Promoting healthy eating in early pregnancy in individuals at risk of gestational diabetes mellitus: does it improve glucose homeostasis? A study protocol for a randomized control trial

BackgroundHealthy eating during pregnancy has favorable effects on glycemic control and is associated with a lower risk of gestational diabetes mellitus (GDM). According to Diabetes Canada, there is a need for an effective and acceptable intervention that could improve glucose homeostasis and support pregnant individuals at risk for GDM.AimsThis unicentric randomized controlled trial (RCT) aims to evaluate the effects of a nutritional intervention initiated early in pregnancy, on glucose homeostasis in 150 pregnant individuals at risk for GDM, compared to usual care.MethodsPopulation: 150 pregnant individuals ≥18 years old, at ≤14 weeks of pregnancy, and presenting ≥1 risk factor for GDM according to Diabetes Canada guidelines. Intervention: The nutritional intervention initiated in the first trimester is based on the health behavior change theory during pregnancy and on Canada’s Food Guide recommendations. It includes (1) four individual counseling sessions with a registered dietitian using motivational interviewing (12, 18, 24, and 30 weeks), with post-interview phone call follow-ups, aiming to develop and achieve S.M.A.R.T. nutritional objectives (specific, measurable, attainable, relevant, and time-bound); (2) 10 informative video clips on healthy eating during pregnancy developed by our team and based on national guidelines, and (3) a virtual support community via a Facebook group. Control: Usual prenatal care. Protocol: This RCT includes three on-site visits (10–14, 24–26, and 34–36 weeks) during which a 2-h oral glucose tolerance test is done and blood samples are taken. At each trimester and 3 months postpartum, participants complete web-based questionnaires, including three validated 24-h dietary recalls to assess their diet quality using the Healthy Eating Food Index 2019. Primary outcome: Difference in the change in fasting blood glucose (from the first to the third trimester) between groups. This study has been approved by the Ethics Committee of the Centre de recherche du CHU de Québec-Université Laval.DiscussionThis RCT will determine whether a nutritional intervention initiated early in pregnancy can improve glucose homeostasis in individuals at risk for GDM and inform Canadian stakeholders on improving care trajectories and policies for pregnant individuals at risk for GDM.Clinical trial registrationhttps://clinicaltrials.gov/study/NCT05299502, NCT0529950

Dual Role for Pilus in Adherence to Epithelial Cells and Biofilm Formation in Streptococcus agalactiae

Streptococcus agalactiae is a common human commensal and a major life-threatening pathogen in neonates. Adherence to host epithelial cells is the first critical step of the infectious process. Pili have been observed on the surface of several gram-positive bacteria including S. agalactiae. We previously characterized the pilus-encoding operon gbs1479-1474 in strain NEM316. This pilus is composed of three structural subunit proteins: Gbs1478 (PilA), Gbs1477 (PilB), and Gbs1474 (PilC), and its assembly involves two class C sortases (SrtC3 and SrtC4). PilB, the bona fide pilin, is the major component; PilA, the pilus associated adhesin, and PilC, are both accessory proteins incorporated into the pilus backbone. We first addressed the role of the housekeeping sortase A in pilus biogenesis and showed that it is essential for the covalent anchoring of the pilus fiber to the peptidoglycan. We next aimed at understanding the role of the pilus fiber in bacterial adherence and at resolving the paradox of an adhesive but dispensable pilus. Combining immunoblotting and electron microscopy analyses, we showed that the PilB fiber is essential for efficient PilA display on the surface of the capsulated strain NEM316. We then demonstrated that pilus integrity becomes critical for adherence to respiratory epithelial cells under flow-conditions mimicking an in vivo situation and revealing the limitations of the commonly used static adherence model. Interestingly, PilA exhibits a von Willebrand adhesion domain (VWA) found in many extracellular eucaryotic proteins. We show here that the VWA domain of PilA is essential for its adhesive function, demonstrating for the first time the functionality of a prokaryotic VWA homolog. Furthermore, the auto aggregative phenotype of NEM316 observed in standing liquid culture was strongly reduced in all three individual pilus mutants. S. agalactiae strain NEM316 was able to form biofilm in microtiter plate and, strikingly, the PilA and PilB mutants were strongly impaired in biofilm formation. Surprisingly, the VWA domain involved in adherence to epithelial cells was not required for biofilm formation

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data

A importância do controle político-parlamentar durante a pandemia COVID-19: experiências regionais e guia de perguntas orientadoras

Título do fascículo: Avaliação de políticas públicas.Enquanto os governos trabalham para prevenir a disseminação de COVID-19, bem como para adquirir e distribuir vacinas, enquanto abordam os impactos socioeconômicos da pandemia, os parlamentos detêm a função crítica de supervisão para responsabilização do Executivo a fim de garantir que as decisões e políticas sejam executadas com transparência e integridade, centradas no bem-estar da população do país, não deixando ninguém para trás. No entanto, são grandes os desafios que os parlamentares enfrentam no cumprimento dessa função, como o atraso ou a falta de acesso às informações do governo e a desinformação online, o que gera falta de confiança nas instituições públicas

Icechrono1 : un modèle probabiliste pour calculer une chronologie commune et optimale pour plusieurs carottes de glace

International audiencePolar ice cores provide exceptional archives of past environmental conditions. The dating of ice cores and the estimation of the age-scale uncertainty are essential to interpret the climate and environmental records that they contain. It is, however, a complex problem which involves different methods. Here, we present IceChrono1, a new probabilistic model integrating various sources of chronological information to produce a common and optimized chronology for several ice cores, as well as its uncertainty. IceChrono1 is based on the inference of three quantities: the surface accumulation rate, the lock-in depth (LID) of air bubbles and the thinning function. The chronological information integrated into IceChrono1 are modeling scenarios of the sedimentation process (accumulation of snow, densification of snow into ice and air trapping, ice flow), ice-and air-dated horizons, ice and air depth intervals with known durations, Δdepth observations (depth shift between synchronous events recorded in the ice and in the air) and finally ice, air or mix stratigraphic links in between ice cores. the inference problem is formulated as a least squares optimisation, implying that all densities of probabilities are assumed to be Gaussian. It is numerically solved using the Levenberg-Marquardt algorithm (thus assuming that the model is almost linear in the vicinity of the solution) and a numerical evaluation of the model's Jacobian. IceChrono1 is freely available under the General Public License v3 open source license.Les forages polaires fournissent des archives exceptionnelles des conditions climatiques et environnementales passées. Produire une datation robuste des carottes de glace ainsi qu'une estimation de l'incertitude associée est essentiel pour interpréter les enregistrements climatiques et environnementaux qu'elles contiennent. Cependant, c'est une tâche complexe car elle implique d'utiliser différentes méthodes. Dans cet article, nous présentons IceChrono1, un modèle probabiliste qui combine différentes sources d'information chronologique pour produire une datation commune et optimale pour plusieurs carottes de glace, ainsi qu'une estimation de l'incertitude associée. IceChrono1 est basé sur l'inférence de trois quantités : le taux d'accumulation de neige en surface, la profondeur de piégeage de l'air et la fonction d'amincissement. IceChrono1 intègre de multiples informations chronologiques : un scénario modélisé du processus de sédimentation (accumulation de la neige, densification de la neige en glace et piégeage de l'air, écoulement de la glace), des horizons bien datés pour contraindre l'âge de la glace ou l'âge de l'air, des intervalles de profon-deur définis sur la glace ou via des mesures sur l'air piégé dont la durée est connue, des observations du Δprofondeur (le décalage en profondeur entre des événements synchrones enregistrés dans la glace et dans l'air) et finalement des liens stratigraphiques reliant des marqueurs identifiés dans la glace, dans l'air piégé ou dans les deux à la fois entre les carottes de glace. L'inférence est formulée comme un problème d'optimisation aux moindres carrés, impliquant que toutes les densités de probabilités sont supposées gaussiennes. Elle est résolue numériquement en utilisant l'algorithme de Levenberg-Marquardt (supposant ainsi que le modèle est presque linéaire au voisinage de la solution) et une évaluation numérique du Jacobien du modèle. IceChrono1 est librement disponible sous la licence libre GPL v3 (General Public License v3)

IceChrono1: a probabilistic model to compute a common and optimal chronology for several ice cores

International audiencePolar ice cores provide exceptional archives of past environmental conditions. The dating of ice cores and the estimation of the age-scale uncertainty are essential to interpret the climate and environmental records that they contain. It is, however, a complex problem which involves different methods. Here, we present IceChrono1, a new probabilistic model integrating various sources of chronological information to produce a common and optimized chronology for several ice cores, as well as its uncertainty. IceChrono1 is based on the inversion of three quantities: the surface accumulation rate, the lock-in depth (LID) of air bubbles and the thinning function. The chronological information integrated into the model are models of the sedimentation process (accumulation of snow, densification of snow into ice and air trapping, ice flow), ice- and air-dated horizons, ice and air depth intervals with known durations, Δdepth observations (depth shift between synchronous events recorded in the ice and in the air) and finally air and ice stratigraphic links in between ice cores. The optimization is formulated as a least squares problem, implying that all densities of probabilities are assumed to be Gaussian. It is numerically solved using the Levenberg–Marquardt algorithm and a numerical evaluation of the model's Jacobian. IceChrono follows an approach similar to that of the Datice model which was recently used to produce the AICC2012 (Antarctic ice core chronology) for four Antarctic ice cores and one Greenland ice core. IceChrono1 provides improvements and simplifications with respect to Datice from the mathematical, numerical and programming point of views. The capabilities of IceChrono1 are demonstrated on a case study similar to the AICC2012 dating experiment. We find results similar to those of Datice, within a few centuries, which is a confirmation of both IceChrono1 and Datice codes. We also test new functionalities with respect to the original version of Datice: observations as ice intervals with known durations, correlated observations, observations as air intervals with known durations and observations as mixed ice–air stratigraphic links. IceChrono1 is freely available under the General Public License v3 open source license

Fully automatic hippocampus segmentation and classification in Alzheimer's disease and mild cognitive impairment applied on data from ADNI

International audienceThe hippocampus is among the first structures affected in Alzheimer's disease (AD). Hippocampal magnetic resonance imaging volumetry is a potential biomarker for AD but is hindered by the limitations of manual segmentation. We proposed a fully automatic method using probabilistic and anatomical priors for hippocampus segmentation. Probabilistic information is derived from 16 young controls and anatomical knowledge is modeled with automatically detected landmarks. The results were previously evaluated by comparison with manual segmentation on data from the 16 young healthy controls, with a leave-one-out strategy, and eight patients with AD. High accuracy was found for both groups (volume error 6 and 7%, overlap 87 and 86%, respectively). In this article, the method was used to segment 145 patients with AD, 294 patients with mild cognitive impairment (MCI), and 166 elderly normal subjects from the Alzheimer's Disease Neuroimaging Initiative database. On the basis of a qualitative rating protocol, the segmentation proved acceptable in 94% of the cases. We used the obtained hippocampal volumes to automatically discriminate between AD patients, MCI patients, and elderly controls. The classification proved accurate: 76% of the patients with AD and 71% of the MCI converting to AD before 18 months were correctly classified with respect to the elderly controls, using only hippocampal volume

Trimester-Specific Serum Fructosamine in Association with Abdominal Adiposity, Insulin Resistance, and Inflammation in Healthy Pregnant Individuals

This study aimed to (1) characterize the variations in serum fructosamine across trimesters and according to pre-pregnancy BMI (ppBMI), and (2) examine associations between fructosamine and adiposity/metabolic markers (ppBMI, first-trimester adiposity, leptin, glucose homeostasis, and inflammation measurements) during pregnancy. Serum fructosamine, albumin, fasting glucose and insulin, leptin, adiponectin, interleukin-6 (IL-6), and C-reactive protein (CRP) concentrations were measured at each trimester. In the first trimester, subcutaneous (SAT) and visceral (VAT) adipose tissue thicknesses were estimated by ultrasound. In the 101 healthy pregnant individuals included (age: 32.2 ± 3.5 y.o.; ppBMI: 25.5 ± 5.5 kg/m2), fructosamine concentrations decreased during pregnancy whereas albumin-corrected fructosamine concentrations increased (p p p p p < 0.05 for both). In conclusion, serum fructosamine is inversely associated with adiposity before and during pregnancy, with markers of glucose homeostasis and inflammation, but the latter associations are partially influenced by albumin concentrations and ppBMI