Symptomatic adrenal insufficiency during inhaled corticosteroid treatment

Symptomatic adrenal insufficiency, presenting as hypoglycaemia or poor weight gain, may occur on withdrawal of corticosteroid treatment but has not previously been reported during inhaled corticosteroid treatment. This case series illustrates the occurence of clinically significant adrenal insufficiency in asthmatic children while patients were on inhaled corticosteroid treatment and the unexpected modes of presentation. General practitioners and paediatricians need to be aware that this unusual but acute serious complication may occur in patients treated

Applying Alternative Teaching Methods to Impart a Rounded, Liberal Arts and Sciences (LAS) Education: Students’ Reflections on the Role of Magazines as Instructional Tools

In a constantly and rapidly changing social world, students from all disciplines ought to attain a rounded education within the tradition of a “Liberal Arts and Sciences” (LAS) context. Students outside of the natural sciences must be encouraged to appreciate the place of those sciences in their lives. Conversely, students in the natural sciences must be encouraged to envision the role of other subjects in their lives. In order to accomplish this, however, we need to go beyond basic instructional approaches by applying alternatives such as using magazines and newspapers. This paper reports students’ reflections on the use of newspapers as supplementary instructional materials to enhance learning. Data were collected from an introductory liberal arts physics course using a survey instrument. The survey had five descriptive measures: student perceptions; creativity based on activities learned; ability to link concepts learned in class to articles in the news journal; ability to impart knowledge acquired; and identifying lessons based on a case study of a selected news article from the newspaper. Student reflections indicate that magazines can effect a positive learning experience and stimulate curiosity to read. It is concluded that this approach can be used to enhance student motivation and persistence in introductory classes, particularly in schools where resources are limited. Keywords: improvisation, Liberal Arts and Science education, magazines, student reflections

Use of laboratory-developed assays in global HIV-1 treatment-monitoring and research

There has been a surge in the emergence of HIV-1 drug resistance in Low and Middle-Income Countries (LMICs) due to poor drug-adherence and limited access to viral load testing, the current standard for treatment-monitoring. It is estimated that only 75% of people living with HIV (PLWH) worldwide have access to viral load testing. In LMICs, this figure is below 50%. In a recent WHO survey in mostly LMICs, 21 out of 30 countries surveyed found HIV-1 first-line pre-treatment drug resistance in over 10% of study participants. In the worst-affected regions, up to 68% of infants born to HIV-1 positive mothers were found to harbour first-line HIV-1 treatment resistance. This is a huge public health concern. Greater access to treatment-monitoring is required in LMICs if the UNAIDS "third 95" targets are to be achieved by 2030. Here, we review the current challenges of viral load testing and present the case for greater utilization of Laboratory-based assays that quantify intracellular HIV-1 RNA and/or DNA to provide broader worldwide access to HIV-1 surveillance, drug-resistance monitoring, and cure-research

Comparative Analysis of Participation of Teachers of STEM and Non-STEM Subjects in Professional Development

School administrators continuously consider teacher professional development (PD) as one of the key strategies to improving teachers’ pedagogical skills. Modern proposals for advancing education by improving student learning outcomes are centered on high quality professional development for teachers. However, teachers face a number of barriers when it comes to participation in PD. Also, students in K-12 levels taking Science, Technology, Engineering, and Mathematics (STEM) and non-STEM subjects often report different learning experiences, most of which influence their decisions to enroll in STEM or non-STEM career-related programs in higher education. Understanding factors that influence the differential in teacher participation in PD is a critical step towards addressing student interest in STEM careers. Using the cross-sectional survey data from the Teaching and Learning International Survey of 2013, this study compared the participation of middle school STEM and non-STEM teachers in PD activities in the US. A bivariate analysis was used to compare STEM subject teachers versus non-STEM subject teachers’ participation in PD activities, its impact, and challenges. The findings showed that PD participation was higher among teachers of STEM subjects, but not significantly different from those for non-STEM subjects. Out-field teaching (no formal training of subject taught) accounted for 10.3% of the survey participants. Further, conflict with one’s work schedule was one of the major barriers to PD participation for teachers

Author Correction: Development of a sensitive, quantitative assay with broad subtype specificity for detection of total HIV-1 nucleic acids in plasma and PBMC

Correction to: Scientific Reports https://doi.org/10.1038/s41598-021-03016-1, published online 28 January 202

Preconception maternal iodine status is associated with IQ but not with measures of executive function in childhood

Background: adverse effects of severe maternal iodine deficiency in pregnancy on fetal brain development are wellestablished, but the effects of milder deficiency are uncertain. Most studies examine iodine status in pregnancy; less is known about iodine nutrition before conception. Objective: we examined relations between maternal preconception iodine status and offspring cognitive function, within a prospective mother-offspring cohort. Methods: maternal iodine status was assessed through the use of the ratio of iodine:creatinine concentrations (I/Cr) in spot urine samples [median (IQR) period before conception 3.3 y (2.2-4.7 y)]. Childhood cognitive function was assessed at age 6-7 y. Full-scale IQ was assessed via the Wechsler Abbreviated Scale of Intelligence, and executive function through the use of tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB). Analyses (n = 654 mother-child dyads) were adjusted for potential confounders including maternal intelligence, education, and breastfeeding duration. Results: the median (IQR) urinary iodine concentration was 108.4 μg/L (62.2-167.8 μg/L) and the I/Cr ratio 114 μg/g (76- 164 μg/g). The preconception I/Cr ratio was positively associated with child IQ, before and after adjustment for potential confounding influences [β = 0.13 (95% CI: 0.04, 0.21)/SD, P = 0.003]. 8.9% of women had a preconception urinary I/Cr ratio &lt; 50 μg/g; compared with those with an I/Cr ratio ≥150 μg/g, the IQ of their offspring was 0.49 (95% CI: 0.79, 0.18) SD lower. There were no associations with the executive function outcomes assessed via CANTAB, before or after adjustment for confounders. Conclusions: the positive association between iodine status before conception and child IQ provides some support for demonstrated links between low maternal iodine status in pregnancy and poorer cognitive function reported in other studies. However, given the negative effects on school performance previously observed in children born to iodine-deficient mothers, the lack of associations with measures of executive function in the present study was unexpected. Further data are needed to establish the public health importance of low preconception iodine status.</p

Response to IJTLD article, "Having diabetes and being underweight in Asia: a potent risk factor for tuberculosis"

Contains fulltext : 220544pub.pdf (Publisher’s version ) (Closed access

Serum leptin and leptin binding activity in children and adolescents with hypothalamic dysfunction

Marked disturbance in eating behaviour and obesity are common sequelae of hypothalamic damage. To investigate whether these were associated with dysfunctional leptin central feedback, we evaluated serum leptin and leptin binding activity in 37 patients (age 3.5-21 yr) with tumour or trauma involving the hypothalamic-pituitary axis compared with 138 healthy children (age 5.0-18.2 yr). Patients were subdivided by BM

BMI is an important driver of beta-cell loss in type 1 diabetes upon diagnosis in 10 to 18-year-old children.

OBJECTIVE: Body weight-related insulin resistance probably plays a role in progression to type 1 diabetes, but has an uncertain impact following diagnosis. In this study, we investigated whether BMI measured at diagnosis was an independent predictor of C-peptide decline 1-year post-diagnosis. DESIGN: Multicentre longitudinal study carried out at diagnosis and up to 1-year follow-up. METHODS: Data on C-peptide were collected from seven diabetes centres in Europe. Patients were grouped according to age at diagnosis (5 years 10 years 18 years, n=410). Linear regression was used to investigate whether BMI was an independent predictor of change in fasting C-peptide over 1 year. Models were additionally adjusted for baseline insulin dose and HbA1c. RESULTS: In individuals diagnosed between 0 and 5 years, 5 and 10 years and those diagnosed >18 years, we found no association between BMI and C-peptide decline. In patients aged 10-18 years, higher BMI at baseline was associated with a greater decline in fasting C-peptide over 1 year with a decrease (beta 95% CI; P value) of 0.025 (0.010, 0.041) nM/kg per m(2) higher baseline BMI (P=0.001). This association remained significant after adjusting for gender and differences in HbA1c and insulin dose (beta=0.026, 95% CI=0.0097, 0.042; P=0.002). CONCLUSIONS: These observations indicate that increased body weight and increased insulin demand are associated with more rapid disease progression after diagnosis of type 1 diabetes in an age group 10-18 years. This should be considered in studies of beta-cell function in type 1 diabetes