To date, numerous projects have demonstrated that an ongoing limited access to nutritionally dense food (i.e., "food insecurity") plays a key role in the overall health and wellbeing of lower income at-risk populations. METHODSFor this 2019-2020 pilot project, the resident physician authors first created and administered a simple five-item questionnaire screening process to systematically identify food insecure patients in their metropolitan Detroit residency clinic. A sample of patients who had been identified as food insecure and pre-diabetic were then provided improved access to healthy foods, supplemented by a six-week program of nutritional education classes using a nationally recognized "Cooking Matters'' six-week long curriculum with a licensed chef and nutrition educator RESULTSAfter institutional review board approval, the authors enrolled a sample of 10 adults. The authors successfully measured both pre-and post-program Hemoglobin A1c (HbA1C) levels for all participants who completed the required course and subsequent clinic follow up visits. Using a series of initial non-parametric Wilcoxon Signed Rank matched pair tests, post-program follow-up at three months revealed statistically significant reductions in documented HbA1c levels from baseline for six enrolled patients (W=1, Z = -2.226, p = 0.026) and six-month follow up (i.e., more than four months after completion of the program) (W = 1, Z = -2.060, p = 0.039). In post-program surveys, each respondent indicated that they found the class content to be generally beneficial to increase their nutritional knowledge. CONCLUSIONSIn the authors' setting, this food insecurity program has subsequently led to a more formal screening process to evaluate and identify food insecure patients. The authors discuss the scheduling difficulties they experienced from the COVID-19 pandemic for their sample patients. However, these pilot results suggest that prolonged benefits may require ongoing "virtual" teaching sessions with pre-diabetic patients to address the complex factors influencing food insecurity levels identified in similar inner-city settings.Ghouse A, Gunther W, Sebastian M. Evaluation of a COVID-influenced Curriculum to Address Food Insecurity in a Detroit Family Medicine Residency Clinic. SMRJ. 2020;5(2).
McCune‐Albright Syndrome (MAS) is a human genetic disorder caused by a mutation that constitutively activates the Gs alpha subunit by abolishing GTP hydrolysis. Previous work in this laboratory modeled the MAS mutation in a yeast system, and identified an intragenic suppressor of the MAS mutation, which substituted two residues in the GTP‐binding site: L318P and D319V. To extend these studies, the human GNAS1 gene, encoding Gs alpha, was subjected to site‐directed mutagenesis. Constructs expressing the MAS mutation (R201H), the MAS mutation plus the mutations homologous to the yeast suppressors (R201H/F699P/D700V), the MAS mutation plus each of the amino acid changes in the yeast suppressor (R201H/F699P), (R201H/D700V), or the yeast suppressor mutation alone (F699P/D700V) were transfected into HEK293 cells, and basal and receptor‐stimulated cAMP levels were measured. R201H/F699P/D700V abolished the constitutive activity of the MAS mutation. Interestingly, F699P/D700V blocked the response to hCG. Cotransfection of F699P/D700V with R201H blocked the rise in basal cAMP. Thus, F669P/D700V acts as a dominant negative allele by competing with other G‐proteins for adenylyl cyclase, not the GPCR.
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