Association between First Trimester Pregnancy Associated Plasma Protein–A and the Development of Gestational Diabetes Mellitus

Background: Gestational diabetes (GDM) is a common pregnancy complication with significant cardiometabolic consequences for mothers and offspring. Previous research from our group suggests that adipose tissue IGFBP-5 and its unique metalloprotease PAPP-A (Pregnancy Associated Plasma Protein-A) may play mechanistic roles in GDM development by regulating functional IGF-1 levels and lipid storage and metabolism. Aim: To examine the relationship between circulating PAPP-A levels and GDM development. We hypothesized that high first trimester PAPP-A levels would be associated with decreased GDM risk. Methods: A retrospective cohort of women delivering singleton gestations at UMass Memorial Healthcare (2009, 2010, 2014, 2015) was assembled by abstracting electronic medical records. PAPP-A was measured in first trimester (11-14 weeks), and reported as quartiles of multiples of the mean (MoM) based on gestational age and adjusted for maternal weight and race/ethnicity. GDM diagnosis based on standard 2-step protocol (~24-28 weeks; failed 50g 1hr glucola screen then ≥2 abnormal values per Carpenter-Coustan criteria on 100g 3hr glucose tolerance test). Crude and multivariable-adjusted logistic regression models estimated the association between PAPP-A MoM quartiles and GDM. Results: Women (N=1,251) were 29.7 (SD:5.7) years old and 12.5 (SD:0.6) weeks gestation at PAPP-A measurement. 7.6% (n=95) developed GDM. Median PAPP-A MoM were 0.7 (inter-quartile range [IQR]=0.5-1.0) among women with GDM and 0.9 (IQR=0.6-1.3) among controls; 39% versus 23% were in the 1st quartile, respectively. After adjusting for pre-pregnancy body mass index, nuchal translucency, crown rump length, smoking status, and parity, women with PAPP-A MoM in 2nd, 3rd, and 4th quartiles had 52% (OR=0.48, 95%CI=0.26-0.88), 45% (OR=0.55, 95%CI=0.30-0.99) and 73% (OR=0.27, 95%CI=0.13-0.53) lower odds of GDM compared to women in the 1st quartile. Conclusion: Higher PAPP-A MoM levels were associated with lower GDM risk. Future studies will assess whether higher PAPP-A levels are associated with enhanced IGF-1 signaling and improved pregnancy metabolic homeostasis

Association between First Trimester Pregnancy Associated Plasma Protein–A (PAPP-A) and Gestational Diabetes Mellitus Development

Background: Gestational diabetes (GDM) is a common pregnancy complication with significant cardiometabolic consequences for mothers and offspring. Previous research from our group suggests that adipose tissue IGFBP-5 and its unique metalloprotease PAPP-A (Pregnancy Associated Plasma Protein-A) may play mechanistic roles in GDM development by regulating functional IGF-1 levels and lipid storage and metabolism. Aim: To examine the relationship between circulating PAPP-A levels and GDM development. We hypothesized that high first trimester PAPP-A levels would be associated with decreased GDM risk. Methods: A retrospective cohort of women delivering singleton gestations at UMass Memorial Healthcare (2009, 2010, 2014, 2015) was assembled by abstracting electronic medical records. PAPP-A was measured in first trimester (11-14 weeks), and reported as quartiles of multiples of the mean (MoM) based on gestational age and adjusted for maternal weight and race/ethnicity. GDM diagnosis based on standard 2-step protocol (~24-28 weeks; failed 50g 1hr glucola screen then ≥2 abnormal values per Carpenter-Coustan criteria on 100g 3hr glucose tolerance test). Crude and multivariable-adjusted logistic regression models estimated the association between PAPP-A MoM quartiles and GDM. Results: Women (N=1,251) were 29.7 (SD:5.7) years old and 12.5 (SD:0.6) weeks gestation at PAPP-A measurement. 7.6% (n=95) developed GDM. Median PAPP-A MoM were 0.7 (inter-quartile range [IQR]=0.5-1.0) among women with GDM and 0.9 (IQR=0.6-1.3) among controls; 39% versus 23% were in the 1st quartile, respectively. After adjusting for pre-pregnancy body mass index, nuchal translucency, crown rump length, smoking status, and parity, women with PAPP-A MoM in 2nd, 3rd, and 4th quartiles had 52% (OR=0.48, 95%CI=0.26-0.88), 45% (OR=0.55, 95%CI=0.30-0.99) and 73% (OR=0.27, 95%CI=0.13-0.53) lower odds of GDM compared to women in the 1st quartile. Conclusion: Higher PAPP-A MoM levels were associated with lower GDM risk. Future studies will assess whether higher PAPP-A levels are associated with enhanced IGF-1 signaling and improved pregnancy metabolic homeostasis

What to do in case of an endoscopic image of gastric necrosis or ischaemia post-funduplication? A case report

The association of gastric ischemia with a fundoplication is very rare and its management is not always surgical. The present paper describes the mechanism of post-fundoplication gastric ischemia that occurred in a patient diagnosed with gastroesophageal reflux disease treated with a Nissen-type gastric fundoplication. A clinical case of the Foregut Clinic of the Hospital General de Mexico (HGM) is presented. This is a 24-year-old patient undergoing a Nissen-type fundoplication who was discharged without eventualities and who presented intestinal occlusion, acute gastric dilation and gastric ischemia

Adipose Tissue Inflammation in Diabetic versus Non-diabetic Pregnancies

Objective: Beyond weight associated with fetus, placenta, amniotic fluid and increased blood volume, adipose tissue (AT) expansion is an accepted and expected component of pregnancy weight gain. Normal pregnancy is associated with relative insulin resistance (IR). In non-pregnant humans, AT expansion has been associated with IR and AT inflammation. However, it is not known whether AT expansion and IR in pregnancy are also associated with AT inflammation. This pilot study examined relationships between AT expansion and inflammation in control versus diabetic pregnancies. Methods: Eligible subjects undergoing scheduled Cesarean delivery for obstetric indications were prospectively enrolled. Subjects provided demographic and anthropometric data, and biologic specimens. Immunofluorescence microscopy was performed on subcutaneous (SQ) and omental (OM) AT samples to evaluate macrophage infiltration. Included gravidas had paired AT samples and either negative glucola screening (controls) or gestational or pre-gestational Type 2 diabetes mellitus (T2DM). Results: 13 subjects with SQ and OM AT samples were evaluated (10-controls, 3-diabetics (2-T2DM and 1-GDM)). Mean BMI and gestational weight gain of controls was 27.8 kg/m2 (range 19.5-42) and 27.6 pounds (range 15-36) and of diabetics was 30.6 kg/m2 (range 30-33) and 19 pounds (range -3-30), respectively. Macrophage infiltration was seen in OM AT from 2/ 3 diabetics and 0/ 10 controls (see figure). Conclusions: These results indicate that AT expansion in non-diabetic pregnancies is not accompanied by macrophage infiltration. Thus, the IR of normal pregnancy is unlikely to be related to AT inflammation, and AT expansion per se does not lead to AT inflammation. However, as has been reported for T2DM in non-pregnant humans, the presence (T2DM) or development (GDM) of diabetes in pregnancy is associated with macrophage infiltration of AT. Despite the small sample size, the observed large differences in macrophage infiltration between controls and diabetics suggest that these findings will persist in a larger cohort

Understanding the 2016 yields and interactions between soils, crops, climate and management

Several technologies to forecast crop yields and soil nutrient dynamics have emerged over the past years. These include process-based models, statistical models, machine learning, aerial images, or combinations. These technologies are viewed as promising to assist Midwestern agriculture to achieve production and environmental goals, but in general, most of these technologies are in their initial stages of implementation. In June 2016 we launched a web-tool (http://crops.extension.iastate.edu/facts/) that provided real-time information and yield predictions for 20 combinations of crops and management practices. Our project, which is called FACTS (Forecast and Assessment of Cropping sysTemS), takes a systems approach to forecast and evaluate cropping systems performance. In this paper we report FACTS yield predictions accuracy against ground-truth measurements and analyzing factors responsible for achieving 200-240 bu/acre corn yield and 55-75 bu/acre soybean yields in the FACTS plots in 2016

Maize and soybean root front velocity and maximum depth in Iowa, USA

Quantitative measurements of root traits can improve our understanding of how crops respond to soil and weather conditions, but such data are rare. Our objective was to quantify maximum root depth and root front velocity (RFV) for maize (Zea mays) and soybean (Glycine max) crops across a range of growing conditions in the Midwest USA. Two sets of root measurements were taken every 10–15 days: in the crop row (in-row) and between two crop rows (center-row) across six Iowa sites having different management practices such as planting dates and drainage systems, totaling 20 replicated experimental treatments. Temporal root data were best described by linear segmental functions. Maize RFV was 0.62 ± 0.2 cm d−1 until the 5th leaf stage when it increased to 3.12 ± 0.03 cm d−1 until maximum depth occurred at the 18th leaf stage (860 °Cd after planting). Similar to maize, soybean RFV was 1.19 ± 0.4 cm d−1 until the 3rd node when it increased to 3.31 ± 0.5 cm d−1 until maximum root depth occurred at the 13th node (813.6 °C d after planting). The maximum root depth was similar between crops (P \u3e 0.05) and ranged from 120 to 157 cm across 18 experimental treatments, and 89–90 cm in two experimental treatments. Root depth did not exceed the average water table (two weeks prior to start grain filling) and there was a significant relationship between maximum root depth and water table depth (R2 = 0.61; P = 0.001). Current models of root dynamics rely on temperature as the main control on root growth; our results provide strong support for this relationship (R2 \u3e 0.76; P \u3c 0.001), but suggest that water table depth should also be considered, particularly in conditions such as the Midwest USA where excess water routinely limits crop production. These results can assist crop model calibration and improvements as well as agronomic assessments and plant breeding efforts in this region

Confined benzene within InOF-1: Contrasting CO2 and SO2 capture behaviours

The confinement of small amounts of benzene in InOF-1 (Bz@InOF-1) shows a contradictory behavior in the capture of CO2 and SO2. While the capture of CO2 is increased 1.6 times, compared to the pristine material, the capture of SO2 shows a considerable decrease. To elucidate these behaviors, the interactions of CO2 and SO2 with Bz@InOF-1 were studied by DFT periodical calculations postulating a plausible explanation: (a) in the case of benzene and CO2, these molecules do not compete for the preferential adsorption sites within InOF-1, providing a cooperative CO2 capture enhancement and (b) benzene and SO2 strongly compete for these preferential adsorption sites inside the MOF material, reducing the total SO2 capture