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Impact of Elexacaftor/Tezacaftor/Ivacaftor on Lipid and Fat‐Soluble Vitamin Levels and Association with Body Mass Index
Get PDFIntroduction:Cystic fibrosis transmembrane conductance regulator (CFTR) modulators improve gastrointestinal absorption of nutrients and may result in changes in body mass index (BMI), serum lipids, and fat-soluble vitamin levels. We hypothesized that serum lipids and vitamin levels would increase with CFTR modulator therapy and that greater increase in lipids and vitamin levels would be related to greater increase in BMI. Methods:A retrospective study was performed to evaluate the impact of elexacaftor/tezacaftor/ivacaftor (ETI) on nutritional parameters, serum lipids, and fat-soluble vitamin levels. Pre-ETI values (\u3c2 years prior) and post-ETI values (\u3e1 month after) were compared. Linear regression was used to evaluate whether change in BMI is associated with the change in lipid and/or vitamin levels and whether modulator duration is associated with the degree of rise in lipid and/or vitamin levels. Results:Adults and adolescents with CF (n = 137) were evaluated before and 31–300 days after starting ETI. Median BMI (adults 21.9 vs. 23.5 kg/m2; adolescents 48 vs. 63 percentile) increased after initiation of ETI. Total cholesterol (126 vs. 154 mg/dL), low-density lipoprotein cholesterol (63 vs. 78 mg/dL), non-high-density lipoprotein cholesterol (84 vs. 102 mg/dL), and high density lipoprotein cholesterol (43 vs. 49 mg/dL) increased after ETI, while triglycerides and very low density lipoprotein did not change. Median values for vitamin D (34.5 vs. 38.0 ng/mL) and vitamin A (40.1 vs. 47.9 µg/dL) increased, while vitamin E did not change significantly. There was no significant correlation between BMI change or duration of modulator therapy with vitamin levels or lipid changes. Conclusion:After initiation of ETI therapy, serum lipids increased in our population, but most values remained within the normal range. Vitamins A and D levels increased post-ETI and no changes were noted in vitamin E. No significant correlation between the degree of BMI change and the magnitude of increase in lipids or vitamin levels was found
A Synergistic Approach to Outreach and Teaching: Combining Service Learning at the College Level with a Summer Hands-on Outreach Program in Chemical and Biomolecular Engineering for High School Girls
Get PDFA synergetic approach to combine service learning at the university level with a high school outreach program is described. A holistic view is presented by discussing the importance of outreach and service learning, survey results, and outcomes. Overall, it was found that the unique program increased the self-efficacy (belief about one’s abilities) of students ranging from high school to graduate level, and positively impacted the social responsibility attitudes of university student participants
Variation in Diet and Leafy Browse Offerings AmongColobus Monkeys (Colobus spp.) and Langurs(Trachypithecus spp.) in AZA Facilities
Get PDFProviding nutritionally balanced diets is a key aspect of successful husbandry and can help support sustainable ex situ populations. This study focuses on the diets of zoo‐housed colobus monkeys (Colobus angolensis and C. guereza) and langurs (Trachypithecus cristatus and T. francoisi) across AZA institutions. We utilized survey responses from 34 institutions to (1)document the extent of dietary variation with regard to food categories and macronutrients offered, (2) assess interspecific variation in diets offered, and (3) identify important aspects of browse provisioning among institutions. A total of 95 different food items and 229 common‐name browse types were offered across institutions. Leafy greens was the only food category offered at every institution. The proportion of root and non‐root vegetables in the diet was highly variable. Nonstructural carbohydrates were the most variable macronutrient, and their concentrations were considerably higher than those food items consumed by free‐ranging colobines. Conversely, neutral detergent fiber and acid detergent fiber contents were more consistent across institutions but were notably lower than those of free‐ranging colobine food items. There were no significant interspecific differences in diets with regard to food categories or macronutrients offered. There was substantial variation in how frequently browse was offered, how it was regarded across zoos (either as diet, enrichment, or both), and whether or how it was quantified. This study provides context for future studies examining whether and how diet and macronutrient intake impact the behavior, health, and welfare of these populations
Managing the Cost of Services for People With Disabilities: An International Approach. Part I: Poland
Get PDFIntroduction: The cost of care for people with disabilities is rising, whereas all forms of support for them are decreasing. Countries and communities develop different ways to serve the disabled. We examined the comprehensive state of care from the perspective of cost management of services for individuals with disabilities in Poland. Method: This paper is based on a review of relevant international literature, with a special focus on the situation in Poland. A keyword search was completed in both Polish- and English-language databases. Results: In Poland, people with disabilities usually live with their families, and specialized services are offered outside the place of residence. Community and privately-owned housing resembling family homes is being developed. However, for many families with disabled members, such an option is unaffordable. Discussion: New policy programs are being developed to protect, care for, and support people with disabilities in Poland. However, some of these policies have not been implemented due to limited financial resources. Overall, the development of health care services offered in places where individuals with disabilities live improves their quality of life but also increases the costs of care
Avidity Maturation of Humoral Response Following Primary and Booster Doses of BNT162b2 mRNA Vaccine Among Nursing Home Residents and Healthcare Workers
Get PDFInfections, despite vaccination, can be clinically consequential for frail nursing home residents (NHR). Poor vaccine-induced antibody quality may add risk for such subsequent infections and more severe disease. We assessed antibody binding avidity, as a surrogate for antibody quality, among NHR and healthcare workers (HCW). We longitudinally sampled 112 NHR and 52 HCWs who received the BNT162b2 mRNA vaccine after each dose up to the Wuhan-BA.4/5-based Omicron bivalent boosters. We quantified anti-spike, anti-receptor binding domain (RBD), and avidity levels to the ancestral Wuhan, Delta, and Omicron BA.1 & 4/5 strains. The primary vaccination series produced substantial anti-spike and RBD levels which were low in avidity against all strains tested. Antibody avidity progressively increased in the 6–8 months that followed. Avidity significantly increased after the 1st booster but not for subsequent boosters. This study underscores the importance of booster vaccination among NHR and HCWs. The 1st booster dose increases avidity, increasing vaccine-induced functional antibody. The higher cross-reactivity of higher avidity antibodies to other SARS-CoV-2 strains should translate to better protection from ever-evolving strains. Higher avidities may help explain how the vaccine’s protective effects persist despite waning antibody titers after each vaccine dose
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