Folic acid ingestion improves skeletal muscle blood flow during graded handgrip and plantar flexion exercise in aged humans.

Skeletal muscle blood flow is attenuated in aged humans performing dynamic exercise, which is due, in part, to impaired local vasodilatory mechanisms. Recent evidence suggests that folic acid improves cutaneous vasodilation during localized and whole body heating through nitric oxide-dependent mechanisms. However, it is unclear whether folic acid improves vasodilation in other vascular beds during conditions of increased metabolism (i.

Age Modulates Physiological Responses during Fan Use under Extreme Heat and Humidity.

Purpose: We examined the effect of electric fan use on cardiovascular and thermoregulatory responses of nine young (26 ± 3 yr) and nine aged (68 ± 4 yr) adults exposed to extreme heat and humidity.

Methods: While resting at a temperature of 42°C, relative humidity increased from 30% to 70% in 2% increments every 5 min. On randomized days, the protocol was repeated without or with fan use.

Associations of Parity, Breastfeeding, and Fractures in the Women's Health Observational Study.

Objective: To examine associations of several aspects of parity and history of lactation with incident hip fractures and clinical fractures and, in a subset of women, with bone mineral density.

Methods: In this observational study, we analyzed data from 93,676 postmenopausal women participating in the Women's Health Initiative Observational Study and all bone density data from the subset of participants who underwent bone density testing at three clinical centers. At baseline, participants were aged 50-79 years.

What Happens to High-Cost Patients? An Analysis of the Trajectories of Billed Charges Over Time.

A growing literature documents the substantial burden that a small proportion of high-cost, medically complex patients impose on health care systems. However, it is not clear whether high-cost patients remain costly over time. This study looks at the monthly distribution of billed charges for a cohort of high-cost, medically complex patients enrolled in an intensive care management program in a university health care system, and finds that the billing trajectory is heterogeneous and highly nonlinear, characterized by a substantial spike in billed charges prior to identification, followed by a considerable drop prior to enrollment and a sustained drop thereafter.

Interaction of insulin-like growth factor-I and insulin resistance-related genetic variants with lifestyle factors on postmenopausal breast cancer risk.

Purpose: Genetic variants and traits in metabolic signaling pathways may interact with obesity, physical activity, and exogenous estrogen (E), influencing postmenopausal breast cancer risk, but these inter-related pathways are incompletely understood.

Methods: We used 75 single-nucleotide polymorphisms (SNPs) in genes related to insulin-like growth factor-I (IGF-I)/insulin resistance (IR) traits and signaling pathways, and data from 1003 postmenopausal women in Women's Health Initiative Observation ancillary studies. Stratifying via obesity and lifestyle modifiers, we assessed the role of IGF-I/IR traits (fasting IGF-I, IGF-binding protein 3, insulin, glucose, and homeostatic model assessment-insulin resistance) in breast cancer risk as a mediator or influencing factor.

Freedom of racist speech: Ego and expressive threats.

Do claims of "free speech" provide cover for prejudice? We investigate whether this defense of racist or hate speech serves as a justification for prejudice. In a series of 8 studies (N = 1,624), we found that explicit racial prejudice is a reliable predictor of the "free speech defense" of racist expression. Participants endorsed free speech values for singing racists songs or posting racist comments on social media; people high in prejudice endorsed free speech more than people low in prejudice (meta-analytic r = .

Gene-Hormone Therapy Interaction and Fracture Risk in Postmenopausal Women.

Context: Evidence supports a protective effect of menopausal hormone therapy (HT) on bone. However, whether genetic susceptibility modifies the association of HT and fracture risk is not sufficiently explored.

Objective: The objective was to test an interaction between genetic susceptibility and HT on fracture risk.

Time to Clinically Relevant Fracture Risk Scores in Postmenopausal Women.

Background: Clinical practice guidelines recommend use of fracture risk scores for screening and pharmacologic treatment decisions. The timing of occurrence of treatment-level (according to 2014 National Osteoporosis Foundation guidelines) or screening-level (according to 2011 US Preventive Services Task Force guidelines) fracture risk scores has not been estimated in postmenopausal women.

Methods: We conducted a retrospective competing risk analysis of new occurrence of treatment-level and screening-level fracture risk scores in postmenopausal women aged 50 years and older, prior to receipt of pharmacologic treatment and prior to first hip or clinical vertebral fracture.

Association of genetic variation in the tachykinin receptor 3 locus with hot flashes and night sweats in the Women's Health Initiative Study.

Objective: Vasomotor symptoms (VMS, ie, hot flashes or night sweats) are reported by many, but not all, women. The extent to which VMS are genetically determined is unknown. We evaluated the relationship of genetic variation and VMS.

Increased postural sway in persons with multiple sclerosis during short-term exposure to warm ambient temperatures.

Background: Multiple sclerosis (MS) is a neurological disease marked by demyelination and axonal loss. Individuals with MS experience increases in clinical signs and symptoms during heat exposure.

Objective: To test the hypothesis that moderate heat exposure adversely affects postural sway in individuals with MS.

Cost-effectiveness of denosumab versus oral alendronate for elderly osteoporotic women in Japan.

Unlabelled: We constructed a Markov microsimulation model among hypothetical cohorts of community-dwelling elderly osteoporotic Japanese women without prior hip or vertebral fractures over a lifetime horizon. Compared with weekly oral alendronate for 5 years, denosumab every 6 months for 5 years is cost-saving or cost-effective at a conventionally accepted threshold.

Introduction: The objective of the study was to examine the cost-effectiveness of subcutaneous denosumab every 6 months for 5 years compared with weekly oral alendronate for 5 years in Japan.

The influence of genetic susceptibility and calcium plus vitamin D supplementation on fracture risk.

Fracture is a complex trait, affected by both genetic and environmental factors. A meta-analysis of genome-wide association studies (GWASs) identified multiple bone mineral density (BMD) and fracture-associated loci. We conducted a study to evaluate whether fracture genetic risk score (Fx-GRS) and bone mineral density genetic risk score (BMD-GRS) modify the association between the intake of calcium with vitamin D (CaD) and fracture risk.

Association of sleep disturbance and sexual function in postmenopausal women.

Objective: Sleep disturbance and sexual dysfunction are common in menopause; however, the nature of their association is unclear. The present study aimed to determine whether sleep characteristics were associated with sexual activity and sexual satisfaction.

Methods: Sexual function in the last year and sleep characteristics (past 4 wk) were assessed by self-report at baseline for 93,668 women age 50 to 79 years enrolled in the Women's Health Initiative (WHI) Observational Study (OS).

Electrospun Regenerated Cellulose Nanofiber Membranes Surface-Grafted with Water-Insoluble Poly(HEMA) or Water-Soluble Poly(AAS) Chains via the ATRP Method for Ultrafiltration of Water.

Electrospun nanofiber membranes (ENMs) have demonstrated promising applications for water purification primarily due to high water flux and low degree of fouling. However, the equivalent/apparent pore sizes of as-electrospun ENMs are in microns/submicrons; therefore, the ENMs can only be directly utilized for microfiltration applications. To make regenerated cellulose (RC) ENMs for ultrafiltration applications, atom transfer radical polymerization (ATRP) was studied to graft polymer chains onto the surface of RC nanofibers; specifically, monomers of 2-hydroxyethyl methacrylate (HEMA) and sodium acrylate (AAS) were selected for surface-grafting water-insoluble and water-soluble polymer chains onto RC nanofibers, respectively.

Resuscitative endovascular balloon occlusion of the aorta in trauma patients in youth.

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) has received increasing attention for critically uncontrolled hemorrhagic shock. However, the efficacy of REBOA in patients in youth is unknown.

Objectives: The aim of this study was to evaluate the mortality and characteristics of patients of age ≤18 years with severe traumatic injury who received REBOA.

Plasma hyperosmolality improves tolerance to combined heat stress and central hypovolemia in humans.

Unlabelled: Heat stress profoundly impairs tolerance to central hypovolemia in humans via a number of mechanisms including heat-induced hypovolemia. However, heat stress also elevates plasma osmolality; the effects of which on tolerance to central hypovolemia remain unknown. This study examined the effect of plasma hyperosmolality on tolerance to central hypovolemia in heat-stressed humans.

Elevated skin and core temperatures both contribute to reductions in tolerance to a simulated haemorrhagic challenge.

What is the central question of this study? Combined increases in skin and core temperatures reduce tolerance to a simulated haemorrhagic challenge. The aim of this study was to examine the separate and combined influences of increased skin and core temperatures upon tolerance to a simulated haemorrhagic challenge. What is the main finding and its importance? Skin and core temperatures increase during many occupational settings, including military procedures, in hot environments.

Addressing Interpersonal Violence as a Health Policy Question Using Interprofessional Community Educators.

Introduction: The health effects of intimate partner violence (IPV) not only include physical injury, but can also manifest as posttraumatic stress disorder, anxiety, and others. US medical students report receiving inadequate training about IPV. This case-based tutorial for third-year medical students examines: (1) a clinical encounter with a patient experiencing several complex challenges including IPV and homelessness; (2) the implications of existing policy on the delivery of health care services; and (3) the impact of policies on patient choices.

Does attenuated skin blood flow lower sweat rate and the critical environmental limit for heat balance during severe heat exposure?

What is the central question of this study? Does attenuated skin blood flow diminish sweating and reduce the critical environmental limit for heat balance, which indicates maximal heat loss potential, during severe heat stress? What is the main finding and its importance? Isosmotic hypovolaemia attenuated skin blood flow by ∼20% but did not result in different sweating rates, mean skin temperatures or critical environmental limits for heat balance compared with control and volume-infusion treatments, suggesting that the lower levels of skin blood flow commonly observed in aged and diseased populations may not diminish maximal whole-body heat dissipation. Attenuated skin blood flow (SkBF) is often assumed to impair core temperature (T ) regulation. Profound pharmacologically induced reductions in SkBF (∼85%) lead to impaired sweating, but whether the smaller attenuations in SkBF (∼20%) more often associated with ageing and certain diseases lead to decrements in sweating and maximal heat loss potential is unknown.

Acute limb heating improves macro- and microvascular dilator function in the leg of aged humans.

Unlabelled: Local heating of an extremity increases blood flow and vascular shear stress throughout the arterial tree. Local heating acutely improves macrovascular dilator function in the upper limbs of young healthy adults through a shear stress-dependent mechanism but has no such effect in the lower limbs of this age group. The effect of acute limb heating on dilator function within the atherosclerotic prone vasculature of the lower limbs of aged adults is unknown.

No Increase in Fractures After Stopping Hormone Therapy: Results From the Women's Health Initiative.

Context: The Women's Health Initiative (WHI) hormone therapy (HT) trials showed protection against hip and total fractures, but a later observational report suggested loss of benefit and a rebound increased risk after cessation of HT.

Objective: The purpose of this study was to examine fractures after discontinuation of HT.

Design And Setting: Two placebo-controlled randomized trials served as the study setting.

Long-term oral bisphosphonate use in relation to fracture risk in postmenopausal women with breast cancer: findings from the Women's Health Initiative.

Objective: The aim of the study was to examine the association of long-term oral bisphosphonate use, compared with short-term use, with fracture risk among postmenopausal women with breast cancer.

Methods: We studied 887 postmenopausal women who were enrolled to the Women's Health Initiative from 1993 to 1998, diagnosed with breast cancer after enrollment, and reported current oral bisphosphonate use of 2 years or more on a medication inventory administered in 2008 to 2009. The outcome of any clinical fracture was ascertained by self-report on an annual study form; a subset of fractures was confirmed with medical records.

Longitudinal analysis of changes in weight and waist circumference in relation to incident vasomotor symptoms: the Study of Women's Health Across the Nation (SWAN).

Objective: Greater body mass index (BMI) and body fat are associated with vasomotor symptoms (VMS). Thus, weight loss may prevent VMS. We analyzed whether concurrent BMI or waist circumference and/or changes in weight or waist circumference predicted incident VMS and whether these relations differed by menopause stage or race/ethnicity.