1,684 research outputs found

    Influence of Maternal Glycemia on Intrauterine Fetal Adiposity Distribution after a Normal Oral Glucose Tolerance Test at 28 Weeks Gestation

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    Objective. To examine the relationship between maternal glucose levels and intrauterine fetal adiposity distribution in women with a normal oral glucose tolerance test (OGTT) at 28 weeks gestation. Study Design. We recruited 231 women with a singleton pregnancy. At 28 and 37 weeks gestation, sonographic measurements of fetal body composition were performed. Multiple regression analysis was used to study the influence of different maternal variables on fetal adiposity distribution. Results. Maternal glucose levels correlated with the fetal abdominal subcutaneous tissue measurements (r = 0.2; P = 0.014) and with birth weight (r = 0.1; P = 0.04). Maternal glucose levels did not correlate with the fetal mid-thigh muscle thickness and mid-thigh subcutaneous tissue measurements. Conclusion. We found that in nondiabetic women maternal glucose levels not only influence fetal adiposity and birth weight, but also influence the distribution of fetal adiposity. This supports previous evidence that maternal glycemia is a key determinant of intrauterine fetal programming

    Increasing Capacity for Evaluation of Community-Based Organizations: Lessons from the Ohio Equity Institute

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    Background: Community-based organizations (CBOs) play an important role delivering disease prevention and health promotion activities to address community health needs and improve the health of individuals living in their communities. While CBOs play this important role, evaluation of the services they deliver is hampered by limited infrastructure to systematically collect data from these organizations. To address this gap, we report on a case study of the development of the Ohio Equity Institute (OEI) Data Portal. The OEI is a statewide initiative that supports 65 CBOs across Ohio to deliver 3 evidence-based interventions (ie, CenteringPregnancy, Community Health Workers, and Home Visiting) to address infant mortality in underserved populations. Methods: Employing principles of community-engaged stakeholder research and user-centered design, we conducted Plan-Do-Study-Act cycles, including semistructured interviews with 43 key informants, to improve the development, implementation, and use of the OEI Data Portal. Results: This process identified both technical and implementation challenges, and offered opportunities to make improvements to the data collection system itself as well as to the integration of this system with CBO workflows. These improvements yielded significant gains in terms of the quantity and quality of data submission, ultimately contributing to ongoing outcome evaluation efforts. Conclusion: Our findings provide important insight into the challenges experienced by CBOs when participating in a statewide CBO data evaluation infrastructure development and implementation. As Ohio and other states push to expand collaborations between CBOs and health care organizations, leaders should leverage existing data collection to facilitate a more comprehensive and effective process

    Pilot-scale formation of whey protein aggregates determine the stability of heat-treated whey protein solutions—Effect of pH and protein concentration

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    peer-reviewedDenaturation and consequent aggregation in whey protein solutions is critical to product functionality during processing. Solutions of whey protein isolate (WPI) prepared at 1, 4, 8, and 12% (wt/wt) and pH 6.2, 6.7, or 7.2 were subjected to heat treatment (85°C × 30 s) using a pilot-scale heat exchanger. The effects of heat treatment on whey protein denaturation and aggregation were determined by chromatography, particle size, turbidity, and rheological analyses. The influence of pH and WPI concentration during heat treatment on the thermal stability of the resulting dispersions was also investigated. Whey protein isolate solutions heated at pH 6.2 were more extensively denatured, had a greater proportion of insoluble aggregates, higher particle size and turbidity, and were significantly less heat-stable than equivalent samples prepared at pH 6.7 and 7.2. The effects of WPI concentration on denaturation/aggregation behavior were more apparent at higher pH where the stabilizing effects of charge repulsion became increasingly influential. Solutions containing 12% (wt/wt) WPI had significantly higher apparent viscosities, at each pH, compared with lower protein concentrations, with solutions prepared at pH 6.2 forming a gel. Smaller average particle size and a higher proportion of soluble aggregates in WPI solutions, pre-heated at pH 6.7 and 7.2, resulted in improved thermal stability on subsequent heating. Higher pH during secondary heating also increased thermal stability. This study offers insight into the interactive effects of pH and whey protein concentration during pilot-scale processing and demonstrates how protein functionality can be controlled through manipulation of these factors

    Understanding and application of daptomycin-susceptible dose-dependent category for Enterococcus: A mixed-methods study

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    Background: In 2018, the Clinical Microbiology Laboratory at our institution adopted updated daptomycin Methods: This mixed-methods study combined a clinician survey with a retrospective pre-post prescribing analysis. An 8-question survey was distributed to infectious diseases (ID) and internal medicine (IM) clinicians. A retrospective chart review of hospitalized adults with infections due to Results: Survey response rates were 40 of 98 (41%) for IM and 22 of 34 (65%) for ID clinicians. ID clinicians scored significantly higher than IM clinicians in knowledge of SDD. Chart review of 474 patients (225 pre- vs 249 post-SDD) showed that daptomycin dosage following susceptibility testing was significantly higher post-SDD compared with pre-SDD (8.5 mg/kg vs 6.4 mg/kg; Conclusions: The survey revealed that ID clinicians placed more importance on and had more confidence in the SDD category over IM clinicians. SDD reporting was associated with a change in definitive daptomycin dosing. ID specialist involvement is recommended in the care of infections due to enterococci for which daptomycin is reported as SDD given their expertise

    Children's School Lives in Junior Infants

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    This report is the third in the series from Children’s School Lives, an innovative, longitudinal research study involving almost 4,000 children in 189 primary schools. One of the defining features of the study is the strong emphasis it places on listening to and learning directly from children about their experience of being in primary school in Ireland. This particular report introduces us to the youngest children in the study. The multiple perspectives gathered from the children themselves, their families, teachers and school principals, converge to provide us with a rich, detailed picture of the children’s first year in school. Uniquely, this period incorporates the months just prior to the arrival of the Coronavirus on Irish shores and the weeks immediately after the commencement of the first national lockdown in Spring 2020. Early childhood is a time of being and becoming, a time which provides important foundations for children’s learning and for life itself. We know from research that the first six years of a child’s life, their early childhood years, are particularly important for their holistic development. We also know from research that a positive transition from preschool to primary school is a predictor of children’s future success in terms of social, emotional and educational outcomes. Yet, despite this knowledge, relatively little research exists in the Irish context on children’s initial experiences in primary school. The Children’s School Lives study responds directly to this research gap by capturing, through multiple voices, comprehensive insights into the children’s initial weeks and months in their primary classrooms.National Council for Curriculum and Assessment (NCCA

    A survey of emergency department use in patients with cyclic vomiting syndrome

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    <p>Abstract</p> <p>Background</p> <p>Cyclic vomiting syndrome (CVS), a chronic disorder characterized by recurrent episodes of vomiting, is frequently unrecognized and is associated with high utilization of emergency department (ED) services.</p> <p>Methods</p> <p>A web-based survey was posted on the Cyclic Vomiting Syndrome Association (CVSA) website to assess utilization of ED services in patients with CVS.</p> <p>Results</p> <p>Of 251 respondents, 104 (41.4%) were adult CVS patients and 147 (58.6%) were caregivers of pediatric and adult patients. In the adult group, the median number of ED visits for CVS symptoms was 15(range 1 - 200), with a median of 7 ED visits prior to a diagnosis of CVS (range 0 - 150). In the caregiver group, the median number of ED visits was 10 (range 1 - 175) and the median number of ED visits prior to a diagnosis of CVS was 5 (range 0 - 65). CVS was not diagnosed in the ED in 89/104 (93%) adults and 119/147 (93%) patients in the caregiver group. CVS was not recognized in the ED in 84/95 (88%) of adults and 97/122 (80%) of patients in the caregiver group, despite an established diagnosis of CVS.</p> <p>Conclusion</p> <p>There is a sub-group of adult and pediatric CVS patients who are high utilizers of ED services and CVS is not recognized in the ED in the majority of patients. Improved efforts to educate ED physicians are indicated to optimize treatment of patients with CVS and to decrease potential overuse of ED services.</p

    First-Year Spectroscopy for the SDSS-II Supernova Survey

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    This paper presents spectroscopy of supernovae discovered in the first season of the Sloan Digital Sky Survey-II Supernova Survey. This program searches for and measures multi-band light curves of supernovae in the redshift range z = 0.05 - 0.4, complementing existing surveys at lower and higher redshifts. Our goal is to better characterize the supernova population, with a particular focus on SNe Ia, improving their utility as cosmological distance indicators and as probes of dark energy. Our supernova spectroscopy program features rapid-response observations using telescopes of a range of apertures, and provides confirmation of the supernova and host-galaxy types as well as precise redshifts. We describe here the target identification and prioritization, data reduction, redshift measurement, and classification of 129 SNe Ia, 16 spectroscopically probable SNe Ia, 7 SNe Ib/c, and 11 SNe II from the first season. We also describe our efforts to measure and remove the substantial host galaxy contamination existing in the majority of our SN spectra.Comment: Accepted for publication in The Astronomical Journal(47pages, 9 figures

    EPHA2-dependent outcompetition of KRASG12D mutant cells by wild-type neigbors in the adult pancreas

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    As we age, our tissues are repeatedly challenged by mutational insult, yet cancer occurrence is a relatively rare event. Cells carrying cancer-causing genetic mutations compete with normal neighbors for space and survival in tissues. However, the mechanisms underlying mutant-normal competition in adult tissues and the relevance of this process to cancer remain incompletely understood. Here, we investigate how the adult pancreas maintains tissue health in vivo following sporadic expression of oncogenic Kras (KrasG12D), the key driver mutation in human pancreatic cancer. We find that when present in tissues in low numbers, KrasG12D mutant cells are outcompeted and cleared from exocrine and endocrine compartments in vivo. Using quantitative 3D tissue imaging, we show that before being cleared, KrasG12D cells lose cell volume, pack into round clusters, and E-cadherin-based cell-cell adhesions decrease at boundaries with normal neighbors. We identify EphA2 receptor as an essential signal in the clearance of KrasG12D cells from exocrine and endocrine tissues in vivo. In the absence of functional EphA2, KrasG12D cells do not alter cell volume or shape, E-cadherin-based cell-cell adhesions increase and KrasG12D cells are retained in tissues. The retention of KRasG12D cells leads to the early appearance of premalignant pancreatic intraepithelial neoplasia (PanINs) in tissues. Our data show that adult pancreas tissues remodel to clear KrasG12D cells and maintain tissue health. This study provides evidence to support a conserved functional role of EphA2 in Ras-driven cell competition in epithelial tissues and suggests that EphA2 is a novel tumor suppressor in pancreatic cancer
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