Intrapulmonary expression of PPAR in a rat model of pulmonary hypertension [abstract]

Abstract only availableFaculty Mentor: Jeffrey Skimming MD and Vincent DeMarco PhD, Child HealthActivation of peroxisome proliferator-activated receptor-gamma (PPARγ) inhibits vascular smooth muscle proliferation and neointimal formation associated with pulmonary hypertension. Recently, our laboratory developed a model of pulmonary hypertension incorporating both pnuemonectomy (PNX) of the left lung and exposure to monocrotaline (MCT) in rats. Together, PNX and MCT caused inflammation and vascular remodeling within the right lung including smooth muscle proliferation and neointimal formation. Therefore, we tested the hypothesis that PNX/MCT dual insult induces pulmonary hypertension by decreasing PPARγ expression. METHODS: Sixteen rats were randomly divided into four groups: 1) PNX/MCT, 2) PNX/Phosphate Buffer Solution (PBS), 3) Sham Surgery (SS)/MCT, and 4) SS/PBS. Seven days after surgery, we injected the animals with either monocrotaline (60 mg/kg, s.q.) or PBS. Three weeks after those injections, right ventricular systolic pressures (RVSP) were measured. Lung tissue was harvested for analysis of PPARγ protein expression and histopathology. Right ventricular to left ventricular plus septum ratios (RVR) were also determined. RESULTS: PNX/MCT animals exhibited higher RVSPs and RVRs than the other treatment groups. Also, morphometric analysis revealed medial hypertrophy and neointimal formation within the resistance vessels of PNX/MCT rat lungs. In our study, neither PNX nor MCT alone had an effect on intrapulmonary expression of PPARγ protein. Surprisingly, however, the dual insult induced PPARγ expression (

Be a Better Buyer of Laundry Aids

This archival publication may not reflect current scientific knowledge or recommendations. Current information available from the University of Minnesota Extension: https://www.extension.umn.edu

Incidence of Obesity Among Young US Children Living in Low-Income Families, 2008–2011

OBJECTIVE: To examine the incidence and reverse of obesity among young low-income children and variations across population subgroups. METHODS: We included 1.2 million participants in federally funded child health and nutrition programs who were 0 to 23 months old in 2008 and were followed up 24 to 35 months later in 2010–2011. Weight and height were measured. Obesity at baseline was defined as gender-specific weight-for-length \u3e/=95th percentile on the 2000 Centers for Disease Control and Prevention growth charts. Obesity at follow-up was defined as gender-specific BMI-for-age \u3e/=95th percentile. We used a multivariable log-binomial model to estimate relative risk of obesity adjusting for gender, baseline age, race/ethnicity, duration of follow-up, and baseline weight-for-length percentile. RESULTS: The incidence of obesity was 11.0% after the follow-up period. The incidence was significantly higher among boys versus girls and higher among children aged 0 to 11 months at baseline versus those older. Compared with non-Hispanic whites, the risk of obesity was 35% higher among Hispanics and 49% higher among American Indians (AIs)/Alaska Natives (ANs), but 8% lower among non-Hispanic African Americans. Among children who were obese at baseline, 36.5% remained obese and 63.5% were nonobese at follow-up. The proportion of reversing of obesity was significantly lower among Hispanics and AIs/ANs than that among other racial/ethnic groups. CONCLUSIONS: The high incidence underscores the importance of earlylife obesity prevention in multiple settings for low-income children and their families. The variations within population subgroups suggest that culturally appropriate intervention efforts should be focused on Hispanics and AIs/ANs

Poorly Crystalline, Iron-Bearing Aluminosilicates and Their Importance on Mars

Martian rocks and sediments contain weathering products including evaporite salts and clay minerals that only form as a result of interaction between rocks and water [1-6]. These weathering products are key to studying the history of water on Mars because their type, abundance and location provide clues to past conditions on the surface of the planet, as well as to the possible location of present-day reservoirs of water. Weathering of terrestrial volcanic rocks similar to those on Mars produces nano-sized, variably hydrated aluminosilicate and iron oxide minerals [7-10] including allophane, imogolite, halloysite, hisingerite, and ferrihydrite. The nanoaluminosilicates can contain isomorphically substituted Fe, which affects their spectral and physical properties. Detection and quantification of such minerals in natural environments on earth is difficult due to their variable chemical composition and lack of long-range crystalline order [9, 11, 12]. Despite the difficulty in characterizing these materials, they are common on Earth, and data from orbital remote sensing and rover-based instruments suggest that they are also present on Mars [9, 10, 13-17]. Their accurate detection and quantification require a better understanding of how composition affects their spectral properties. We present here the results of XAFS spectroscopy; these results will be corroborated with planned Mossbauer and reflectance spectroscopy

Hemidiaphragmatic paralysis increases postoperative morbidity after a modified Fontan operation

AbstractObjectives: After a Fontan procedure, forward pulmonary blood flow is augmented during inspiration because of negative intrathoracic pressure. Total pulmonary blood flow is higher during inspiration. With hemidiaphragmatic paralysis, inspiratory augmentation of pulmonary flow is lost or diminished. The objective of this study was to compare early postoperative morbidity after the modified Fontan operation in patients with and without hemidiaphragmatic paralysis. Methods: A case-control analysis was performed comparing 10 patients with documented hemidiaphragmatic paralysis against 30 patients without paralysis who were matched for diagnosis, fenestration, and age. The following early postoperative outcomes were assessed: duration of ventilator support, duration of hospital stay, incidence of ascites, prolonged effusions, and readmission. Results: Preoperatively, there were no significant differences between the 2 groups. However, among the postoperative outcomes, the duration of hospital stay (25.4 ± 16.6 days vs 10.8 ± 6.3 days; P =.03), incidence of ascites (70% vs 3%; P ||.001), prolonged pleural effusions (60% vs 13%; P =.007), and readmission (50% vs 7%; P =.007) were significantly greater in patients with hemidiaphragmatic paralysis than in those without hemidiaphragmatic paralysis. Conclusions: Hemidiaphragmatic paralysis after the modified Fontan operation is associated with an increase in early morbidity. Care should be taken to avoid injury to the phrenic nerve. Patients with prolonged effusions should be evaluated for hemidiaphragmatic paralysis.J Thorac Cardiovasc Surg 2001;122:856-6

An Emergency Room Decision-Support Program That Increased Physician Office Visits, Decreased Emergency Room Visits, and Saved Money

The objective of this study was to evaluate an Emergency Room having a Decision-Support (ERDS) program designed to appropriately reduce ER use among frequent users, defined as 3 or more visits within a 12-month period. To achieve this, adults with an AARP Medicare Supplement Insurance plan insured by UnitedHealthcare Insurance Company (for New York residents, UnitedHealthcare Insurance Company of New York) were eligible to participate in the program. These included 7070 individuals who elected to enroll in the ERDS program and an equal number of matched nonparticipants who were eligible but either declined or were unreachable. Program-related benefits were estimated by comparing the difference in downstream health care utilization and expenditures between engaged and not engaged individuals after using propensity score matching to adjust for case mix differences between these groups. As a result, compared with the not engaged, engaged individuals experienced better care coordination, evidenced by a greater reduction in ER visits (P=0.033) and hospital admissions (P=0.002) and an increase in office visits (P<0.001). The program was cost-effective, with a return on investment (ROI) of 1.24, which was calculated by dividing the total program savings ($3.41 million) by the total program costs ($2.75 million). The ROI implies that for every dollar invested in this program, $1.24 was saved, most of which was for the federal Medicare program. In conclusion, the decrease in ER visits and hospital admissions and the increase in office visits may indicate the program helped individuals to seek the appropriate levels of care. (Population Health Management 2014;17:257?264)Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140184/1/pop.2013.0117.pd

Effect of parallel surface cuts on bonding to dentine

The strength of adhesive joints has been found to result from combinations of micromechanical, chemical and diffusion components depending on the system1. The development of adhesives that bond dental restorative materials to human dentine has been a major advance in the science of dental materials. The purpose of this investigation was to study the contribution of parallel surface cuts on the joint strength of dentine adhesives. Half of the specimens were finished with 60 grit SiC paper as a control. The other half were polished with 600 grit SiC paper and then finished with an instrument that produced a series of parallel surface cuts. A two-way analysis of variance showed that both the surface preparation and the adhesive system had a significant effect on shear bond strength (p &lt; 0.0001). In general, the samples finished with parallel surface cuts gave shear bond strength values about double those finished with silicon carbide alone. For those control samples prepared with a 60 grit surface, the predominant type of failure was at the tooth/adhesive interface. The majority of samples with parallel surface cuts failed cohesively within the adhesive system. The experimental instrument is designed to produce retentive grooves or undercuts in the dentine surface which enhance micromechanical adhesion.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/31465/1/0000387.pd

Developing global guidance on human milk banking

Donor human milk is recommended by the World Health Organization both for its advantageous nutritional and biological properties when mother's own milk is not available and for its recognized support for lactation and breastfeeding when used appropriately. An increasing number of human milk banks are being established around the world, especially in low- and middle-income countries, to facilitate the collection, processing and distribution of donor human milk. In contrast to other medical products of human origin, however, there are no minimum quality, safety and ethical standards for donor human milk and no coordinating global body to inform national policies. We present the key issues impeding progress in human milk banking, including the lack of clear definitions or registries of products; issues around regulation, quality and safety; and ethical concerns about commercialization and potential exploitation of women. Recognizing that progress in human milk banking is limited by a lack of comparable evidence, we recommend further research in this field to fill the knowledge gaps and provide evidence-based guidance. We also highlight the need for optimal support for mothers to provide their own breastmilk and establish breastfeeding as soon as and wherever possible after birth

Influence of CYP2C19 Metabolizer Status on Escitalopram/Citalopram Tolerability and Response in Youth With Anxiety and Depressive Disorders

In pediatric patients, the selective serotonin reuptake inhibitors (SSRIs) escitalopram and citalopram (es/citalopram) are commonly prescribed for anxiety and depressive disorders. However, pharmacogenetic studies examining CYP2C19 metabolizer status and es/citalopram treatment outcomes have largely focused on adults. We report a retrospective study of electronic medical record data from 263 youth &lt; 19 years of age with anxiety and/or depressive disorders prescribed escitalopram or citalopram who underwent routine clinical CYP2C19 genotyping. Slower CYP2C19 metabolizers experienced more untoward effects than faster metabolizers (p = 0.015), including activation symptoms (p = 0.029) and had more rapid weight gain (p = 0.018). A larger proportion of slower metabolizers discontinued treatment with es/citalopram than normal metabolizers (p = 0.007). Meanwhile, faster metabolizers responded more quickly to es/citalopram (p = 0.005) and trended toward less time spent in subsequent hospitalizations (p = 0.06). These results highlight a disparity in treatment outcomes with es/citalopram treatment in youth with anxiety and/or depressive disorders when standardized dosing strategies were used without consideration of CYP2C19 metabolizer status. Larger, prospective trials are warranted to assess whether tailored dosing of es/citalopram based on CYP2C19 metabolizer status improves treatment outcomes in this patient population

Parental Coping Socialization is Associated with Healthy and Anxious Early-Adolescents’ Neural and Real-World Response to Threat

The ways parents socialize their adolescents to cope with anxiety (i.e. coping socialization) may be instrumental in the development of threat processing and coping responses. Coping socialization may be important for anxious adolescents, as they show altered neural threat processing and over-reliance on disengaged coping (e.g., avoidance and distraction), which can maintain anxiety. We investigated whether coping socialization was associated with anxious and healthy adolescents’ neural response to threat, and whether neural activation was associated with disengaged coping. Healthy and clinically anxious early-adolescents (N=120; M=11.46 years; 71 girls) and a parent engaged in interactions designed to elicit adolescents’ anxiety and parents’ response to adolescents’ anxiety. Parents’ use of reframing and problem-solving statements was coded to measure coping socialization. In a subsequent visit, we assessed adolescents’ neural response to threat words during a neuroimaging task. Adolescents’ disengaged coping was measured using ecological momentary assessment. Greater coping socialization was associated with lower anterior insula and perigenual cingulate activation in healthy adolescents and higher activation in anxious adolescents. Coping socialization was indirectly associated with less disengaged coping for anxious adolescents through neural activation. Findings suggest that associations between coping socialization and early adolescents’ neural response to threat differ depending on clinical status and have implications for anxious adolescents’ coping