Fish oils (FOs) have anti-inflammatory effects and lower serum triglycerides. This study examined adipose and muscle inflammatory markers after treatment of humans with FOs and measured the effects of ω-3 fatty acids on adipocytes and macrophages in vitro. Insulin-resistant, nondiabetic subjects were treated with Omega-3-Acid Ethyl Esters (4 g/day) or placebo for 12 weeks. Plasma macrophage chemoattractant protein 1 (MCP-1) levels were reduced by FO, but the levels of other cytokines were unchanged. The adipose (but not muscle) of FO-treated subjects demonstrated a decrease in macrophages, a decrease in MCP-1, and an increase in capillaries, and subjects with the most macrophages demonstrated the greatest response to treatment. Adipose and muscle ω-3 fatty acid content increased after treatment; however, there was no change in insulin sensitivity or adiponectin. In vitro, M1-polarized macrophages expressed high levels of MCP-1. The addition of ω-3 fatty acids reduced MCP-1 expression with no effect on TNF-α. In addition, ω-3 fatty acids suppressed the upregulation of adipocyte MCP-1 that occurred when adipocytes were cocultured with macrophages. Thus, FO reduced adipose macrophages, increased capillaries, and reduced MCP-1 expression in insulin-resistant humans and in macrophages and adipocytes in vitro; however, there was no measureable effect on insulin sensitivity.

Background: Women's status and empowerment influence health, nutrition, and socioeconomic status of women and their children. Despite its benefits, however, research on women's empowerment in Sub-Saharan Africa (SSA) is limited in scope and geography. Empowerment is variably defined and data for comparison across regions is often limited. The objective of the current study was to identify domains of empowerment from a widely available data source, Demographic and Health Surveys, across multiple regions in SSA.Methods: Demographic and Health Surveys from nineteen countries representing four African regions were used for the analysis. A total of 26 indicators across different dimensions (economic, socio-cultural, education, and health) were used to characterize women's empowerment. Pooled data from all countries were randomly divided into two datasets—one for exploratory factor analysis (EFA) and the other for Confirmatory Factor Analysis (CFA)—to verify the factor structure hypothesized during EFA.Results: Four factors including attitudes toward violence, labor force participation, education, and access to healthcare were found to define women's empowerment in Central, Southern, and West Africa. However, in East Africa, only three factors were relevant: attitudes toward violence, access to healthcare ranking, and labor force participation. There was limited evidence to support household decision-making, life course, or legal status domains as components of women's empowerment.Conclusion: This foremost study advances scholarship on women's empowerment by providing a validated measure of women's empowerment for researchers and other stakeholders in health and development.

Context and ObjectiveAdipose tissue in insulin resistant subjects contains inflammatory cells and extracellular matrix components. This study examined adipose pathology of insulin resistant subjects who were treated with pioglitazone or fish oil.Design, Setting and ParticipantsAdipose biopsies were examined from nine insulin resistant subjects before/after treatment with pioglitazone 45 mg/day for 12 weeks and also from 19 subjects who were treated with fish oil (1,860 mg EPA, 1,500 mg DHA daily). These studies were performed in a clinical research center setting.ResultsPioglitazone treatment increased the cross-sectional area of adipocytes by 18% (p = 0.01), and also increased capillary density without affecting larger vessels. Pioglitazone treatment decreased total adipose macrophage number by 26%, with a 56% decrease in M1 macrophages and an increase in M2 macrophages. Mast cells were more abundant in obese versus lean subjects, and were decreased from 24 to 13 cells/mm2 (p = 0.02) in patients treated with pioglitazone, but not in subjects treated with FO. Although there were no changes in total collagen protein, pioglitazone increased the amount of elastin protein in adipose by 6-fold.ConclusionThe PPARγ agonist pioglitazone increased adipocyte size yet improved other features of adipose, increasing capillary number and reducing mast cells and inflammatory macrophages. The increase in elastin may better permit adipocyte expansion without triggering cell necrosis and an inflammatory reaction.

Background: Suicide rates in the United States have increased by 30% since 1999 and suicide is currently the 10 th leading cause of death. Suicide has also become one of the leading causes of death in pregnant and postpartum women. The aim of this study is to examine whether rurality affects the risk of suicide in pregnant and postpartum women. Methods: This study used data from the National Violent Death Reporting System, Restricted Access Dataset (2003-2012). Bivariate and multivariate analyses were used to first describe the pregnant and postpartum population versus non-pregnant females (ages 15-54), who all died by suicide, and then to examine urban-rural differences. Results: Rural suicide decedents were much older, married, less likely to have had a mental health diagnosis, and more likely to use a firearm. Recent intimate partner crisis and intimate partner problems were both associated with increased odds that the suicide decedent was pregnant or postpartum in both urban and rural counties, whereas presence of job problems and report of history of suicide attempt decreased the odds that the suicide decedent was pregnant or postpartum in both urban and rural counties. Multivariable polytomous logistic regression analyses revealed differences in suicide risk factors among pregnant, postpartum and non-pregnant decedents when stratified by rural and urban status. Conclusion: Our findings suggest that pregnant and postpartum women should be screened for risk of suicide, in the clinical setting, especially if there are intimate partner problems or a crisis. With proper identification and response, suicide in pregnant and postpartum women might be decreased.

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