University of Hawaii at Manoa

About: University of Hawaii at Manoa is a education organization based out in Honolulu, Hawaii, United States. It is known for research contribution in the topics: Population & Poison control. The organization has 13693 authors who have published 25161 publications receiving 1023924 citations.

Prevalence of dementia in older Japanese-American men in Hawaii: The Honolulu-Asia Aging Study.

Abstract: Objective. —To determine prevalence of dementia and its subtypes in Japanese-American men and compare these findings with rates reported for populations in Japan and elsewhere. Design and Setting. —The Honolulu Heart Program is a prospective populationbased study of cardiovascular disease established in 1965. Prevalence estimates were computed from cases identified at the 1991 to 1993 examination. Cognitive performance was assessed using standardized methods, instruments, and diagnostic criteria. Participants. —Subjects were 3734 Japanese-American men (80% of surviving cohort) aged 71 through 93 years, living in the community or in institutions. Main Outcome Measures. —Age-specific, age-standardized, and cohort prevalence estimates were computed for dementia (all cause) defined by 2 sets of diagnostic criteria and 4 levels of severity. Prevalence levels for Alzheimer disease and vascular dementia were also estimated. Results. —Dementia prevalence byDiagnostic and Statistical Manual of Mental Disorders, Third Edition, Revisedranged from 2.1% in men aged 71 through 74 years to 33.4% in men aged 85 through 93 years. Age-standardized prevalence was 7.6%. Prevalence estimates for the cohort were 9.3% for dementia (all cause), 5.4% for Alzheimer disease (primary or contributing), and 4.2% for vascular dementia (primary or contributing). More than 1 possible cause was found in 26% of cases. The Alzheimer disease/vascular dementia ratio was 1.5 for cases attributed primarily to Alzheimer disease or vascular dementia. Conclusions. —Prevalence of Alzheimer disease in older Japanese-American men in Hawaii appears to be higher than in Japan but similar to European-ancestry populations. Prevalence of vascular dementia appears to be only slightly lower than in Japan, but higher than in European-ancestry populations. Further cross-national research with emphasis on standardized diagnostic methods is needed.

History of the Medical Home Concept

Abstract: “Every child deserves a medical home” is one of the American Academy of Pediatrics’ (AAP) essential child health outcomes for the 21st century. With increasing health care costs, technology, survivorship, specialization, and fragmentation of care, the medical home is steadily gaining interest and standing in the public eye. Today’s policy makers, those who are involved with children, and parents are increasingly using the term to describe the concept as the form of high-quality health care. With so much attention focused on this concept as the standard of care for all infants, children, adolescents, young adults, and particularly children with special health care needs (CSHCN), it is important to define this term and how its definition has evolved. Whereas the term was originally used to describe a place—a single source of all medical information about a patient—the term now refers to a partnership approach with families to provide primary health care that is accessible, family centered, coordinated, comprehensive, continuous, compassionate, and culturally effective.1 The first known documentation of the term “medical home” appeared in Standards of Child Health Care, a book published by the AAP in 1967 and written by the AAP Council on Pediatric Practice (COPP). The book defines a medical home as one central source of a child’s pediatric records and emphasizes the importance of centralized medical records to CSHCN. “For children with chronic diseases or disabling conditions, the lack of a complete record and a ‘medical home’ is a major deterrent to adequate health supervision. Wherever the child is cared for, the question should be asked, ‘Where is the child’s medical home?’ and any pertinent information should be transmitted to that place” (pp 77–79).2 The COPP, noting that care for CSHCN is often provided by many different practitioners who work in disparate locations independent of each … Reprint requests to (C.S.) 656 Paikau St, Honolulu, HI 96816-4406. E-mail: Calsia{at}pol.net

A molecular role for lysyl oxidase-like 2 enzyme in Snail regulation and tumor progression

Abstract: The transcription factor Snail controls epithelial–mesenchymal transitions (EMT) by repressing E-cadherin expression and other epithelial genes. However, the mechanisms involved in the regulation of Snail function are not fully understood. Here we show that lysyl-oxidase-like 2 and 3 (LOXL2 and LOXL3), two members of the lysyl-oxidase gene family, interact and cooperate with Snail to downregulate E-cadherin expression. Snail's lysine residues 98 and 137 are essential for Snail stability, functional cooperation with LOXL2/3 and induction of EMT. Overexpression of LOXL2 or LOXL3 in epithelial cells induces an EMT process, supporting their implication in tumor progression. The biological importance of LOXL2 is further supported by RNA interference of LOXL2 in Snail-expressing metastatic carcinoma cells, which led to a strong decrease of tumor growth associated to increased apoptosis and reduced expression of mesenchymal and invasive/angiogenic markers. Taken together, these results establish a direct link between LOXL2 and Snail in carcinoma progression.

Contribution of changes in atmospheric circulation patterns to extreme temperature trends

Abstract: This study identifies statistically significant trends in mid-atmospheric circulation patterns that partially explain observed changes in extreme temperature occurrence over Eurasia and North America; although the underlying cause of circulation pattern trends remains uncertain, most extreme temperature trends are shown to be consistent with thermodynamic warming. Changes in atmospheric circulation — the position of the jet stream or intertropical convergence zone for example — may be linked to changes in the occurrence of temperature extremes, but quantitative evidence is scarce. Daniel Horton and colleagues identify statistically significant trends in mid-atmospheric circulation patterns over Eurasia and North America, with the trends partially explaining observed changes in extreme temperature. At present, it is unclear whether these trends are related to greenhouse gas emissions or natural variability, and better-understood thermodynamic changes control more of the overall trends in extremes. But in some regions and for some types of extreme temperature events, shifts in atmospheric circulation are an important actor. Surface weather conditions are closely governed by the large-scale circulation of the Earth’s atmosphere. Recent increases in the occurrence of some extreme weather phenomena1,2 have led to multiple mechanistic hypotheses linking changes in atmospheric circulation to increasing probability of extreme events3,4,5. However, observed evidence of long-term change in atmospheric circulation remains inconclusive6,7,8. Here we identify statistically significant trends in the occurrence of atmospheric circulation patterns, which partially explain observed trends in surface temperature extremes over seven mid-latitude regions of the Northern Hemisphere. Using self-organizing map cluster analysis9,10,11,12, we detect robust circulation pattern trends in a subset of these regions during both the satellite observation era (1979–2013) and the recent period of rapid Arctic sea-ice decline (1990–2013). Particularly substantial influences include the contribution of increasing trends in anticyclonic circulations to summer and autumn hot extremes over portions of Eurasia and North America, and the contribution of increasing trends in northerly flow to winter cold extremes over central Asia. Our results indicate that although a substantial portion of the observed change in extreme temperature occurrence has resulted from regional- and global-scale thermodynamic changes, the risk of extreme temperatures over some regions has also been altered by recent changes in the frequency, persistence and maximum duration of regional circulation patterns.

Nonlinearity and Asymmetry of ENSO(.

Abstract: El Nino events (warm) are often stronger than La Nina events (cold). This asymmetry is an intrinsic nonlinear characteristic of the El Nino-Southern Oscillation (ENSO) phenomenon. In order to measure the nonlinearity of ENSO, the maximum potential intensity (MPI) index and the nonlinear dynamic heating (NDH) of ENSO are proposed as qualitative and quantitative measures. The 1997/98 El Nino that was recorded as the strongest event in the past century and another strong El Nino event in 1982/83 nearly reached the MPI. During these superwarming events, the normal climatological conditions of the ocean and atmosphere were collapsed com- pletely. The huge bursts of ENSO activity manifested in these events are attributable to the nonlinear dynamic processes. Through a heat budget analysis of the ocean mixed layer it is found that throughout much of the ENSO episodes of 1982/83 and 1997/98, the NDH strengthened these warm events and weakened subsequent La Nina events. This led to the warm-cold asymmetry. It is also found that the eastward-propagating feature in these two El Nino events provided a favorable phase relationship between temperature and current that resulted in the strong nonlinear dynamical warming. For the westward-propagating El Nino events prior to the late 1970s (e.g., 1957/58 and 1972/73 ENSOs) the phase relationships between zonal temperature gradient and current and between the surface and subsurface temperature anomalies are unfavorable for nonlinear dynamic heating, and thereby the ENSO events are not strong.