Testing Educational Strategies for Shaken Baby Syndrome

Shaken Baby Syndrome (SBS) occurs from the violent shaking of an infant, which may lead to brain damage or death. The goal of this study was to assess educational methods used to teach new mothers about SBS

Effect of Student Involvement on Patient Perceptions of Ambulatory Care Visits

OBJECTIVE: To determine if patient satisfaction with ambulatory care visits differs when medical students participate in the visit. DESIGN: Randomized controlled trial. SETTING: Academic general internal medicine practice. PARTICIPANTS: Outpatients randomly assigned to see an attending physician only (N = 66) or an attending physician plus medical student (N = 68). MEASUREMENTS AND MAIN RESULTS: Patient perceptions of the office visit were determined by telephone survey. Overall office visit satisfaction was higher for the “attending physician only” group (61% vs 48% excellent), although this was not statistically significant (P = .16). There was no difference between the study groups for patient ratings of their physician overall (80% vs 85% excellent; P = .44). In subsidiary analyses, patients who rated their attending physician as “excellent” rated the overall office visit significantly higher in the “attending physician only” group (74% vs 55%; P = .04). Among patients in the “attending physician plus medical student” group, 40% indicated that medical student involvement “probably” or “definitely” did not improve their care, and 30% responded that they “probably” or “definitely” did not want to see a student at subsequent office visits. CONCLUSIONS: Although our sample size was small, we found no significant decrement in patient ratings of office visit satisfaction from medical student involvement in a global satisfaction survey. However, a significant number of patients expressed discontent with student involvement in the visit when asked directly. Global assessment of patient satisfaction may lack sensitivity for detection of dissatisfaction. Future research in this area should employ more sensitive measures of patient satisfaction

Combined microRNA and mRNA microfluidic TaqMan array cards for the diagnosis of malignancy of multiple types of pancreatico-biliary tumors in fine-needle aspiration material

Pancreatic ductal adenocarcinoma (PDAC) continues to carry the lowest survival rates among all solid tumors. A marked resistance against available therapies, late clinical presentation and insufficient means for early diagnosis contribute to the dismal prognosis. Novel biomarkers are thus required to aid treatment decisions and improve patient outcomes. We describe here a multi-omics molecular platform that allows for the first time to simultaneously analyze miRNA and mRNA expression patterns from minimal amounts of biopsy material on a single microfluidic TaqMan Array card. Expression profiles were generated from 113 prospectively collected fine needle aspiration biopsies (FNAB) from patients undergoing surgery for suspect masses in the pancreas. Molecular classifiers were constructed using support vector machines, and rigorously evaluated for diagnostic performance using 10 710fold cross validation. The final combined miRNA/mRNA classifier demonstrated a sensitivity of 91.7%, a specificity of 94.5%, and an overall diagnostic accuracy of 93.0% for the differentiation between PDAC and benign pancreatic masses, clearly outperfoming miRNA-only classifiers. The classification algorithm also performed very well in the diagnosis of other types of solid tumors (acinar cell carcinomas, ampullary cancer and distal bile duct carcinomas), but was less suited for the diagnostic analysis of cystic lesions. We thus demonstrate that simultaneous analysis of miRNA and mRNA biomarkers from FNAB samples using multi-omics TaqMan Array cards is suitable to differentiate suspect solid pancreatic masses with high precision

A global map of mangrove forest soil carbon at 30 m spatial resolution

With the growing recognition that effective action on climate change will require a combination of emissions reductions and carbon sequestration, protecting, enhancing and restoring natural carbon sinks have become political priorities. Mangrove forests are considered some of the most carbon-dense ecosystems in the world with most of the carbon stored in the soil. In order for mangrove forests to be included in climate mitigation efforts, knowledge of the spatial distribution of mangrove soil carbon stocks are critical. Current global estimates do not capture enough of the finer scale variability that would be required to inform local decisions on siting protection and restoration projects. To close this knowledge gap, we have compiled a large georeferenced database of mangrove soil carbon measurements and developed a novel machine-learning based statistical model of the distribution of carbon density using spatially comprehensive data at a 30 m resolution. This model, which included a prior estimate of soil carbon from the global SoilGrids 250 m model, was able to capture 63% of the vertical and horizontal variability in soil organic carbon density (RMSE of 10.9 kg m−3). Of the local variables, total suspended sediment load and Landsat imagery were the most important variable explaining soil carbon density. Projecting this model across the global mangrove forest distribution for the year 2000 yielded an estimate of 6.4 Pg C for the top meter of soil with an 86–729 Mg C ha−1 range across all pixels. By utilizing remotely-sensed mangrove forest cover change data, loss of soil carbon due to mangrove habitat loss between 2000 and 2015 was 30–122 Tg C with >75% of this loss attributable to Indonesia, Malaysia and Myanmar. The resulting map products from this work are intended to serve nations seeking to include mangrove habitats in payment-for- ecosystem services projects and in designing effective mangrove conservation strategies

Pancreatic cancer risk in relation to lifetime smoking patterns, tobacco type, and dose-response relationships.

BACKGROUND: Despite smoking being a well-established risk factor for pancreatic cancer (PC), there is a need to further characterize PC risk according to lifespan smoking patterns and other smoking features. Our aim was to deeply investigate them within a large European case-control study. METHODS: Tobacco smoking habits and other relevant information was obtained from 2,009 cases and 1,532 controls recruited in the PanGenEU study using standardized tools. Multivariate logistic regression analysis was performed to evaluate PC risk by smoking characteristics and interactions with other PC risk factors. Fractional polynomials and restricted cubic splines were used to test for non-linearity of the dose-response relationships and to analyse their shape. RESULTS: Relative to never-smokers, current smokers (OR=1.72, 95%CI: 1.39-2.12), those inhaling into the throat (OR=1.48, 95%CI: 1.11-1.99), chest (OR=1.33, 95%CI: 1.12-1.58), or using non-filtered cigarettes (OR=1.69, 95%CI: 1.10-2.61), were all at an increased PC risk. PC risk was highest in current black tobacco smokers (OR=2.09, 95%CI: 1.31-3.41), followed by blond tobacco smokers (OR=1.43, 95%CI: 1.01-2.04). Childhood exposure to tobacco smoke relative to parental smoking was also associated with increased PC risk (OR=1.24, 95%CI: 1.03-1.49). Dose-response relationships for smoking duration, intensity, cumulative dose, and smoking cessation were non-linear and showed different shapes by tobacco type. Effect modification by family history of PC and diabetes was likely. CONCLUSIONS: This study reveals differences in PC risk by tobacco type and other habit characteristics, as well as non-linear risk associations. IMPACT: This characterization of smoking-related PC risk profiles may help in defining PC high-risk populations

Inactivation of PRIM1 Function Sensitizes Cancer Cells to ATR and CHK1 Inhibitors

The phosphoinositide 3-kinase–related kinase ATR is a central regulator of the DNA damage response. Its chemical inhibition eliminates subsets of cancer cells in various tumor types. This effect is caused at least partly by the synthetically lethal relationship between ATR and certain DNA repair genes. In a previous screen using an siRNA library against DNA repair genes, we identified PRIM1, a part of the polymerase α-primase complex, as acting synthetically lethal with ATR. Applying a genetic ATR knock-in model of colorectal cancer cells, we confirmed that PRIM1 depletion inhibited proliferation of ATR-deficient cells and excluded artifacts due to clonal variation using an ATR reexpressing cell clone. We expanded these data by demonstrating in different cell lines that also chemical inhibition of ATR or its main effector kinase CHK1 reduces proliferation upon depletion of PRIM1. Mechanistically, PRIM1 depletion in ATR-deficient cells caused S-phase stasis in the absence of increased DNA damage followed by Wee1-mediated activation of caspase 8 and apoptosis. As PRIM1 inactivation sensitizes cancer cells to ATR and CHK1 inhibitors, mutations in PRIM1 or other components of the polymerase α-primase complex could represent novel targets for individualized tumor therapeutic approaches using ATR/CHK1 inhibitors, as has been previously demonstrated for POLD1, the catalytic subunit of polymerase δ

Maternal dietary methionine restriction alters the expression of energy metabolism genes in the duckling liver

International audienceBackground In mammals, the nutritional status experienced during embryonic development shapes key metabolic pathways and influences the health and phenotype of the future individual, a phenomenon known as nutritional programming. In farmed birds as well, the quantity and quality of feed offered to the dam can impact the phenotype of the offspring. We have previously reported that a 38% reduction in the intake of the methyl donor methionine in the diet of 30 female ducks during the growing and laying periods - from 10 to 51 weeks of age - reduced the body weight of their 180 mule ducklings compared to that of 190 ducklings from 30 control females. The maternal dietary methionine restriction also altered the hepatic energy metabolism studied in 30 of their ducklings. Thus, their plasma glucose and triglyceride concentrations were higher while their plasma free fatty acid level was lower than those measured in the plasma of 30 ducklings from the control group. The objective of this new study was to better understand how maternal dietary methionine restriction affected the livers of their newly hatched male and female ducklings by investigating the hepatic expression levels of 100 genes primarily targeting energy metabolism, amino acid transport, oxidative stress, apoptotic activity and susceptibility to liver injury. Results Sixteen of the genes studied were differentially expressed between the ducklings from the two groups. Maternal dietary methionine restriction affected the mRNA levels of genes involved in different pathways related to energy metabolism such as glycolysis, lipogenesis or electron transport. Moreover, the mRNA levels of the nuclear receptors PPARGC1B, PPARG and RXRA were also affected. Conclusions Our results show that the 38% reduction in methionine intake in the diet of female ducks during the growing and egg-laying periods impacted the liver transcriptome of their offspring, which may explain the previously observed differences in their liver energy metabolism. These changes in mRNA levels, together with the observed phenotypic data, suggest an early modulation in the establishment of metabolic pathways

Maternal dietary methionine restriction alters hepatic expression of one-carbon metabolism and epigenetic mechanism genes in the ducklings

International audienceAbstract Background Embryonic and fetal development is very susceptible to the availability of nutrients that can interfere with the setting of epigenomes, thus modifying the main metabolic pathways and impacting the health and phenotypes of the future individual. We have previously reported that a 38% reduction of the methyl donor methionine in the diet of 30 female ducks reduced the body weight of their 180 mule ducklings compared to that of 190 ducklings from 30 control females. The maternal methionine-restricted diet also altered plasmatic parameters in 30 of their ducklings when compared to that of 30 ducklings from the control group. Thus, their plasma glucose and triglyceride concentrations were higher while their free fatty acid level and alanine transaminase activity were decreased. Moreover, the hepatic transcript level of 16 genes involved in pathways related to energy metabolism was significantly different between the two groups of ducklings. In the present work, we continued studying the liver of these newly hatched ducklings to explore the impact of the maternal dietary methionine restriction on the hepatic transcript level of 70 genes mostly involved in one-carbon metabolism and epigenetic mechanisms. Results Among the 12 genes ( SHMT1 , GART , ATIC , FTCD , MSRA , CBS , CTH , AHCYL1 , HSBP1 , DNMT3 , HDAC9 and EZH2 ) identified as differentially expressed between the two maternal diet groups ( p -value < 0.05), 3 of them were involved in epigenetic mechanisms. Ten other studied genes ( MTR , GLRX , MTHFR , AHCY , ADK , PRDM2 , EEF1A1 , ESR1 , PLAGL1 , and WNT11 ) tended to be differently expressed (0.05 < p -value < 0.10). Moreover, the maternal dietary methionine restriction altered the number and nature of correlations between expression levels of differential genes for one-carbon metabolism and epigenetic mechanisms, expression levels of differential genes for energy metabolism, and phenotypic traits of ducklings. Conclusion This avian model showed that the maternal dietary methionine restriction impacted both the mRNA abundance of 22 genes involved in one-carbon metabolism or epigenetic mechanisms and the mRNA abundance of 16 genes involved in energy metabolism in the liver of the newly hatched offspring, in line with the previously observed changes in their phenotypic traits

Thermorégulation des porcelets issus de deux lignées divergentes pour l’efficacité alimentaire

Hypothermia is a factor of piglet neonatal mortality. This study used Infra-Red Thermography (IRT) to assess thermoregulation abilities of piglets from two lines divergent for residual feed intake (RFI). Birth phenotypes (e.g. body weight, rectal temperature, physical measures, vitality test) were recorded from piglets selected for low RFI (more efficient; LRFI; n=34) or high RFI (less efficient; HRFI; n=28). The IRT images were taken at 8, 15, 30 and 60 min post-partum. Temperatures of the ear base and tip, and minimum, maximum and average temperatures of the back (i.e. shoulders to rumps) were extracted with Thermacam Researcher Pro 2.0 and analysed with linear mixed models. No difference in phenotypic data was detected between the two lines. All temperatures increased over time. Rectal temperature of piglets at birth was correlated with the initial temperature of the ear base and the maximum back temperature (0.36 and 0.35, respectively, P < 0.05). Overall, LRFI piglets, compared to HRFI piglets, had higher minimum (28.0 ± 0.2 °C vs 26.8 ± 0.2 °C, respectively, P < 0.001) and average (35.5 ± 0.2 °C vs 34.5 ± 0.1 °C, respectively, P < 0.001) back temperatures. Ear tip temperature decreased in HRFI piglets from 8 to 15 min post-partum, while it increased in LRFI piglets (-1.1 ± 0.4 °C vs 0.5 ± 0.5 °C, respectively, P < 0.05). In conclusion, IRT allowed non-invasive assessment of piglets’ thermoregulation abilities. Piglets selected for low RFI seemed to have better thermoregulation abilities at birth