Antenatal Steroid Therapy for Fetal Lung Maturation and the Subsequent Risk of Childhood Asthma: A Longitudinal Analysis

This study was designed to test the hypothesis that fetal exposure to corticosteroids in the antenatal period is an independent risk factor for the development of asthma in early childhood with little or no effect in later childhood. A population-based cohort study of all pregnant women who resided in Nova Scotia, Canada, and gave birth to a singleton fetus between 1989 and 1998 was undertaken. After a priori specified exclusions, 80,448 infants were available for analysis. Using linked health care utilization records, incident asthma cases developed after 36 months of age were identified. Extended Cox proportional hazards models were used to estimate hazard ratios while controlling for confounders. Exposure to corticosteroids during pregnancy was associated with a risk of asthma in childhood between 3–5 years of age: adjusted hazard ratio of 1.19 (95% confidence interval: 1.03, 1.39), with no association noted after 5 years of age: adjusted hazard ratio for 5–7 years was 1.06 (95% confidence interval: 0.86, 1.30) and for 8 or greater years was 0.74 (95% confidence interval: 0.54, 1.03). Antenatal steroid therapy appears to be an independent risk factor for the development of asthma between 3 and 5 years of age

Inadequate prenatal care and its association with adverse pregnancy outcomes: A comparison of indices

<p>Abstract</p> <p>Background</p> <p>The objectives of this study were to determine rates of prenatal care utilization in Winnipeg, Manitoba, Canada from 1991 to 2000; to compare two indices of prenatal care utilization in identifying the proportion of the population receiving inadequate prenatal care; to determine the association between inadequate prenatal care and adverse pregnancy outcomes (preterm birth, low birth weight [LBW], and small-for-gestational age [SGA]), using each of the indices; and, to assess whether or not, and to what extent, gestational age modifies this association.</p> <p>Methods</p> <p>We conducted a population-based study of women having a hospital-based singleton live birth from 1991 to 2000 (N = 80,989). Data sources consisted of a linked mother-baby database and a physician claims file maintained by Manitoba Health. Rates of inadequate prenatal care were calculated using two indices, the R-GINDEX and the APNCU. Logistic regression analysis was used to determine the association between inadequate prenatal care and adverse pregnancy outcomes. Stratified analysis was then used to determine whether the association between inadequate prenatal care and LBW or SGA differed by gestational age.</p> <p>Results</p> <p>Rates of inadequate/no prenatal care ranged from 8.3% using APNCU to 8.9% using R-GINDEX. The association between inadequate prenatal care and preterm birth and LBW varied depending on the index used, with adjusted odds ratios (AOR) ranging from 1.0 to 1.3. In contrast, both indices revealed the same strength of association of inadequate prenatal care with SGA (AOR 1.4). Both indices demonstrated heterogeneity (non-uniformity) across gestational age strata, indicating the presence of effect modification by gestational age.</p> <p>Conclusion</p> <p>Selection of a prenatal care utilization index requires careful consideration of its methodological underpinnings and limitations. The two indices compared in this study revealed different patterns of utilization of prenatal care, and should not be used interchangeably. Use of these indices to study the association between utilization of prenatal care and pregnancy outcomes affected by the duration of pregnancy should be approached cautiously.</p

Insomnia and Hypnotic Use, Recorded in the Minimum Data Set, as Predictors of Falls and Hip Fractures in Michigan Nursing Homes

To examine the relationship between insomnia, hypnotic use, falls, and hip fractures in older people. Design : Secondary analysis of a large, longitudinal, assessment database. Setting : Four hundred thirty-seven nursing homes in Michigan. Participants : Residents aged 65 and older in 2001 with a baseline Minimum Data Set assessment and a follow-up 150 to 210 days later. Measurements : Logistic regression modeled any follow-up report of fall or hip fracture. Predictors were baseline reports of insomnia (previous month) and use of hypnotics (previous week). Potential confounds taken into account included standard measures of functional status, cognitive status, intensity of resource utilization, proximity to death, illness burden, number of medications, emergency room visits, nursing home new admission, age, and sex. Results : In 34,163 nursing home residents (76% women, mean age±standard deviation 84±8), hypnotic use did not predict falls (adjusted odds ratio (AOR)=1.13, 95% confidence interval (CI)=0.98, 1.30). In contrast, insomnia did predict future falls (AOR=1.52, 95% CI=1.38, 1.66). Untreated insomnia (AOR=1.55, 95% CI=1.41, 1.71) and hypnotic-treated (unresponsive) insomnia (AOR=1.32, 95% CI=1.02, 1.70) predicted more falls than did the absence of insomnia. After adjustment for confounding variables, insomnia and hypnotic use were not associated with subsequent hip fracture. Conclusion : In elderly nursing home residents, insomnia, but not hypnotic use, is associated with a greater risk of subsequent falls. Future studies will need to confirm these findings and determine whether appropriate hypnotic use can protect against future falls.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66254/1/j.1532-5415.2005.53304.x.pd

The sustainability of habitability on terrestrial planets: Insights, questions, and needed measurements from Mars for understanding the evolution of Earth-like worlds

What allows a planet to be both within a potentially habitable zone and sustain habitability over long geologic time? With the advent of exoplanetary astronomy and the ongoing discovery of terrestrial-type planets around other stars, our own solar system becomes a key testing ground for ideas about what factors control planetary evolution. Mars provides the solar system's longest record of the interplay of the physical and chemical processes relevant to habitability on an accessible rocky planet with an atmosphere and hydrosphere. Here we review current understanding and update the timeline of key processes in early Mars history. We then draw on knowledge of exoplanets and the other solar system terrestrial planets to identify six broad questions of high importance to the development and sustaining of habitability (unprioritized): (1) Is small planetary size fatal? (2) How do magnetic fields influence atmospheric evolution? (3) To what extent does starting composition dictate subsequent evolution, including redox processes and the availability of water and organics? (4) Does early impact bombardment have a net deleterious or beneficial influence? (5) How do planetary climates respond to stellar evolution, e.g., sustaining early liquid water in spite of a faint young Sun? (6) How important are the timescales of climate forcing and their dynamical drivers? Finally, we suggest crucial types of Mars measurements (unprioritized) to address these questions: (1) in situ petrology at multiple units/sites; (2) continued quantification of volatile reservoirs and new isotopic measurements of H, C, N, O, S, Cl, and noble gases in rocks that sample multiple stratigraphic sections; (3) radiometric age dating of units in stratigraphic sections and from key volcanic and impact units; (4) higher-resolution measurements of heat flux, subsurface structure, and magnetic field anomalies coupled with absolute age dating. Understanding the evolution of early Mars will feed forward to understanding the factors driving the divergent evolutionary paths of the Earth, Venus, and thousands of small rocky extrasolar planets yet to be discovered

Caffeine taste signaling in drosophila larvae

The Drosophila larva has a simple peripheral nervous system with a comparably small number of sensory neurons located externally at the head or internally along the pharynx to assess its chemical environment. It is assumed that larval taste coding occurs mainly via external organs (the dorsal, terminal, and ventral organ). However, the contribution of the internal pharyngeal sensory organs has not been explored. Here we find that larvae require a single pharyngeal gustatory receptor neuron pair called D1, which is located in the dorsal pharyngeal sensilla, in order to avoid caffeine and to associate an odor with caffeine punishment. In contrast, caffeine-driven reduction in feeding in non-choice situations does not require D1. Hence, this work provides data on taste coding via different receptor neurons, depending on the behavioral context. Furthermore, we show that the larval pharyngeal system is involved in bitter tasting. Using ectopic expressions, we show that the caffeine receptor in neuron D1 requires the function of at least four receptor genes: the putative co-receptors Gr33a, Gr66a, the putative caffeine-specific receptor Gr93a, and yet unknown additional molecular component(s). This suggests that larval taste perception is more complex than previously assumed already at the sensory level. Taste information from different sensory organs located outside at the head or inside along the pharynx of the larva is assembled to trigger taste guided behaviors

Um modelo para análise socioeconômica da criminalidade no município de Aracaju

Este trabalho tem por objetivo investigar as razões socioeconômicas da criminalidade em Aracaju, a partir de fontes primárias e secundárias de informação. Para tanto, parte-se de uma análise teórica, na qual foram identificadas quatro hipóteses explicativas para a criminalidade: (i) ato racional deliberado; (ii) relacionada com o ciclo econômico; (iii) decorrente da maior desigualdade social existente na economia contemporânea e; (iv) não diretamente relacionada com variáveis socioeconômicas. A seção seguinte descreve a metodologia empregada para a construção do banco de dados e para a análise por meio de regressão do tipo stepwise. Na última seção são apresentados os resultados: o modelo explica 90% do comportamento dos crimes contra o patrimônio, e as variáveis responsáveis por tal comportamento são: a concentração de renda, características da infra-estrutura existente nos bairros, a baixa densidade demográfica e a menor participação dos jovens no total da população.________________________________________________________________________________________ ABSTRACT: This paper aims to investigate the socioeconomic reasons of criminality in Aracaju/SE, using primary and secondary sources of information. Beginning with a theoretical analysis, we identified four hyphotesis to the criminality which are: (i) a deliberated rational action; (ii) related to the economic cycle; (iii) consequence of the growing social inequality in the contemporary economy and (iv) not directly related to the socioeconomic reasons. The next section describes the methodology employed to construct the database and for analysis through stepwise regression. The results are presented in the last section: our model explains 90% of the property crime behavior, mainly due: income inequality, existing characteristics of infrastructure in the city districts, low demographic density and low rate of youths participation in the whole population

The relationship between zooplankton and their physico-chemical environment at the mesoscale

The objective of this thesis is to examine what influences the distribution of different sized mesozooplankton at the mesoscale. Zooplankton distributions are influenced by both the physico-chemical environment and by biological processes. To study the relationship between these processes at the mesoscale, biological and physical variables were measured concurrently using a combination of the SeaSoar, fluorimeter, optical plankton counter (OPC) and EK500 echosounder instruments. These data were collected in March 1997, during a survey of the Strait of Hormuz, that connects the Arabian Gulf to the Gulf of Oman in the North West Indian Ocean.OPC data were used to describe and study the distribution of mesozooplankton. The accuracy of the OPC's estimates of abundance and biovolume was determined by comparison with net samples of zooplankton collected by a Longhurst-Hardy Plankton Recorder (LHPR). The correlation of the OPC abundance data with the net samples showed an approximate 1:1 relationship, suggesting that the OPC was capable of reliably enumerating mesozooplankton. Biovolume was first calculated from the sizes of particles measured by the OPC using a spherical model for the zooplankton. The resulting OPC biovolume data were consistently larger than the biovolume measured in the net samples. The OPC biovolume was then calibrated using a spheroidal model, which better represented the zooplankton in the Strait and incorporated measurements of the dimensions of animals in the net samples. The resulting OPC biovolume was within the range of the net samples, although the OPC overestimated biovolume relative to the net at low in situ concentration.</p