Effects of Varying Doses of Oral Bisphenol A Consumption on Type 2 Diabetes Risk Markers in Healthy Adults

Objective To determine the effects of varying doses of orally administered BPA on indices of glucose metabolism. Methods Eleven college students (21.0 ± 0.8 years; 24.2 ± 3.9 kg/m2) were randomized in a double-blinded, crossover fashion separated by \u3e1 week to placebo (PL), deuterated BPA at 4 µg/kg body weight (BPA-4), and deuterated BPA at 50 µg/kg body weight (BPA-50). Total BPA, glucose, insulin, and C-peptide were assessed at baseline, minutes 15, 30, 45, 60, and every 30 minutes for 2 hours in response to a glucose tolerance test. Results There was a significant condition × time interaction for total BPA (P \u3c 0.001) such that BPA increased more rapidly in BPA-50 than BPA-4 and PL (P = 0.003) and increased more rapidly in BPA-4 than PL (P \u3c 0.001). There were no significant condition × time interactions on glucose, insulin, and C-peptide. Significant condition main effects were observed for glucose such that BPA-50 was significantly lower than PL (P = 0.036) and nearly lower for BPA-4 vs PL (P = 0.056). Significant condition main effects were observed such that insulin in BPA-50 was lower than BPA-4 (P = 0.021), and C-peptide in BPA-50 was lower than BPA-4 (t18 = 3.95; Tukey-adjusted P = 0.003). Glucose, insulin, and C-peptide areas under the curve for the 3-hour profile were significantly lower in BPA-50 vs PL (P \u3c 0.05). Conclusion Orally administered BPA protocol appeared feasible and has immediate effects on glucose, insulin, and C-peptide concentrations

Enhancing the detection of delirium by nurses in acute care

Objective: Delirium is an acute brain failure commonly experienced by hospitalized patients with serious consequences when it is not recognized and treated. Little is known about why difficulties occur or what can be done improve delirium detection. The study objective was to increase our understanding of how experienced nurses use clinical reasoning to detect, diagnose, and respond to delirium symptoms and identify improvement opportunities. Methods: Ten focus groups were conducted with experienced staff nurses at three diverse medical centers in the Midwest. Sessions were audio-recorded, transcribed, reviewed, and coded using NVIVO-12 software. Dimensional analysis was used to identify concepts, conditions, and processes. Results: Participants (N=39) ranged in age from 18-65 (59%yrs), were female (97%), Caucasian (87%) and worked on medical (42%), surgical (31%), and intensive care (28%) units. Most were BSNprepared or higher (81%), certified (28%), worked 12-hour shifts (51%), and managed delirium more than 1-2 times per week (84%). Nurses describe having knowledge to identify and manage delirium, prioritizing care to maintain patient safety. Nurses use a variety of nonpharmacological strategies to address changes in patient status. The nurses described that the diagnosis of delirium is not necessary to manage symptoms and behaviors. Nurses reported negative consequences to discussing or making a diagnosis of delirium. Both the clinical and social aspects of the nurse’s approach are related to the nature of delirium and their experience with delirium, the environment, the family, and interprofessional communication. Navigating both the clinical and social aspects of delirium is essential for successful management. Conclusions: Nurses use clinical reasoning processes to manage delirium symptoms. These processes and their subsequent actions are influenced by social factors. The nurse work within social structures that impact their thinking and actions. A larger study examining social factors that influence staff nurse clinical reasoning regarding delirium is recommended

Hippocampal dentate gyrus integrity revealed with ultrahigh resolution diffusion imaging predicts memory performance in older adults.

Medial temporal lobe (MTL) atrophy is a core feature of age-related cognitive decline and Alzheimer's disease (AD). While regional volumes and thickness are often used as a proxy for neurodegeneration, they lack the sensitivity to serve as an accurate diagnostic test and indicate advanced neurodegeneration. Here, we used a submillimeter resolution diffusion weighted MRI sequence (ZOOMit) to quantify microstructural properties of hippocampal subfields in older adults (63-98 years old) using tensor derived measures: fractional anisotropy (FA) and mean diffusivity (MD). We demonstrate that the high-resolution sequence, and not a standard resolution sequence, identifies dissociable profiles for CA1, dentate gyrus (DG), and the collateral sulcus. Using ZOOMit, we show that advanced age is associated with increased MD of the CA1 and DG as well as decreased FA of the DG. Increased MD of the DG, reflecting decreased cellular density, mediated the relationship between age and word list recall. Further, increased MD in the DG, but not DG volume, was linked to worse spatial pattern separation. Our results demonstrate that ultrahigh-resolution diffusion imaging enables the detection of microstructural differences in hippocampal subfield integrity and will lead to novel insights into the mechanisms of age-related memory loss

Reduced structural connectivity of the medial temporal lobe including the perforant path is associated with aging and verbal memory impairment

The perforant path, the white matter bundle connecting the entorhinal cortex (ERC) with the hippocampal formation deteriorates with age-related cognitive decline. Previous investigations using diffusion-weighted MRI to quantify perforant path integrity in-vivo have been limited due to image resolution or have quantified the perforant path using methods susceptible to partial volume effects such as the tensor model and without consideration of its 3-dimensional morphology. In this investigation, we use quantitative-anisotropy informed tractography derived from ultra-high resolution diffusion imaging (ZOOMit) to investigate structural connectivity of the perforant path and other medial temporal lobe (MTL) pathways in older adults (63 to 98 years old, n = 51). We show that graph density within the MTL declines with age and is associated with lower delayed recall performance. We also show that older age and poorer delayed recall are associated with reduced streamlines connecting the ERC and dentate gyrus of the hippocampus (the putative perforant path). This work suggest that intra-MTL connectivity may new candidate biomarkers for age-related cognitive decline

Down syndrome: Distribution of brain amyloid in mild cognitive impairment.

IntroductionDown syndrome (DS) is associated with a higher risk of dementia. We hypothesize that amyloid beta (Aβ) in specific brain regions differentiates mild cognitive impairment in DS (MCI-DS) and test these hypotheses using cross-sectional and longitudinal data.Methods18F-AV-45 (florbetapir) positron emission tomography (PET) data were collected to analyze amyloid burden in 58 participants clinically classified as cognitively stable (CS) or MCI-DS and 12 longitudinal CS participants.ResultsThe study confirmed our hypotheses of increased amyloid in inferior parietal, lateral occipital, and superior frontal regions as the main effects differentiating MCI-DS from the CS groups. The largest annualized amyloid increases in longitudinal CS data were in the rostral middle frontal, superior frontal, superior/middle temporal, and posterior cingulate cortices.DiscussionThis study helps us to understand amyloid in the MCI-DS transitional state between cognitively stable aging and frank dementia in DS. The spatial distribution of Aβ may be a reliable indicator of MCI-DS in DS

Down syndrome: Distribution of brain amyloid in mild cognitive impairment.

IntroductionDown syndrome (DS) is associated with a higher risk of dementia. We hypothesize that amyloid beta (Aβ) in specific brain regions differentiates mild cognitive impairment in DS (MCI-DS) and test these hypotheses using cross-sectional and longitudinal data.Methods18F-AV-45 (florbetapir) positron emission tomography (PET) data were collected to analyze amyloid burden in 58 participants clinically classified as cognitively stable (CS) or MCI-DS and 12 longitudinal CS participants.ResultsThe study confirmed our hypotheses of increased amyloid in inferior parietal, lateral occipital, and superior frontal regions as the main effects differentiating MCI-DS from the CS groups. The largest annualized amyloid increases in longitudinal CS data were in the rostral middle frontal, superior frontal, superior/middle temporal, and posterior cingulate cortices.DiscussionThis study helps us to understand amyloid in the MCI-DS transitional state between cognitively stable aging and frank dementia in DS. The spatial distribution of Aβ may be a reliable indicator of MCI-DS in DS

Vogue

This article explores the possibility of cosmopolitics, using the global magazine franchise Vogue as our starting point. Drawing on Saito's conceptualizations of cosmopolitanism, we investigate whether Vogue promotes cosmopolitan engagement, which we define as promotion of human diversity, cultural omnivorousness and cosmopolitics. Our analysis focuses on racial diversity and health, two moral issues recently addressed by Vogue itself. We present a content analysis of Vogue and media coverage of Vogue in China, the Netherlands and the USA. We conclude that Vogue, because of its global basis, high status and reliance on visual materials, has the potential to address and unite transnational publics around global issues. However, the success of such attempts depends on local cultural and institutional contexts and the role of local actors, who may adopt, but also reframe or ignore, attempts to promote cosmopolitan engagement