Safety and effectiveness of insulin pump therapy in children and adolescents with type 1 diabetes

WSTĘP. Celem pracy była ocena bezpieczeństwa skuteczności stosowania pompy insulinowej u dzieci młodzieży chorych na cukrzycę typu 1. MATERIAŁ I METODY. Do badania włączono 95 dzieci, które rozpoczęły stosowanie pompy insulinowej w Johns Hopkins Hospital w okresie od stycznia 1990 do grudnia 2000 roku. Średni wiek badanych wynosił 12,0 lat (przedział 4&#8211;18 lat); 29% badanych było poniżej 10 roku życia. Dane zebrano z dokumentacji medycznej, począwszy od okresu 6&#8211;12 miesięcy przed zastosowaniem terapii pompą insulinową. Średni czas obserwacji wynosił 28 miesięcy. WYNIKI. Zaobserwowano niewielkie, lecz znamienne statystycznie obniżenie stężenia HbA1c w 3.&#8211;6. miesiącu terapii (7,7% vs. 7,5%, p = 0,03). W czasie dalszej obserwacji stężenie to stopniowo zwiększało się i pozostało podwyższone po roku, jednak na to zjawisko wpływał wiek badanych i czas trwania cukrzycy. Obie wymienione zmienne wiązały się z wyższym stężeniem HbA1c. Po uwzględnieniu wieku i czasu trwania cukrzycy średnie stężenie HbA1c po rozpoczęciu terapii pompą insulinową było znamiennie niższe niż przed jej zastosowaniem (7,7% vs. 8,1%, p < 0,001). Częstość powikłań (kwasica ketonowa, interwencje w izbie przyjęć) była podobna przed i po rozpoczęciu leczenia. Zaobserwowano mniej incydentów hipoglikemii po rozpoczęciu terapii (12 vs. 17, współczynnik częstości = 0,46; 95% CI 0,21&#8211;1,01). WNIOSKI. Badanie to sugeruje, że stosowanie pompy insulinowej jest bezpieczną i skuteczną metodą leczenia u wybranych dzieci chorych na cukrzycę typu 1.INTRODUCTION. To evaluate the safety and effectiveness of insulin pump therapy in children and adolescents with type 1 diabetes. MATERIAL AND METHODS. All 95 patients who began insulin pump therapy at Johns Hopkins Hospital between January 1990 and December 2000 were included in the study. The mean age was 12.0 years (range 4&#8211;18), and 29% of the patients were < 10 years old. Data were obtained by chart review beginning 6&#8211;12 months before pump start. The median duration of follow-up was 28 months. RESULTS. There was a small but significant decrease in HbA1c at 3&#8211;6 months after pump start (7.7% vs. 7.5%; P = 0.03). HbA1c levels then gradually increased and remained elevated after 1 year of followup; however, this association was confounded by age and diabetes duration, both of which were associated with higher HbA1c levels. After adjusting for duration and age, mean HbA1c after pump start was significantly lower than before pump start (7.7% vs. 8.1%; P < 0.001). The number of medical complications (diabetic ketoacidosis, emergency department visits) was similar before and after pump start. There were fewer hypoglycemic events after pump start (12 vs. 17, rate ratio 0.46, 95% CI 0.21&#8211;1.01). CONCLUSIONS. This study suggests that pump therapy is safe and effective in selected children and adolescents with type 1 diabetes

Using dust, gas and stellar mass selected samples to probe dust sources and sinks in low metallicity galaxies

We combine samples of nearby galaxies with Herschel photometry selected on their dust, metal, H I and stellar mass content, and compare these to chemical evolution models in order to discriminate between different dust sources. In a companion paper, we used an H I-selected sample of nearby galaxies to reveal a subsample of very gas-rich (gas fraction >80 per cent) sources with dust masses significantly below predictions from simple chemical evolution models, and well below Md/M* and Md/Mgas scaling relations seen in dust and stellar-selected samples of local galaxies. We use a chemical evolution model to explain these dust-poor, but gas-rich, sources as well as the observed star formation rates (SFRs) and dust-to-gas ratios. We find that (i) a delayed star formation history is required to model the observed SFRs; (ii) inflows and outflows are required to model the observed metallicities at low gas fractions; (iii) a reduced contribution of dust from supernovae (SNe) is needed to explain the dust-poor sources with high gas fractions. These dust-poor, low stellar mass galaxies require a typical core-collapse SN to produce 0.01-0.16 M⊙ of dust. To match the observed dust masses at lower gas fractions, significant grain growth is required to counteract the reduced contribution from dust in SNe and dust destruction from SN shocks. These findings are statistically robust, though due to intrinsic scatter it is not always possible to find one single model that successfully describes all the data. We also show that the dust-to-metal ratio decreases towards lower metallicity

Depressive Symptom Severity as a Predictor of Attendance in the HOME Behavioral Weight Loss Trial

Objective We examined whether total depressive symptoms and symptom clusters predicted behavioral weight loss attendance among economically disadvantaged adults in a randomized controlled trial. Methods 150 adults with obesity were randomized to 12 months of in-person, video conference, or enhanced usual care weight loss groups. We categorized percent session attendance in the intervention arms into three levels: no attendance, poorer attendance, and better attendance. Results Higher baseline Patient Health Questionnaire-8 (PHQ-8) score was associated with a greater odds of being in the poorer versus better attendance group (OR = 1.94, 95% CI: 1.02–3.69, p = .04). A similar relationship between PHQ-8 score and odds of being in the no attendance versus better attendance group was observed but was not statistically significant (OR = 1.63, 95% CI: 0.94–2.81, p = .08). Both cognitive/affective and somatic clusters contributed to the depressive symptoms-attendance relationships. Conclusion Greater depressive symptoms at the start of a behavioral weight loss program may predict poorer subsequent session attendance. Screening for and addressing depression may improve intervention uptake

Childhood in Sociology and Society: The US Perspective

The field of childhood studies in the US is comprised of cross-disciplinary researchers who theorize and conduct research on both children and youth. US sociologists who study childhood largely draw on the childhood literature published in English. This article focuses on American sociological contributions, but notes relevant contributions from non-American scholars published in English that have shaped and fueled American research. This article also profiles the institutional support of childhood research in the US, specifically outlining the activities of the ‘Children and Youth’ Section of the American Sociological Association (ASA), and assesses the contributions of this area of study for sociology as well as the implications for an interdisciplinary field.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

The causes of the red sequence, the blue cloud, the green valley, and the green mountain

The galaxies found in optical surveys fall in two distinct regions of a diagram of optical colour versus absolute magnitude: the red sequence and the blue cloud with the green valley in between. We show that the galaxies found in a submillimetre survey have almost the opposite distribution in this diagram, forming a `green mountain'. We show that these distinctive distributions follow naturally from a single, continuous, curved Galaxy Sequence in a diagram of specific star-formation rate versus stellar mass without there being the need for a separate star-forming galaxy Main Sequence and region of passive galaxies. The cause of the red sequence and the blue cloud is the geometric mapping between stellar mass/specific star-formation rate and absolute magnitude/colour, which distorts a continuous Galaxy Sequence in the diagram of intrinsic properties into a bimodal distribution in the diagram of observed properties. The cause of the green mountain is Malmquist bias in the submillimetre waveband, with submillimetre surveys tending to select galaxies on the curve of the Galaxy Sequence, which have the highest ratios of submillimetre-to-optical luminosity. This effect, working in reverse, causes galaxies on the curve of the Galaxy Sequence to be underrepresented in optical samples, deepening the green valley. The green valley is therefore not evidence (1) for there being two distinct populations of galaxies, (2) for galaxies in this region evolving more quickly than galaxies in the blue cloud and the red sequence, (c) for rapid quenching processes in the galaxy population

The causes of the red sequence, the blue cloud, the green valley, and the green mountain

The galaxies found in optical surveys fall in two distinct regions of a diagram of optical colour versus absolute magnitude: the red sequence and the blue cloud, with the green valley in between. We show that the galaxies found in a submillimetre survey have almost the opposite distribution in this diagram, forming a \u27green mountain\u27. We show that these distinctive distributions follow naturally from a single, continuous, curved Galaxy Sequence in a diagram of specific star formation rate versus stellar mass, without there being the need for a separate star-forming galaxy main sequence and region of passive galaxies. The cause of the red sequence and the blue cloud is the geometric mapping between stellar mass/specific star formation rate and absolute magnitude/colour, which distorts a continuous Galaxy Sequence in the diagram of intrinsic properties into a bimodal distribution in the diagram of observed properties. The cause of the green mountain isMalmquist bias in the submillimetre waveband, with submillimetre surveys tending to select galaxies on the curve of the Galaxy Sequence, which have the highest ratios of submillimetre-to-optical luminosity. This effect, working in reverse, causes galaxies on the curve of the Galaxy Sequence to be underrepresented in optical samples, deepening the green valley. The green valley is therefore not evidence (1) for there being two distinct populations of galaxies, (2) for galaxies in this region evolving more quickly than galaxies in the blue cloud and the red sequence, and (3) for rapid-quenching processes in the galaxy population

H-ATLAS/GAMA: quantifying the morphological evolution of the galaxy population using cosmic calorimetry

Using results from the Herschel Astrophysical Terrahertz Large-Area Survey (H-ATLAS) and the Galaxy and Mass Assembly (GAMA) project, we show that, for galaxy masses above ≃ 108 M⊙, 51 per cent of the stellar mass-density in the local Universe is in early-type galaxies (ETGs; Sérsic n > 2.5) while 89 per cent of the rate of production of stellar mass-density is occurring in late-type galaxies (LTGs; Sérsic n < 2.5). From this zero-redshift benchmark, we have used a calorimetric technique to quantify the importance of the morphological transformation of galaxies over the history of the Universe. The extragalactic background radiation contains all the energy generated by nuclear fusion in stars since the big bang. By resolving this background radiation into individual galaxies using the deepest far-infrared survey with the Herschel Space Observatory and a deep near-infrared/optical survey with the Hubble Space Telescope (HST), and using measurements of the Sérsic index of these galaxies derived from the HST images, we estimate that ≃83 per cent of the stellar mass-density formed over the history of the Universe occurred in LTGs. The difference between this value and the fraction of the stellar mass-density that is in LTGs today implies there must have been a major transformation of LTGs into ETGs after the formation of most of the stars

Active Mile Briefing: Evidence And Policy Summary

Active mile initiatives can be defined as initiatives that support pupils to be active during the school day by providing regular opportunities for them to move around a marked route for a dedicated period of time (for example 15 minutes) and at a self-directed pace. It is thought that if moving continuously for this amount of time, most children will accumulate the equivalent distance of approximately one mile. As such, they have been termed as active mile initiatives. Active mile initiatives have gained in popularity and momentum over recent years. Whilst there is much evidence surrounding the health benefits of physical activity for children and young people, there is currently limited peer-reviewed high-quality evaluation and/or research which has focussed specifically on the effectiveness and cost-effectiveness of active mile initiatives. Furthermore, active mile initiatives have predominantly focused on primary schools, therefore there is limited research and/or information on their delivery with other age groups and/or settings such as nurseries and secondary schools. However, many of the principles are equally valid, for example they require no specialised equipment or resources. The evidence base surrounding active mile initiatives is evolving, and further research is needed to be able to draw firm conclusions. However, the evidence reviewed in this document indicates that active mile initiatives: • are intuitively appealing to schools as a means of providing regular physical activity and have high levels of acceptability among teachers and pupils • provide a simple physical activity opportunity for pupils which is suitable for all ages and are fully inclusive • can make a meaningful contribution to the in-school delivery of 30 active minutes and the Chief Medical Officer’s recommendation of an average of at least 60 minutes of physical activity each day across the week • can contribute to improvements in children’s health and wellbeing if implemented as part of a whole school approach to physical activity • should provide an additional opportunity to be active during the school day, they are not equivalent to and should not replace Physical Education (PE) This briefing accompanies, and should be used alongside, Implementing active mile initiatives in primary schools and Practice examples of active mile initiatives in schools

Active Mile Briefing: Evidence And Policy Summary

Active mile initiatives can be defined as initiatives that support pupils to be active during the school day by providing regular opportunities for them to move around a marked route for a dedicated period of time (for example 15 minutes) and at a self-directed pace. It is thought that if moving continuously for this amount of time, most children will accumulate the equivalent distance of approximately one mile. As such, they have been termed as active mile initiatives. Active mile initiatives have gained in popularity and momentum over recent years. Whilst there is much evidence surrounding the health benefits of physical activity for children and young people, there is currently limited peer-reviewed high-quality evaluation and/or research which has focussed specifically on the effectiveness and cost-effectiveness of active mile initiatives. Furthermore, active mile initiatives have predominantly focused on primary schools, therefore there is limited research and/or information on their delivery with other age groups and/or settings such as nurseries and secondary schools. However, many of the principles are equally valid, for example they require no specialised equipment or resources. The evidence base surrounding active mile initiatives is evolving, and further research is needed to be able to draw firm conclusions. However, the evidence reviewed in this document indicates that active mile initiatives: • are intuitively appealing to schools as a means of providing regular physical activity and have high levels of acceptability among teachers and pupils • provide a simple physical activity opportunity for pupils which is suitable for all ages and are fully inclusive • can make a meaningful contribution to the in-school delivery of 30 active minutes and the Chief Medical Officer’s recommendation of an average of at least 60 minutes of physical activity each day across the week • can contribute to improvements in children’s health and wellbeing if implemented as part of a whole school approach to physical activity • should provide an additional opportunity to be active during the school day, they are not equivalent to and should not replace Physical Education (PE) This briefing accompanies, and should be used alongside, Implementing active mile initiatives in primary schools and Practice examples of active mile initiatives in schools

The Public Repository of Xenografts enables discovery and randomized phase II-like trials in mice

More than 90% of drugs with preclinical activity fail in human trials, largely due to insufficient efficacy. We hypothesized that adequately powered trials of patient-derived xenografts (PDX) in mice could efficiently define therapeutic activity across heterogeneous tumors. To address this hypothesis, we established a large, publicly available repository of well-characterized leukemia and lymphoma PDXs that undergo orthotopic engraftment, called the Public Repository of Xenografts (PRoXe). PRoXe includes all de-identified information relevant to the primary specimens and the PDXs derived from them. Using this repository, we demonstrate that large studies of acute leukemia PDXs that mimic human randomized clinical trials can characterize drug efficacy and generate transcriptional, functional, and proteomic biomarkers in both treatment-naive and relapsed/refractory disease