Although Vibrio cholerae is an important human pathogen, little is known about its populations in regions where the organism is endemic but where cholera disease is rare. A total of 31 independent isolates confirmed as V. cholerae were collected from water, sediment, and oysters in 2008 and 2009 from the Great Bay Estuary (GBE) in New Hampshire, a location where the organism has never been detected. Environmental analyses suggested that abundance correlates most strongly with rainfall events, as determined from data averaged over several days prior to collection. Phenotyping, genotyping, and multilocus sequence analysis (MLSA) revealed a highly diverse endemic population, with clones recurring in both years. Certain isolates were closely related to toxigenic O1 strains, yet no virulence genes were detected. Multiple statistical tests revealed evidence of recombination among strains that contributed to allelic diversity equally as mutation. This relatively isolated population discovered on the northern limit of detection for V. cholerae can serve as a model of natural population dynamics that augments predictive models for disease emergence.Vibrio cholerae is a ubiquitous waterborne bacterium found commonly in estuarine environments (37). Although V. cholerae is comprised of over 200 serotypes, only serotypes O1 and O139 are currently responsible for epidemic and pandemic cholera outbreaks (1,9,14,15,37,49,57,60). Closely related clones of types O1 and O139 are found rarely in the environment and only in warm waters (16,54). Whereas these pandemic serotypes and their associated populations have been the subjects of intense study, investigations of the remaining ecotypes are less common (29, 31-33, 36, 53). Yet other serotypes could be reservoirs of new pathogenic lineages that emerge by horizontal transfer and recombination. Recombination has been observed in several V. cholerae collections (31, 61) and is thought to have driven the emergence of new infective variants (16).Only 40 domestically acquired toxigenic V. cholerae cases have been reported in the United States since 1995 (66), but epidemics are ongoing in warm, subtropical climates, the most recent occurring in Haiti, which had been cholera-free for decades (6). Variation in disease incidence is caused in part by transmission between patients by feces-contaminated drinking water and by endemic populations of toxigenic cholera organisms in warm subtropical environments (11,12,37). Endemic cholera has not posed a public health threat in temperate regions in modern times (38, 60). Toxigenic O1 and O139 serotypes of V. cholerae are not regularly isolated from temperate waters in the United States, but some environmental non-O1/non-O139 populations, a few of which are associated with disease, have been described (11,31,43,58). Even so, the pathogenic potential and ecology of most endemic populations are not well understood.Here we describe the genotypic and phenotypic characteristics of a newly identified and highly diverse population of non-O1 V. cholerae is...

Posttraumatic stress disorder (PTSD) is increasingly recognized as a relatively common condition that is associated with poor health, including obesity. With a sizable proportion of the population approaching older adulthood, it is important to understand PTSD health associations in the context of age. Participants were recruited from two Veterans Administration medical centers and included 380 patients age 60 and over and 365 under age 60. PTSD diagnosis was determined by the Clinician Administered PTSD Scale. BMI was trichotomized into normal/under (≤.24.9), overweight (25.0–29.9), and obese (≥30.0). Models were run in the total sample, as well as stratified by age group, and adjusted for demographics, depression, antipsychotic medication use, and physical activity. Current PTSD was associated with greater likelihood of overweight and obesity in the total sample, and lifetime PTSD was associated with significantly increased odds of obesity. In the stratified models, current and lifetime PTSD were associated with increased likelihood of overweight and obesity in the older group only. Results suggest that PTSD is associated with risk for overweight and obesity, an effect that may be particularly strong in older adults. These findings support the importance of examining PTSD and potential health correlates across the life course.

Abstract-This pilot study assessed the effects of cardiopulmonary exercise testing and cardiorespiratory fitness on plasma neuropeptide Y (NPY), allopregnanolone and pregnanolone (ALLO), cortisol, and dehydroepiandrosterone (DHEA), and their association with pain sensitivity. Medication-free traumaexposed participants were either healthy (n = 7) or experiencing comorbid chronic pain/posttraumatic stress disorder (PTSD) (n = 5). Peak oxygen consumption (VO 2 ) during exercise testing was used to characterize cardiorespiratory fitness. Peak VO 2 correlated with baseline and peak NPY levels (r = 0.66, p < 0.05 and r = 0.69, p < 0.05, respectively), as well as exercise-induced changes in ALLO (r = 0.89, p < 0.001) and peak ALLO levels (r = 0.71, p < 0.01). NPY levels at the peak of exercise correlated with pain threshold 30 min after exercise (r = 0.65, p < 0.05), while exercise-induced increases in ALLO correlated with pain tolerance 30 min after exercise (r = 0.64, p < 0.05). In contrast, exercise-induced changes in cortisol and DHEA levels were inversely correlated with pain tolerance after exercise (r = -0.69, p < 0.05 and r = -0.58, p < 0.05, respectively). These data suggest that cardiorespiratory fitness is associated with higher plasma NPY levels and increased ALLO responses to exercise, which in turn relate to pain sensitivity. Future work will examine whether progressive exercise training increases cardiorespiratory fitness in association with increases in NPY and ALLO and reductions in pain sensitivity in chronic pain patients with PTSD.Abbreviations: ALLO = allopregnanolone and pregnanolone, ANOVA = analysis of variance, BMI = body mass index, CPT = cold pressor test, CPX = cardiopulmonary exercise testing, CSF = cerebrospinal fluid, CSU = clinical studies unit, CV = coefficient of variation, DHEA = dehydroepiandrosterone, DHEA(S) = DHEA-sulfate, DSM-IV = Diagnostic and Statistical Manual of Mental Disorders-4th Edition, EKG = electrocardiogram, GABA = gamma-aminobutyric acid, GC-MS = gas chromatography-mass spectrometry, IV = intravenous line, NPY = neuropeptide Y, OEF = Operation Enduring Freedom, OIF = Operation Iraqi Freedom, PTSD = posttraumatic stress disorder, RIA = radioimmunoassay, TC = trauma-exposed healthy control, VA = Department of Veterans Affairs, VO 2 = oxygen consumption.

Objective Patients with lung cancer experience significant declines in psychosocial and physical function during and after treatment that impact quality of life (QOL) and survival. Yoga is a potential strategy to mitigate functional decline among patients with lung cancer. Methods A single group 12‐week pilot trial of low‐moderate intensity yoga among patients with stage I‐IV lung cancer and their partners (n = 46; 23 patient‐partner dyads) during cancer treatment from two hospital systems. Feasibility, acceptability, descriptive statistics, and Cohen d effect sizes were calculated at 6 and 12‐weeks for psychosocial and physical outcomes using validated questionnaires and assessments. Results At 6 and 12‐weeks, retention was 65% and withdrawals were mainly due to disease progression. Among study completers (n = 26; 13 dyads) adherence was 80%. Comparing baseline to 12‐week measurements, fatigue, depression symptoms, and sleep disturbance improved in 54% of participants for all three measures (Cohen's d = 0.40‒0.53). QOL improved in 77% of participants (Cohen's d = 0.34). Upper and lower body flexibility, and lower body strength improved in 92%, 85% and 77% of participants, respectively (Cohen's d = 0.39‒1.08). Six‐minute walk test improved in 62% of participants an average of 32 meters (SD = 11.3; Cohen's d = 0.17). No serious adverse events were reported. Conclusions Among patients with stage I‐IV lung cancer including active treatment, a 12‐week partner‐supported yoga program is feasible, acceptable, and improved psychosocial and physical function. Low‐intensity yoga may be a complimentary approach to reduce the effects of cancer treatment, however, more research is needed to determine the efficacy of partner‐supported yoga to mitigate functional decline.