Olivia M. Thompson

Associations of dioxins, furans and dioxin-like PCBs with diabetes and pre-diabetes: is the toxic equivalency approach useful?

Toxic equivalency factors for dioxins and dioxin-like compounds have been established by the World Health Organization. Toxic equivalency (TEQ) was derived using 6 chlorinated dibenzo-p-dioxins, 9 chlorinated dibenzofurans and 8 polychlorinated biphenyls, in blood, from the 1999-2004 National Health and Nutrition Examination Survey. Relationships of 8 individual chemicals, the number of compounds elevated, and TEQ with pre-diabetes and total diabetes (diagnosed and undiagnosed) were investigated using logistic regressions. For the 8 chemicals analyzed separately, values above the 75th percentile were considered elevated, whereas for the other 15 compounds, values above the maximum limit of detection were considered elevated. Pre-diabetes with glycohemoglobin (A1c) 5.9-6.4% was associated with PCB 126, PCB 118 and having one or more compounds elevated (odds ratio 2.47, 95% CI 1.51-4.06). Pre-diabetes with A1c 5.7-5.8% was not associated with any individual chemical or the number of compounds elevated. Total diabetes was associated with 6 of the 8 individual compounds tested, and was associated with having 4 or more compounds elevated. Toxic equivalency ≥81.58 TEQ fg/g was associated with total diabetes (odds ratio 3.08, 95% CI 1.20-7.90), but was not associated with A1c 5.9-6.4%. Having multiple compounds elevated appeared to be important for total diabetes, whereas for pre-diabetes with A1c 5.9-6.4%, having a single compound elevated appeared most important. Diabetes plus A1c ≥5.9% was associated with 34.16-81.57 TEQ fg/g (odds ratio 2.00, 95% CI 1.06-3.77) and with ≥81.58 TEQ fg/g (odds ratio 2.48, 95% CI 1.21-5.11), indicating that half the population has elevated risk for this combination of conditions.

Farm to School Program Participation: An Emerging Market for Small or Limited-Resource Farmers?

We sought to examine the benefits and barriers of farm to school participation among small or limited-resource farmers in the Charleston tricounty area within South Carolina and to discuss food policy factors that contribute to both the scalability and sustainability of farm to school programs in South Carolina and nationwide. To achieve these objectives, we administered a modified version of the Farmer Survey developed by the Institute for Agriculture and Trade Policy and conducted qualitative research with area farmers. Study findings suggest that, before small or limited-resource farmers will be able to truly consider entering “school” markets, appropriate state- and local-level agriculture infrastructure supports (eg, food safety and good agriculture practice training, market-ready workshops, accessible value-add processing centers, and contract-grow procurement options) should be put in place. Moreover, farm to school trainings and networking events that include school foodservice directors, food distributers, and the farmers themselves should be sponsored by state and local organizations and conducted on a routine basis. Future research should be conducted at the state level (in South Carolina as well as in other states) to better understand farm to school participation benefits and barriers from the perspective of both the farmer and the school foodservice director.

Dioxins, furans and dioxin-like PCBs in human blood: causes or consequences of diabetic nephropathy?

Nephropathy, or kidney disease, is a major, potential complication of diabetes. We assessed the association of 6 chlorinated dibenzo-p-dioxins, 9 chlorinated dibenzofurans and 8 polychlorinated biphenyls (PCBs) in blood with diabetic nephropathy in the 1999-2004 National Health and Nutrition Examination Survey (unweighted N=2588, population estimate=117,658,357). Diabetes was defined as diagnosed or undiagnosed (glycohemoglobin ≥ 6.5%) and nephropathy defined as urinary albumin to creatinine ratio >30 mg/g, representing microalbuminuria or macroalbuminuria. For the 8 chemicals analyzed separately, values above the 75th percentile were considered elevated, whereas for the other 15 compounds values above the maximum limit of detection were considered elevated. Seven of 8 dioxins and dioxin-like compounds, analyzed separately, were found to be associated with diabetic nephropathy. The chemicals associated with diabetic nephropathy were: 1,2,3,6,7,8-Hexachlorodibenzo-p-dioxin; 1,2,3,4,6,7,8,9-Octachlorodibenzo-p-dioxin; 2,3,4,7,8-Pentachlorodibenzofuran; PCB 126; PCB 169; PCB 118; and PCB 156. Three of the 8 dioxins and dioxin-like compounds; 1,2,3,4,6,7,8,9-Octachlorodibenzo-p-dioxin; 2,3,4,7,8-Pentachlorodibenzofuran and PCB 118; expressed as log-transformed continuous variables; were associated with diabetes without nephropathy. When 4 or more of the 23 chemicals were elevated the odds ratios were 7.00 (95% CI=1.80-27.20) for diabetic nephropathy and 2.13 (95% CI=0.95-4.78) for diabetes without nephropathy. Log-transformed toxic equivalency (TEQ) was associated with both diabetic nephropathy, and diabetes without nephropathy, the odds ratios were 2.35 (95% CI=1.57-3.52) for diabetic nephropathy, and 1.44 (95% CI=1.11-1.87) for diabetes without nephropathy. As the kidneys function to remove waste products from the blood, diabetic nephropathy could be either the cause or the consequence (or both) of exposure to dioxins, furans and dioxin-like PCBs.

Association of DDT and heptachlor epoxide in human blood with diabetic nephropathy

Abstract Six organochlorine pesticides and pesticide metabolites in human blood were tested to determine their relationships with diabetic nephropathy. The data were derived from the National Health and Nutrition Examination Survey (NHANES) 1999–2004 (unweighted, n=2992, population estimate=133,088,752). The six chemicals were p,p′-DDT (dichlorodiphenyltrichloroethane), p,p′-DDE (dichlorodiphenyltrichloroethylene), beta-hexachlorocyclohexane, oxychlordane, trans-nonachlor and heptachlor epoxide. In this research, total diabetes included diagnosed and undiagnosed diabetes (glycohemoglobin, A1c ≥6.5%), and nephropathy was defined as a urinary albumin to creatinine ratio >30 mg/g, representing microalbuminuria and macroalbuminuria. The pesticide p,p′-DDT and pesticide metabolite heptachlor epoxide were significantly associated with total diabetes with nephropathy, with odds ratios of 2.08 (95% CI 1.06–4.11) and 1.75 (95% CI 1.05–2.93), respectively. Organochlorine pesticides are thought to act through the constitutive androstane receptor/pregnane X receptor disease pathway, but this is not well established. When p,p′-DDT and heptachlor epoxide were both elevated, the odds ratio for diabetic nephropathy was 2.76 (95% CI 1.31–5.81), and when six of six organochlorine pesticides and pesticide metabolites, were elevated, the odds ratio for diabetic nephropathy was 3.00 (95% CI 1.08–8.36). The differences in the odds ratios for these groups appear to be due to differences in the mean heptachlor epoxide concentration of each category. Organochlorine pesticides and pesticide metabolites are known to have estrogenic, antiestrogenic or antiandrogenic activity. The constitutive androstane receptor/pregnane X receptor pathway is thought to interact with the aryl hydrocarbon receptor pathway, and the associations noted may be due to that interaction.

Place-based economic development: examining the relationship between the US Supplemental Nutrition Assistance Program and farmers markets in Mississippi

Placed-based development theory assumes that assets and liabilities within a geographical context matter for community development. Drawing on this framework, this article argues that the United States Supplemental Nutrition Assistance Program (SNAP) at farmers markets is an underutilized asset for community development. Therefore, community developers should explore this asset to better develop sustainable farmers markets. The authors utilized the US National Farmers Market Directory and the SNAP Data System to determine if SNAP beneficiaries had access to use Electronic Benefit Transaction (EBT) cards at farmers markets in Mississippi. The findings indicate that SNAP accessibility at farmers markets remains an underutilized resource for capturing consumer spending and capitalizing on the local multiplier effect. The authors recommend that policy-makers and community developers enact and implement public policies that will: (1) assist farmers and farmers markets with enhancing SNAP accessibility by installing EBT card readers, (2) establish local coordination that will assist in supporting the utilization of SNAP benefits at farmers markets, and (3) incentivize SNAP beneficiaries to shop at local farmers markets by initiating “matching dollar” programs.

Farm-to-school programmes in the USA: An examination of state-level enacted, pending and vetoed or dead bills

Objectives: We sought to determine the prevalence and distribution of state-level legislation regulating farm-to-school programmes throughout the United States of America (USA). The research is timely given national goals put forth by the Let’s Move Campaign and the Healthy, Hunger-Free Kids Act to reduce childhood obesity prevalence and improve access to local foods in schools by 2015. Design and methods: The US Centers for Disease Control and Prevention’s (CDC) Database of State Legislative and Regulatory Action to Prevent Obesity and Improve Nutrition and Physical Activity and the national Farm-to-School Network’s database of legislation were used to conduct an online search of farm-to-school legislation in all 50 US states and the District of Columbia as of March 2012. Setting: Schools. Results: Our search identified a total of 43 bills (33 enacted bills, two pending bills, and eight vetoed or dead bills) that aimed to facilitate farm-to-school programmes. Of the enacted bills, their foci were described according to regional location and statewide or local impact, appropriation of funds, provision of other monetary incentives, establishment of a task force, and preference for purchasing local products. Conclusions: Given the successes of state-level laws regulating injury- and disease-related risk factors such as seatbelt and helmet use, tobacco use, and water fluoridation, we conclude that state-level legislation regulating dietary risk factors and, importantly, school nutrition environments may hold significant public health promise.

Assessing a School Gardening Program as an Integrated Component of a Pilot Farm-to-school Initiative Based in South Carolina

South Carolina public schools consistently rank low in academic performance. In addition, 39% of elementary, 40% of middle, and 30% of high school students within the state are classified as overweight or obese. School gardenbased learning (GBL) is a low-cost and high-impact initiative that addresses both poor academic performance and childhood obesity. This study examined how school-based gardens, as part of a pilot farm-to-school (FtS) initiative, are administered and used within academic and cafeteria meal programs. An online survey was developed and sent to 102 educators who previously completed an online training course entitled School Gardening for South Carolina Educators during the 2012–15 academic school years. Data were collected from 37 educators (36% response rate). Survey results indicate that the majority of these educators, although they completed the training course, were unaware that their garden was a component of an FtS program. Moreover, gardens were not integrated with school-wide programs, especially in the cafeteria: most gardens did not contribute food to the cafeteria and meals offered most often did not align with plants learned about in the gardens. Successes of the pilot program were that the majority of educators started and maintained their garden for over 1 year and they were able to use their gardens during the day for academic instruction in multiple disciplines, including math, science, and nutrition.

Diabetic nephropathy and organochlorine pesticides

Yves Tremblay is a full Professor at Laval University and in the Department of Obstetrics/Gynecology. He obtained his bachelor’s in 1980, and his Ph.D. in 1984. From 1985 to 1990, he pursued his post-doctoral training at the Louis Pasteur University in Strasbourg, then at the UCSF. In 1990, he became Professor at Laval University. He is recognized by the FRQS as a career research professor. He is also a member of Universite Laval’s Centre de recherche en biologie de la reproduction. He is the Director of the Quebec’s Respiratory Health Network. He is also a member of the Board of Directors of the Quebec Lung Association. Prenatal glucocorticoid administration and fetal lung maturation: Can we learn more?Rahul Ray is a Professor of Medicine at Boston University School of Medicine. He is an authority in the structure-function and cancer therapeutic areas of the vitamin D endocrine system. He has received numerous extra-mural grants and contracts for his research and four awarded patents. He has served as a member in several National Institutes of Health Study Sections and he is an editorial board member of steroid hormone-related journals. Ampi-109, a novel Vitamin D analog for androgen-insensitive prostate and renal cancerNarayan R. Bhat is a Professor in the department of Neurosciences at the Medical University of South Carolina (MUSC), Charleston. He got his Ph.D. in Biochemistry from the Indian Institute of Science, Bangalore and postdoctoral training in neurochemistry/neuroscience at Temple University, Philadelphia and Washington University in St. Louis following which, he moved to University of Kentucky, Lexington to take up a Junior faculty position where he was also associated with the Center on Aging. In 1991, he moved to MUSC as an Associate Professor in the department of Neurology and was then promoted to a Full Professor. Current research focus is on glia-mediated neuroinflammation relevant to mechanisms of neurodegeneration and repair, and the link between metabolic disorders and Alzheimer’s disease. He serves(d) on the editorial boards of J. Neurochem (2000-2010), J. Biol Chem (2003-) and J. Alz. Dis (2014-) and on NIH and VA Merit Review Study Sections. Diet, diabetes and Alzheimer’s diseaseStephanie Corriveau is a Ph.D. student from Université de Sherbrooke (Québec, Canada). Her work focuses on the prevention of preterm labor and more specifically, on the inhibition of myometrial contractile activity. She has already published 5 articles in international journals, among which an original observation in the Am J. of Physiol. Endocrinology and metabolism. She is a recipient of Ph.D. bursaries from both FRQS (Fond de Recherche du Québec-Santé) and Rx & D Health Research Foundation. She is the recipient of several awards from the Foundation of Stars, Club de Recherches Cliniques du Québec and the Université de Sherbrooke Faculty of Medicine and Health Sciences. Thyroid hormones modify uterine contractilityKhalid S. Al-Numair is currently a Professor of Community Nutrition Science and Policy in the College of Applied Medical Sciences, King Saud University. He obtained his Ph.D. in Community and Applied Nutrition from the University of Nebraska, USA He is a member of the Scientific Council at King Saud University, resides on several permanent committees and serves as consultant for the King Abdullah Ben Abdul-Aziz Research Chair for Food Security. He is also the recipient of several distinguished awards including the Prince Bandar Ben Sultan Al-Saud Academic Excellence Award for doctoral degree in 2004 and the King Saud University Outstanding Research Award in 2012. The primary focus of his research is nutrition and phytochemicals on health diseases. He has published more than 50 articles in peer-reviewed international journals and currently serves as an editorial board member and reviewer in reputed publications. Kaempferol, a dietary flavonoid improves glucose homeostasis in streptozotocin diabetic tissues by altering glycolytic and gluconeogenic enzymes: A possible role of insulinThomas C. Lee was raised in Toronto, Canada. He received his bachelor’s degree in Biochemical Studies at Harvard College and medical degree from McGill University. After completing a radiology residency and neuroradiology fellowship at the University of Toronto, he became an attending at Brigham & Women’s Hospital and Dana-Farber Cancer Institute in Boston, Massachusetts and instructor of radiology at Harvard Medical School. In early 2013 he became assistant section head of neuroradiology at Brigham & Women’s Hospital and Dana-Farber Cancer Institute. Currently he is co-authoring the neuroradiology textbook for Netter’s Correlative Imaging series to be completed this year. The utility of ct and MRI in diagnosis and image guided therapy of the thyroid and parathyroid glandsKathleen Rodgers completed her Ph.D. in 1984 and joined the faculty at the University of Southern California in 1986 after completing a postdoctoral fellowship. She has focused her career on drug discovery and preclinical development of therapies for the regeneration of damaged tissue. Currently she has developed several products with marketing approval and several others in clinical development including DSC127. She has published over 120 papers in the fields of toxicology, immunology, device development and exploitation of the renin angiotensin system as a platform for drug discovery. Development of DSC127 for the treatment of diabetic foot ulcersSalvatore Mancarella, Ph.D. is an Assistant Professor at the University of Tennessee Health Science Center. As a graduate student and postdoc he has devoted his career investigating how calcium fluctuations control cardiac contraction. Recently he is focusing on understanding how calcium signaling at the sub-membrane space is deciphered into the nucleus to control cell growth and proliferation. STIMDependent calcium signaling mediate smooth muscle and cardiac cell growthSpinal cord injury (SCI) is devastating and debilitating and, depending on the severity of injury, can lead to loss of neurological function, sphincter dysfunction, and paralysis. Healthy young adults are often affected, and there is no cure. The only treatment currently available is the use of methylprednisolone (MP) with limited efficacy. Therefore, new therapies must be developed and/or tested to protect cells and their processes for improvement/recovery of function. We have previously shown that use of high does estrogen (17β-estradiol) provided neuroprotection and improved locomotor function in experimental SCI in rats. Since this dose of estrogen (4 mg/kg) will never be used in clinics, the efficacy of low doses of estrogen (1-10 μg/kg) was tested in both acute and chronic animals following injury. Our findings in acute SCI indicated attenuation of astrogliosis, microgliosis, and inflammation and protection of cells, which were correlated with reduction of the expression of death genes Bax/Bcl2. This work was extended to chronic SCI studies (4-6 weeks) with administration of 10ug/kg estrogen given intravenously. Like the acute, analysis of tissue samples from chronic studies demonstrated reduction of inflammation and astroglial/microglial activation, promotion of microvessel growth, protection of neurons and oligodendrocytes, and preservation of axons. Locomotor function, as assessed using the BBB scale, demonstrated improvement at 4-6 weeks post-injury. These studies suggest that estrogen, by modulating different destructive pathways, has potential as an agent for treatment of individuals with SCI. Supported by grants from NIH and VA.Nephropathy, or kidney disease, is a major, potential complication of diabetes. We assessed the association of 6 chlorinated dibenzo-p-dioxins, 9 chlorinated dibenzofurans and 8 polychlorinated biphenyls (PCBs) in blood, with diabetic nephropathy in the 1999-2004 National Health and Nutrition Examination Survey (unweighted N=2,588, population estimate=117,658,357). Diabetes was defined as diagnosed or undiagnosed (glycohemoglobin >6.5%), and nephropathy defined as urinary albumin to creatinine ratio >30 mg/g, representing microalbuminuria or macroalbuminuria. For the 8 chemicals analyzed separately, values above the 75 th percentile were considered elevated, whereas for the other 15 compounds, values above the maximum limit of detection were considered elevated. Seven of 8 dioxins and dioxin-like compounds, analyzed separately, were found to be associated with diabetic nephropathy. The chemicals associated with diabetic nephropathy were: 1,2,3,6,7,8-Hexachlorodibenzo-p-dioxin; 1,2,3,4,6,7,8,9-Octachlorodibenzo-p-dioxin; 2,3,4,7,8entachlorodibenzofuran; PCB 126; PCB 169; PCB 118; and PCB 156. In contrast, only 2 of the 8 dioxins and dioxin-like compounds were associated with diabetes without nephropathy. When 4 or more of the 23 chemicals were elevated the odds ratios were 7.87 (95% CI=2.34-26.49) for diabetic nephropathy, and 1.95 (95% CI=0.88-4.33) for diabetes without nephropathy. As the kidneys function to remove waste products from the blood, diabetic nephropathy could be either the cause or the effect (or both) of exposure to dioxins, furans and dioxin-like PCBs. Diabetes with and without nephropathy should be analyzed as independent outcomes in future cross-sectional and longitudinal investigations.Insulin-like growth factor I (IGF-I) is normally produced from hepatocytes and various other sources including the pancreas. Acting through its receptor, IGF-IR, IGF-I promotes embryonic development, postnatal growth, and maturation of major organ systems. In order to explore novel targets of IGF-I action within the pancreatic islets, we have recently performed a whole-genome DNA microarray analysis on total RNA prepared from IGF-I overexpressing islets and found ~100 genes specifically upor down-regulated. Prominently among them, CCN5 mRNA level was found increased 2.7 and 3.4 fold respectively in the islets of MT-IGF mice using microarray and real-time PCR; the protein level was increased 2fold in isolated islets from MT-IGF mice; using dual-labeled immunohistochemistry, CCN5 was normally expressed at low level in the β-cells of wild-type islets, but exhibited significant induction upon IGF-I overexpression. Our results demonstrated for the first time that CCN5 is expressed in the β-cells and its expression is stimulated by IGF-I overexpression. The IGF-I effect seemed to be directly on the islet cells as 6-24 h treatment increased CCN5 mRNA level significantly in parimary islets. To define the role of CCN5 in islet function, we stably overexpressed its cDNA in insulinoma MIN6 cells using pcDNA3.1 vector. Using Western blots, we confirmed that normally CCN5 expression was very low in those cells, and the level was increased 30-fold in stably transfected cell lines (MIN6-CCN5). To explore possible effect of CCN5 on cell proliferation, we detected 2-fold increases in the cell numbers of three independent lines of MIN6-CCN5 cells vs. parental cells after 3-d culture, using MTT cell viability assay. In order to investigate intracellular mechanism, in CCN5-expressing cells, we detected 3-fold increase in the level of cyclin D1 which paralleled a 2-fold increase in the rate of Akt phosphorylation at Ser-473 and 2.5-fold elevation in Erk1/2 phosphorylation. It is established that β-cell replication is associated with increased cyclin D1 and CDK4 levels (1); deficiency in CDK4 or cyclin D2 results in reduced β-cell mass and type 1 diabetes. Our results suggest that CCN5 stimulates β-cell replication, by activating Akt and Erk1/2 kinases and increasing the levels of cyclin D1. Finally, CCN5 overexpressing cells were resistant to streptozotocin-induced cell death by decreasing the % apoptotic cells and the level of caspase-3 cleavage. CCN proteins are involved in cell adhesion and extracellular matrix remodelling, skeletal development and chondrogenesis, angiogenesis and wound repair, proliferation and tumorigenesis (2). Among them, CCN5 is a secreted protein of 29 kDa, known to play positive or negative roles in cell proliferation, carcinogen and other events (3). As a putative growth factor, its expression in breast cancer cells can be induced by steroid hormones, serum, EGF, phorbol esters and IGF-I (4). In normal human pancreas, the mRNA and protein expression was detected in both ducts and acini; however, its expression in endocrine islet cells has not been explored. We have shown that CCN5 is normally expressed in islet β-cells, IGF-I directly stimulates its expression, and IGF-I overexpression causes increased level in the islets. We further demonstrate CCN5 overexpression accelerates the proliferation of MIN6 cells, activates Akt and/or Erk1/2 kinase, and is anti-apoptotic against streptozotocin. Thus, increased CCN5 expression may mediate IGF-I stimulated islet cell growth and/or survival.Chronic hyperglycemia and hypercortisolemia have deleterious effect on the hippocampus, brain area responsible for learning and memory. We aimed to determine the relationship between hypercorticolemia and cognitive function with T2DM. Included were 57 patients. Cognition was tested using battery of psychometric testing (Mini-Mental State Examination or MMSE, Stanford Binet Test (4th edition) or SBST and Wechsler Memory Scale-Revised or WMS-R) and by recording P300 component of Event Related Potential (ERPs). Depression was assessed using Beck Depression Inventory (BDI-II). We also measured cortisol at basal state and after dexamethasone injection. Compared to controls (n=40), patients had lower scores of subsets and total scores of cognitive testing (MMSE, SBST and WMS-R) (P=0.004), abnormalities in P300 and higher depression scores (P=0.001). Comprehension, bead memory, memory for sentences, digit forward, digit backward, mental control, logical memory, total scores of cognitive testing, P300 amplitude and depression scores were markedly affected with poor glycemic control. Patients had high levels HbA1c and cortisol at basal state and after dexamethasone. This relationship was only significant in presence of poor glycemic control after controlling for age, duration of illness and dyslipidemia. We concluded that hypercortisolemia appears to exacerbate cognition dysfunction in T2DM only in presence of poor glycemic control.Nephropathy, or kidney disease, is a major, potential complication of diabetes. We assessed the association of 6 organochlorine pesticides, and pesticide metabolites, in blood, with diabetic nephropathy in the 1999-2004 National Health and Nutrition Examination Survey (NHANES). Diabetes was defined as diagnosed or undiagnosed (glycohemoglobin >6.5%), and nephropathy defined as urinary albumin to creatinine ratio >30 mg/g, representing microalbuminuria or macroalbuminuria. The proportion of the sample with diabetic nephropathy was 2.4%, and proportion having diabetes without nephropathy was 5.3%. Only p,p ’ -DDT (dichlorodiphenyltrichloroethane) was associated with diabetic nephropathy. Beta-hexachlorocyclohexane, oxychlordane, trans-nonachlor, and heptachlor epoxide were associated with diabetes without nephropathy, but not with diabetic nephropathy, as might be expected given the relative sizes of each group. A metabolite of DDT, p,p ’ -DDE (dichlorodiphenyltrichloroethylene) was not associated with either diabetic nephropathy or diabetes without nephropathy. When all 6 pesticides, and pesticide metabolites were elevated the odds ratio (OR) for diabetic nephropathy was 3.39 (95% CI 1.23-9.29), which was higher then that of p,p ’ -DDT alone. When one or more of the 6 compounds were elevated, there was a strong association with diabetes without nephropathy (OR=3.64, 95% CI 1.78-7.44). These results differ from what we expected given the associations of dioxin and dioxin-like compounds with diabetic nephropathy that we found previously. As the kidneys function to remove waste products from the blood, diabetic nephropathy could be either the cause or the effect (or both) of exposure to DDT. Diabetes with and without nephropathy should be analyzed as independent outcomes in future investigations involving DDT.Susan J. Appel has completed her Ph.D. at the University of North Carolina at Chapel Hill and postdoctoral studies from Georgetown University and the NINR NIH. She is a Professor in the Capstone College of Nursing at: The University of Alabama in Tuscaloosa Alabama. Having been a RN for 33 years, and a NP for 18 years, She also maintains a clinical practice as an Acute Care and Family Nurse Practitioner within a Hospitalist group. She has conducted research and published in the area of cardiometabolic risk and advanced diabetes management. Discovering a slowly developing type 1 diabetes in adulthood: A case study of Latent Autoimmune Diabetes of Adulthood (LADA)Camel milk is different from other ruminant milk; having low cholesterol; low sugar; high minerals especially Zinc; high vitamin C; low protein and large concentrations of insulin. In Saudi Arabia, camel milk is traditionally used for many medical approaches. The study was designed to investigate the antihyperglycemic effect of camel milk on streptozotocin (STZ)-diabetic rats. Diabetes was induced in adult male albino rats of the Wistar strain, weighing 180–200 g, by administration of streptozotocin (40 mg/kg of body weight) intraperitoneally. Diabetic rats showed increase of plasma glucose and glycosylated haemoglobin (HbA1c) and a decrease of plasma insulin and haemoglobin (Hb). Activities of gluconeogenic enzymes such as glucose 6-phosphatase, fructose 1, 6-bisphosphatase increased and glucokinase, glucose 6-phosphate dehydrogenase decreased in the liver along with glycogen. Oral administration of camel milk 250 ml for 45 days prevented the above changes and improved towards normalcy. Histological study of pancreas and liver also confirmed the biochemical findings. These results indicate that camel milk possesses antihyperglycemic effect on longterm treatment and its effect was comparable with glibenclamide.Nils Habbe graduated from Medical School of the University Marburg in 2004 and completed his M.D. in 2005. Furthermore, he worked from 20072008 as a postdoctoral fellow at the Johns Hopkins School of Medicine, Baltimore, USA. In 2010, Nils Habbe became a board-certified surgeon and serves since January 2012 as a consultant at the Department of General and Visceral Surgery of the University Hospital Frankfurt, Germany. He has published and co-authored more than 25 papers in reputed journals. Surgical strategies and outcome in small bowel neuroendocrine tumors

Association of dioxins, furans and dioxin-like PCBs in human blood with nephropathy among US teens and young adults.

Abstract We assessed the association of three chlorinated dibenzo-p-dioxins, a chlorinated dibenzofuran, and four dioxin-like polychlorinated biphenyls (PCBs) in human blood with nephropathy (microalbuminuria or macroalbuminuria) among teens and young adults (12–30 years old) having normal glycohemoglobin (A1c <5.7%). The data were derived from the 1999–2004 National Health and Nutrition Examination Survey (unweighted n=1504, population estimate=38,806,338). In this paper, nephropathy refers to normal A1c with nephropathy. In an all-adult sample (Everett CJ, Thompson OM. Dioxins, furans and dioxin-like PCBs in human blood: causes or consequences of diabetic nephropathy? Environ Res 2014;132:126–31), the cut-offs for these chemicals being considered elevated, were defined as the 75th percentile. Using these same cut-offs again, the proportion of those with one or more of the eight dioxin-like compounds elevated was 9.9%. The four chemicals associated with nephropathy were 1,2,3,6,7,8-hexachlorodibenzo-p-dioxin, PCB 126, PCB 169, and PCB 156. The proportion with one or more of these four dioxin-like chemicals elevated was 3.9% (unweighted n=46) and the odds ratio (OR) for nephropathy was 7.1 [95% confidence interval (CI) 1.8–28.1]. The association was strong among females (OR 17.4, 95% CI 3.4–88.6), but among males there were no cases of nephropathy when one or more of the four dioxin-like chemicals were elevated, and therefore no association. In a separate analysis, elevated toxic equivalency, defined using the eight dioxin-like chemicals (TEQ8), was associated with nephropathy. TEQ8 ≥50.12 fg/g included 2.6% of the sample (unweighted n=28) and had an OR of 5.8 (95% 1.3–25.9) for nephropathy. As found in the analysis of one or more of four dioxin-like chemicals elevated, TEQ8 ≥50.12 fg/g was associated with nephropathy among females (OR 11.9, 95% CI 1.6–87.2), but not males. Trends for least-squares means also differed by gender, but there were no significant differences in mean TEQ8 between normal subjects and those having nephropathy in either males or females. We also evaluated pre-diabetes (A1c 5.7–6.4%) without nephropathy and found no associations when one or more of four dioxin-like compounds were elevated, or when TEQ8 was ≥50.12 fg/g. In this study, associations of dioxin-like chemicals with nephropathy were found among females at an early age. Prospective studies are needed to determine if dioxin-like compounds cause nephropathy, or if these relationships are cases of reverse causation.

Farm-to-School Programming in South Carolina: An Economic Impact Projection Analysis

Farm-to-school (F2S) programs are among the new and innovative initiatives that are emerging from the local food systems movement. These programs connect K–12 schools with local farms with the objectives of improving the access and availability of healthful, local foods while at the same time supporting area small- to medium-sized farmers. Researchers have demonstrated that F2S programs are beneficial for both youth and farmers because program participation is associated with improved wellness among youth and a better economic outlook among farmers. Importantly, however, though F2S benefits abound, there are many challenges that oftentimes must be overcome for F2S implementation to be fully realized. This research examines the F2S movement nationally and explores the potential economic impacts associated with the initiative within South Carolina.