Ethylene is involved in strawberry fruit ripening in an organ-specific manner

The fruit of the strawberry Fragaria×ananassa has traditionally been classified as non-climacteric because its ripening process is not governed by ethylene. However, previous studies have reported the timely endogenous production of minor amounts of ethylene by the fruit as well as the differential expression of genes of the ethylene synthesis, reception, and signalling pathways during fruit development. Mining of the Fragaria vesca genome allowed for the identification of the two main ethylene biosynthetic genes, 1-aminocyclopropane-1-carboxylic acid (ACC) synthase and ACC oxidase. Their expression pattern during fruit ripening was found to be stage and organ (achene or receptacle) specific. Strawberry plants with altered sensitivity to ethylene could be employed to unravel the role of ethylene in the ripening process of the strawberry fruit. To this end, independent lines of transgenic strawberry plants were generated that overexpress the Arabidopsis etr1-1 mutant ethylene receptor, which is a dominant negative allele, causing diminished sensitivity to ethylene. Genes involved in ethylene perception as well as in its related downstream processes, such as flavonoid biosynthesis, pectin metabolism, and volatile biosynthesis, were differently expressed in two transgenic tissues, the achene and the receptacle. The different transcriptional responsiveness of the achene and the receptacle to ethylene was also revealed by the metabolic profiling of the primary metabolites in these two organs. The free amino acid content was higher in the transgenic lines compared with the control in the mature achene, while glucose and fructose, and citric and malic acids were at lower levels. In the receptacle, the most conspicuous change in the transgenic lines was the depletion of the tricarboxylic acid cycle intermediates at the white stage of development, most probably as a consequence of diminished respiration. The results are discussed in the context of the importance of ethylene during strawberry fruit ripening.Facultad de Ciencias ExactasInstituto de Fisiología Vegeta

Ethylene is involved in strawberry fruit ripening in an organ-specific manner

The fruit of the strawberry Fragaria×ananassa has traditionally been classified as non-climacteric because its ripening process is not governed by ethylene. However, previous studies have reported the timely endogenous production of minor amounts of ethylene by the fruit as well as the differential expression of genes of the ethylene synthesis, reception, and signalling pathways during fruit development. Mining of the Fragaria vesca genome allowed for the identification of the two main ethylene biosynthetic genes, 1-aminocyclopropane-1-carboxylic acid (ACC) synthase and ACC oxidase. Their expression pattern during fruit ripening was found to be stage and organ (achene or receptacle) specific. Strawberry plants with altered sensitivity to ethylene could be employed to unravel the role of ethylene in the ripening process of the strawberry fruit. To this end, independent lines of transgenic strawberry plants were generated that overexpress the Arabidopsis etr1-1 mutant ethylene receptor, which is a dominant negative allele, causing diminished sensitivity to ethylene. Genes involved in ethylene perception as well as in its related downstream processes, such as flavonoid biosynthesis, pectin metabolism, and volatile biosynthesis, were differently expressed in two transgenic tissues, the achene and the receptacle. The different transcriptional responsiveness of the achene and the receptacle to ethylene was also revealed by the metabolic profiling of the primary metabolites in these two organs. The free amino acid content was higher in the transgenic lines compared with the control in the mature achene, while glucose and fructose, and citric and malic acids were at lower levels. In the receptacle, the most conspicuous change in the transgenic lines was the depletion of the tricarboxylic acid cycle intermediates at the white stage of development, most probably as a consequence of diminished respiration. The results are discussed in the context of the importance of ethylene during strawberry fruit ripening.Facultad de Ciencias ExactasInstituto de Fisiología Vegeta

Evaluating Computer Capabilities in a Primary Care Practice-Based Research Network

PURPOSE We wanted to assess computer capabilities in a primary care practice-based research network and to understand how receptive the practices were to new ideas for automation of practice activities and research. METHOD This study was conducted among members of the Pediatric Practice Research Group (PPRG). A survey to assess computer capabilities was developed to explore hardware types, software programs, Internet connectivity and data transmission; views on privacy and security; and receptivity to future electronic data collection approaches. RESULTS Of the 40 PPRG practices participating in the study during the autumn of 2001, all used IBM-compatible systems. Of these, 45% used stand-alone desktops, 40% had networked desktops, and approximately 15% used laptops and minicomputers. A variety of software packages were used, with most practices (82%) having software for some aspect of patient care documentation, patient accounting (90%), business support (60%), and management reports and analysis (97%). The main obstacles to expanding use of computers in patient care were insufficient staff training (63%) and privacy concerns (82%). If provided with training and support, most practices indicated they were willing to consider an array of electronic data collection options for practice-based research activities. CONCLUSIONS There is wide variability in hardware and software use in the pediatric practice setting. Implementing electronic data collection in the PPRG would require a substantial start-up effort and ongoing training and support at the practice site

Screening for elevated risk of liver disease in preschool children (aged 2–5 years) being seen for obesity management

Objectives: Elevated alanine aminotransferase can heighten concern for the presence of nonalcoholic fatty liver disease in obese children. Guidelines recommend alanine aminotransferase screening of obese children start at the age of 10 years. We examined alanine aminotransferase values routinely obtained for tertiary obesity care among preschool (2–5 years) and school-age children. Methods: Medical records of children attending a tertiary obesity clinic and with alanine aminotransferase measured within 6 months of the initial visit were reviewed. Children with known genetic abnormalities were excluded. Children were grouped by age to focus attention on groups not covered by screening guidelines. Associations with elevated alanine aminotransferase (>30 IU/L) were examined. Results: A total of 284 records were analyzed (73 preschool, 143 young school-age (6–9 years), 68 older school-age (10–11 years)). Children were primarily Hispanic and had body mass index ≥ 99th percentile (preschool children 92%, young school-age 73%, older school-age 59%). In all, 26% of preschool children had elevated alanine aminotransferase (young school-age 30%, older school-age 44%). Preschool children with elevated alanine aminotransferase had higher body mass index compared to preschool children with alanine aminotransferase ≤ 30 IU/L (median body mass index 27.8 kg/m 2 vs 24.0 kg/m 2 ; Mann–Whitney U test, p = 0.003), but there was no disparity for elevated alanine aminotransferase related to Hispanic ethnicity. For older children, Hispanic ethnicity, not body mass index, predicted elevated alanine aminotransferase. Conclusion: Alanine aminotransferase elevation was common in these preschool children. Screening severely obese children for elevated alanine aminotransferase should begin at the age of 2 years

Case Reports: Multifaceted Experiences Treating Youth with Severe Obesity

The management of youth with severe obesity is strongly impacted by social determinants of health and family dynamics. We present case studies of three patients seen in our tertiary care obesity treatment clinic as examples of the challenges faced by these patients and their families, as well as by the medical team. We discuss how these cases illustrate potential barriers to care, the role of child protective services, and we reflect upon lessons learned through the care of these patients. These cases highlight the need for comprehensive care in the management of youth with severe obesity, which can include: visits to multiple medical specialists, and mental and behavioral health providers; school accommodations; linkage to community resources; and, potentially, child protective services involvement. Through the care of these youth, our medical team gained more experience with using anti-obesity medications and meal replacements. The care of these youth also heightened our appreciation for the integral role of mental health services and community-based resources in the management of youth with severe obesity

Identifying characteristics and outcomes in youth with obesity and developmental disabilities

BACKGROUND: Youth with developmental disability are at increased risk of obesity; literature focusing on the two is rare. OBJECTIVE: To identify characteristics and outcomes of youth presenting for obesity care having a disability as compared to without. METHODS: A medical record review of youth aged 2-18 years initiating obesity care 2013-2015 at a tertiary care obesity management program. Youth were grouped by disability status to identify differences in presenting characteristics and factors associated with a reduction in body mass index (BMI) percent of the 95th BMI percentile (BMIp95) over 12 months. Logistic regression (LR) models examined associations with BMIp95 drop ( RESULTS: Of 887 subjects, 253 (28.5%) had a disability. At presentation, youth with disability were more often (p \u3c 0.01) male (58.5% versus 47.9%), had birth weight CONCLUSION: Youth with developmental disabilities were as successful in obesity care as those without disabilities. Predictors of success differed between the groups

Characteristics of Very Young Hispanic Children Referred for Obesity Management

Information on risks associated with obesity during infancy specific to Hispanic children is scarce. This retrospective medical record review describes characteristics and parenting practices of Hispanic children age <2 years referred for obesity care at a tertiary hospital over a 6-year period. Data on 29 Hispanic children collected from parent-completed assessment forms and clinician documentation were analyzed. Children were of mean age 16.2 ± 4.9 months; body mass index z scores ranged from 1.5 to 9.4 (mean 4.5 ± 1.7); 45% were male; 97% received public insurance; 38% were breastfed ≥6 months; and 93% had a parent who was overweight or obese. Parenting practices included bottle feeding in bed (50%), regularly drinking sweetened beverages (33%), ≥2 hours of screen time (60%), and having a TV in child’s bedroom (55%). Better understanding of factors that contribute to the development of rapid weight gain of Hispanic children can inform future clinical and public health interventions

Does History of Prematurity Prompt Blood Pressure Evaluations at Primary Care Visits?

Prematurity is a risk factor for elevated blood pressure (BP). We performed a mixed-methods study of care patterns and awareness of early BP screening recommendations for infants born prematurely (IBP) by interviewing/surveying providers on practice- and provider-level BP screening. IBP’s records were reviewed for BP screening documentation, demographics, and gestational age (GA). Visits <33 months were reviewed for anthropometrics, BP, and comorbidities. Chi-square analysis evaluated BP screening by GA and comorbidities. Twenty-six of 49 practices completed interviews; 81% had infant BP equipment available; 4% had BP measurement protocol for IBP. Twenty-eight of 86 providers were aware of screening guidelines; none reported routine assessment. Twenty-eight of 118 IBP had ≥1 BP documented; 43% had BP ≥90th percentile. Screening did not differ by GA group. Kidney-related diagnosis was associated with more frequent BP screening ( P = .0454). BP is not routinely measured though often elevated before age 3 in IBP