca2+. These findings will be discussed in terms of the route(s) and consequence(s) of the uncontrolled entry of Ca2+ that occurs when Ca2+ is reintroduced after a period of Ca2+-free perfusion.

Parents' perceptions of their newborn following structured interactions

A study of 57 married couples and their normal-term firstborn infants investigated (a) if parents' perceptions are related to behavior of infants and (b) if a structured interaction of parent with infant positively influences parents' perceptions of their infant. Mothers, fathers, or parents in three experimental groups participated in a structured interaction with their infants. Parents and infants in a control group received no structured interaction. The interaction consisted of the parents assessing their infant using the Mother's Assessment of the Behavior of Her Infant (MABI). Infants' behaviors were measured with the Neonatal Behavioral Assessment Scale (NBAS) and parents' perceptions with the Neonatal Perception Inventories (NPI). There was no relation between infant behavior and parental perception. The factor structure of NBAS items was similar to that found by other investigators. The structured interaction differentially affected perception scores of mothers at Time 2 (F 3, 53 = 3.96, p = .013). Perceptions of mothers and fathers achieved some congruence over time (Time 1, r = .18, p = .189; Time 2, r = .45, p = .001; Time 3, r = .41, p = .002). Seven other variables contributed more to variance in mothers' than fathers' perceptions.