Breaking the Cycle of Pain In Diabetic Peripheral Neuropathy

An attitude of helplessness pervades both patients and health professionals when dealing with the problems of dia betic peripheral neuropathy. Those afflicted are often over whelmed by the pain and find themselves unable to fulfill the daily requirements of their diabetes regimen. The in consistencies in amounts and timing of meals, levels of ac tivity, and scheduling of insulin injections can result in hyperglycemia, a state that has been found to correlate strongly with the occurrence of nerve damage. Thus the pain perpetrates itself. For the health professional, having to confront this devastating pain without objective factors to assess and few scientific treatment measures to offer con tributes to a sense of inadequacy and ignorance. It is fre quently assumed that "nothing can be done." In reality, health professionals do have something to offer the person suffering from this condition. First, they can provide infor mation about the relationship between control and compli cations, and explain the need for the patient to change those behaviors that may be perpetuating the pain. Sec ond, and most importantly, health professionals can con vey support and confidence, without which many patients will be unable to make the changes in their behavior neces sary to resolve their pain.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68854/2/10.1177_014572178501100103.pd

Development and Interim Evaluation of WeCare Indiana: a Community-tailored Text Messaging Intervention to Reduce Infant Mortality in East Central Indiana

poster abstractBackground: Text messaging is an effective way to distribute health information and reduce risky health behaviors.1,2 In 2014, the East Central Indiana Fetal and Infant Mortality Program of the Delaware County Health Department developed a community-based text messaging intervention program called “WeCare Indiana” as an innovative approach to promote positive pregnancy outcomes. This abstract reports the interim evaluation of health promotional text messages for prenatal clients. Methods: The program was developed using a community-collaborative model. Over 200 prenatal and infant health text messages were reviewed and evaluated by community representatives. Messages included information regarding fetal and infant development, health promotion, and risk prevention strategies with links to local resources. Prenatal messages were then reviewed by prenatal clients for their relevance, clarity, and likelihood to change healthrelated behavior during pregnancy. The program was promoted locally and currently has 98 enrollees. A 4-month interim program evaluation was developed to assess program awareness, reasons for enrolling or not enrolling, and overall satisfaction with text message content. A convenience sample of prenatal clients at a Federally Qualified Health Center participated in the evaluation process. Results: Of the 43 prenatal clients that participated, 10 (23%) clients had heard about the health messaging service. Of those participants, 6 (60%) had chosen to enroll in the program. Enrollees reported hearing about the program through word of mouth, posters, fliers, health care providers, and social media. Reasons given for not enrolling included lack of awareness or interest, technical difficulties, and procrastination. All enrollees reported that the messages were helpful. Conclusions: An effort to reduce fetal and infant mortality in East Central Indiana led to the development and evaluation of community-tailored health messages. The evaluation results will be used to encourage client awareness and enrollment in the program

Identifying Risk Factors for Levels of Per- And Polyfluoroalkyl Substances (PFAS) in the Placenta in a High-Risk Pregnancy Cohort in North Carolina

Prenatal exposure to per- and polyfluoroalkyl substances (PFAS), a ubiquitous class of chemicals, is associated with adverse outcomes such as pre-eclampsia, low infant birth weight, and later-life adiposity. The objectives of this study were to examine PFAS levels in the placenta and identify sociodemographic risk factors in a high-risk pregnancy cohort (n = 122) in Chapel Hill, North Carolina. Of concern, PFOS, PFHxS, PFHpS, and PFUnA were detected above the reporting limit in 99, 75, 55, and 49% of placentas, respectively. Maternal race/ethnicity was associated with significant differences in PFUnA levels. While the data from this high-risk cohort did not provide evidence for an association with hypertensive disorders of pregnancy, fetal growth, or gestational age, the prevalence of detectable PFAS in the placenta suggests a need to biomonitor for exposure to PFAS during pregnancy. Future research should investigate factors underlying the differences in PFAS levels in association with a mother's race/ethnicity, as well as potential effects on pregnancy and child health

Histologic chorioamnionitis and risk of neurodevelopmental impairment at age 10 years among extremely preterm infants born before 28 weeks of gestation

Background: Extremely preterm infants whose placenta had histologic evidence of chorioamnionitis have early brain dysfunction, but little is known about neurologic development at 10 years of age. Objective: We investigated the association between histologic chorioamnionitis and neurodevelopmental impairment at 10 years among children born 2 standard deviations below the mean), and epilepsy at the age of 10 years by blinded evaluators using validated measures. Multivariable logistic regression with generalized estimating equations was used. Results: Among 805 placentas, 43% (347/805) had histologic chorioamnionitis by moderate or advanced maternal stage, 36% (286/805) by severe maternal grade, 18% (132/737) by moderate or advanced fetal stage, and 1% (10/737) by severe fetal grade. The frequencies of impairments were 11% (88/767) for cerebral palsy, 7% (56/773) for autism spectrum disorder, 15% (120/788) for cognitive impairment, and 7% (52/763) for epilepsy. After adjustment for maternal age, body mass index, race, insurance status, maternal education, tobacco use, infant sex, and multiple gestations, the adjusted odds ratio for the association between histologic chorioamnionitis and cerebral palsy years was increased with advanced maternal stage (adjusted odds ratio, 2.5; 95% confidence interval, 1.6–3.9), severe maternal grade (adjusted odds ratio, 2.0; 95% confidence interval, 1.2–3.4), moderate fetal stage (adjusted odds ratio, 2.20; 95% confidence interval, 2.1–2.2), and mild or moderate fetal grade (adjusted odds ratio, 1.5; 95% confidence interval, 1.0–2.2). Similarly, the adjusted odds ratio for the association between histologic chorioamnionitis and epilepsy was increased with advanced maternal stage (adjusted odds ratio, 1.5; 95% confidence interval, 1.3–1.6) and severe fetal grade (adjusted odds ratio, 5.9; 95% confidence interval, 1.9–17.8). In addition, the adjusted odds ratio for the association between histologic chorioamnionitis and autism spectrum disorder was increased with mild or moderate fetal grade (adjusted odds ratio, 1.7; 95% confidence interval, 1.0–2.9). Histologic chorioamnionitis was not associated with cognitive impairment. These findings held after adjustment for gestational age at delivery. In contrast to histologic chorioamnionitis, a clinical diagnosis of chorioamnionitis was not associated with neurodevelopmental impairment. Conclusion: Histologic chorioamnionitis may be associated with some forms of neurodevelopmental impairment at 10 years of life among infants born <28 weeks’ gestation

Organic nitrate and secondary organic aerosol yield from NO3 oxidation of ß-pinene evaluated using a gas-phase kinetics/aerosol partitioning model

The yields of organic nitrates and of secondary organic aerosol (SOA) particle formation were measured for the reaction NO3+beta-pinene under dry and humid conditions in the atmosphere simulation chamber SAPHIR at Research Center Julich. These experiments were conducted at low concentrations of NO3 (NO3+N2O5 < 10 ppb) and beta-pinene (peak similar to 15 ppb), with no seed aerosol. SOA formation was observed to be prompt and substantial (similar to 50% mass yield under both dry conditions and at 60% RH), and highly correlated with organic nitrate formation. The observed gas/aerosol partitioning of organic nitrates can be simulated using an absorptive partitioning model to derive an estimated vapor pressure of the condensing nitrate species of p(vap) similar to 5x10(-6) Torr (6.67x10(-4) Pa), which constrains speculation about the oxidation mechanism and chemical identity of the organic nitrate. Once formed the SOA in this system continues to evolve, resulting in measurable aerosol volume decrease with time. The observations of high aerosol yield from NOx-dependent oxidation of monoterpenes provide an example of a significant anthropogenic source of SOA from biogenic hydrocarbon precursors. Estimates of the NO3+beta-pinene SOA source strength for California and the globe indicate that NO3 reactions with monoterpenes are likely an important source (0.5-8% of the global total) of organic aerosol on regional and global scales

Understanding the relationship between environmental arsenic and prostate cancer aggressiveness among African-American and European-American men in North Carolina

High-level exposure to arsenic, a known carcinogen and endocrine disruptor, is associated with prostate cancer (PCa) mortality. Whether low-level exposure is associated with PCa aggressiveness remains unknown. We examined the association between urinary arsenic and PCa aggressiveness among men in North Carolina. This cross-sectional study included 463 African-American and 491 European-American men with newly diagnosed, histologically confirmed prostate adenocarcinoma. PCa aggressiveness was defined as low aggressive (Gleason score &lt; 7, stage = cT1–cT2, and PSA &lt; 10 ng/mL) versus intermediate/high aggressive (all other cases). Total arsenic and arsenical species (inorganic arsenic (iAsIII + iAsV), arsenobetaine, monomethyl arsenic, and dimethyl arsenic)) and specific gravity were measured in spot urine samples obtained an average of 23.7 weeks after diagnosis. Multivariable logistic regression was used to estimate the covariate-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for PCa aggressiveness in association with arsenic tertiles/quantiles overall and by race. The highest (vs. lowest) tertile of total arsenic was associated with PCa aggressiveness ORs of 1.77 (95% CI = 1.05–2.98) among European-American men, and 0.94 (95% CI = 0.57–1.56) among African-American men (PInteraction = 0.04). In contrast, total arsenic and arsenical species were not associated with PCa aggressiveness in unstratified models. Low-level arsenic exposure may be associated with PCa aggressiveness among European-Americans, but not among African-Americans

Obtaining CKM Phase Information from B Penguin Decays

We discuss a method for extracting CP phases from pairs of B decays which are related by flavor SU(3). One decay (B0 -> M1 M2) receives a significant bbar -> dbar penguin contribution. The second (B' -> M1' M2') has a significant bbar -> sbar penguin contribution, but is dominated by a single amplitude. CP phase information is obtained using the fact that the B' -> M1' M2' amplitude is related by SU(3) to a piece of the B0 -> M1 M2 amplitude. The leading-order SU(3)-breaking effect (~25%) responsible for the main theoretical error can be removed. For some decay pairs, it can be written in terms of known decay constants. In other cases, it involves a ratio of form factors. However, this form-factor ratio can either be measured experimentally, or eliminated by considering a double ratio of amplitudes. In all cases, one is left only with a second-order effect, ~5%. We find twelve pairs of B decays to which this method can be applied. Depending on the decay pair, we estimate the total theoretical error in relating the B' -> M1' M2' and B0 -> M1 M2 amplitudes to be between 5% and 15%. The most promising decay pairs are Bd -> pi+ pi- and Bu+ -> K0 pi+, and Bd -> D+ D- and Bd -> Ds+ D- or Bu+ -> Ds+ D0bar.Comment: 38 pages, JHEP format, no figures. Comments added to text regarding most promising decay pairs; references added; conclusions unchange

Spin density wave dislocation in chromium probed by coherent x-ray diffraction

We report on the study of a magnetic dislocation in pure chromium. Coherent x-ray diffraction profiles obtained on the incommensurate Spin Density Wave (SDW) reflection are consistent with the presence of a dislocation of the magnetic order, embedded at a few micrometers from the surface of the sample. Beyond the specific case of magnetic dislocations in chromium, this work may open up a new method for the study of magnetic defects embedded in the bulk.Comment: 8 pages, 7 figure

Organic nitrate aerosol formation via NO³ + biogenic volatile organic compounds in the southeastern United States

Gas- and aerosol-phase measurements of oxidants, biogenic volatile organic compounds (BVOCs) and organic nitrates made during the Southern Oxidant and Aerosol Study (SOAS campaign, Summer 2013) in central Alabama show that a nitrate radical (NO₃) reaction with monoterpenes leads to significant secondary aerosol formation. Cumulative losses of NO₃ to terpenes are correlated with increase in gasand aerosol-organic nitrate concentrations made during the campaign. Correlation of NO₃ radical consumption to organic nitrate aerosol formation as measured by aerosol mass spectrometry and thermal dissociation laser-induced fluorescence suggests a molar yield of aerosol-phase monoterpene nitrates of 23–44 %. Compounds observed via chemical ionization mass spectrometry (CIMS) are correlated to predicted nitrate loss to BVOCs and show C₁₀H₁₇NO₅, likely a hydroperoxy nitrate, is a major nitrate-oxidized terpene product being incorporated into aerosols. The comparable isoprene product C₅H₉NO₅ was observed to contribute less than 1% of the total organic nitrate in the aerosol phase and correlations show that it is principally a gas-phase product from nitrate oxidation of isoprene. Organic nitrates comprise between 30 and 45% of the NOy budget during SOAS. Inorganic nitrates were also monitored and showed that during incidents of increased coarse-mode mineral dust, HNO₃ uptake produced nitrate aerosol mass loading at a rate comparable to that of organic nitrate produced via NO₃ CBVOCs