Attitudes towards Nutrition Education among Pediatricians and Guardians

Presented as a poster at 2020 IUSM Education Day.Childhood obesity rates in the United States are at historic highs. In Lake County, Indiana, the obesity rates of WIC children ages 2-5 years old is 12.1%. While the causes of obesity are well known within the scientific community, there appears to be a disconnect when relaying this information to patients. One cause of this disconnect is the inadequate nutrition education that physicians receive during medical school and residency. A survey found that the average medical school devotes less than 20 hours to nutrition education. Additionally, the biochemical nutrition education that students receive in medical school cannot be easily translated to patient intervention. Since 62% of patients believe that their physicians can help them lose weight, having physicians who do not have adequate education on nutrition leaves patients without the help they need. Our surveys were developed to assess the level of nutrition counseling provided by pediatricians and how patients/guardians prefer to be educated. Our hypothesis is that pediatricians will benefit from further nutrition education in medical school, and that guardians will desire in person instructions in pediatric offices as well as easy and accessible online sources. Two surveys were created, one for physicians and another for parents/guardians of children ages 1-12 years old residing in Lake County. The physician survey contained 15 items that evaluated attitudes toward nutrition and obesity education. Topics included level of nutrition counseling education received in medical school and residency, how much time physicians spend educating patients/parents on nutrition, what nutrition education resources they currently provide, opinion on whose responsibility it is to provide nutrition education, and what approach they think would be best to educate patients and parents. The guardian survey contained 21 items that evaluated dietary behaviors. The dietary behaviors included family dynamics (who typically feds the children, if food is prepared in the home, and how much is spent on food each week) and child eating habits (how many snacks per day, how often the child eats fast food, and how often the child consumes sweetened beverages). The surveys will be utilized for future research, and the results will help determine the approach for educating physicians and guardians. A booklet of healthy recipes was also developed to educate on healthy eating and as a participation benefit. The goal of the booklet was to choose easy, child friendly recipes that the family could cook together. To gain background on nutrition education, we observed the different education methods of local pediatricians and reviewed the literature. Intervention at both the clinical and community levels will be important for improving long-term health outcomes in pediatric patients. The knowledge gained from these surveys will aide in the development of programs needed to provide physicians, guardians,and patients with proper nutrition education

Frazil ice Growth and Production during Katabatic Wind Events in the Ross Sea, Antarctica

Katabatic winds in coastal polynyas expose the ocean to extreme heat loss, causing intense sea ice production and dense water formation around Antarctica throughout autumn and winter. The advancing sea ice pack, combined with high winds and low temperatures, has limited surface ocean observations of polynyas in winter, thereby impeding new insights into the evolution of these ice factories through the dark austral months. Here, we describe oceanic observations during multiple katabatic wind events during May 2017 in the Terra Nova Bay and Ross Sea polynyas. Wind speeds regularly exceeded 20 m s−1, air temperatures were below −25 ∘C, and the oceanic mixed layer extended to 600 m. During these events, conductivity–temperature–depth (CTD) profiles revealed bulges of warm, salty water directly beneath the ocean surface and extending downwards tens of meters. These profiles reflect latent heat and salt release during unconsolidated frazil ice production, driven by atmospheric heat loss, a process that has rarely if ever been observed outside the laboratory. A simple salt budget suggests these anomalies reflect in situ frazil ice concentration that ranges from 13 to 266×10-3 role= presentation style= box-sizing: border-box; display: inline; line-height: normal; word-spacing: normal; word-wrap: normal; white-space: nowrap; float: none; direction: ltr; max-width: none; max-height: none; min-width: 0px; min-height: 0px; border: 0px; padding: 0px; margin: 0px; position: relative; \u3e266×10−3 kg m−3. Contemporaneous estimates of vertical mixing reveal rapid convection in these unstable density profiles and mixing lifetimes from 7 to 12 min. The individual estimates of ice production from the salt budget reveal the intensity of short-term ice production, up to 110 cm d−1 during the windiest events, and a seasonal average of 29 cm d−1. We further found that frazil ice production rates covary with wind speed and with location along the upstream–downstream length of the polynya. These measurements reveal that it is possible to indirectly observe and estimate the process of unconsolidated ice production in polynyas by measuring upper-ocean water column profiles. These vigorous ice production rates suggest frazil ice may be an important component in total polynya ice production

Technology Advancement of the Visible Nulling Coronagraph

The critical high contrast imaging technology for the Extrasolar Planetary Imaging Coronagraph (EPIC) mission concept is the visible nulling coronagraph (VNC). EPIC would be capable of imaging jovian planets, dust/debris disks, and potentially super-Earths and contribute to answering how bright the debris disks are for candidate stars. The contrast requirement for EPIC is 10(exp 9) contrast at 125 milli-arseconds inner working angle. To advance the VNC technology NASA/Goddard Space Flight Center, in collaboration with Lockheed-Martin, previously developed a vacuum VNC testbed, and achieved narrowband and broadband suppression of the core of the Airy disk. Recently our group was awarded a NASA Technology Development for Exoplanet Missions to achieve two milestones: (i) 10(exp 8) contrast in narrowband light, and, (ii) 10(ecp 9) contrast in broader band light; one milestone per year, and both at 2 Lambda/D inner working angle. These will be achieved with our 2nd generation testbed known as the visible nulling testbed (VNT). It contains a MEMS based hex-packed segmented deformable mirror known as the multiple mirror array (MMA) and coherent fiber bundle, i.e. a spatial filter array (SFA). The MMA is in one interferometric arm and works to set the wavefront differences between the arms to zero. Each of the MMA segments is optically mapped to a single mode fiber of the SFA, and the SFA passively cleans the sub-aperture wavefront error leaving only piston, tip and tilt error to be controlled. The piston degree of freedom on each segment is used to correct the wavefront errors, while the tip/tilt is used to simultaneously correct the amplitude errors. Thus the VNT controls both amplitude and wavefront errors with a single MMA in closed-loop in a vacuum tank at approx.20 Hz. Herein we will discuss our ongoing progress with the VNT

Risk Levels and Adverse Clinical Outcomes Among Patients With Nonvalvular Atrial Fibrillation Receiving Oral Anticoagulants

Importance The CHA2DS2-VASc score (calculated as congestive heart failure, hypertension, age 75 years and older, diabetes, stroke or TIA, vascular disease, age 65 to 74 years, and sex category) is the standard for assessing risk of stroke and systemic embolism and includes age and thromboembolic history. To our knowledge, no studies have comprehensively evaluated safety and effectiveness outcomes among patients with nonvalvular atrial fibrillation receiving oral anticoagulants according to independent, categorical risk strata. Objective To evaluate the incidence of key adverse outcomes among patients with nonvalvular atrial fibrillation receiving oral anticoagulants by CHA2DS2-VASc risk score range, thromboembolic event history, and age group. Design, Setting, and Participants This cohort study was a retrospective claims data analysis using combined data sets from 5 large health claims databases. Eligible participants were adult patients with nonvalvular atrial fibrillation who initiated oral anticoagulants. Data were analyzed between January 2012 and June 2019. Exposure Initiation of oral anticoagulants. Main Outcomes and Measures We observed clinical outcomes (including stroke or systemic embolism, major bleeding, and a composite outcome) on treatment through study end, censoring for discontinuation of oral anticoagulants, death, and insurance disenrollment. The population was stratified by CHA2DS2-VASc risk score; history of stroke, systemic embolism, or transient ischemic attack; and age groups. We calculated time to event, incidence rates, and cumulative incidence for outcomes. Results We identified 1 141 097 patients with nonvalvular atrial fibrillation; the mean (SD) age was 75.0 (10.5) years, 608 127 patients (53.3%) were men, and over 1 million were placed in the 2 highest risk categories (high risk 1, 327 766 participants; high risk 2, 688 449 participants). Deyo-Charlson Comorbidity Index scores ranged progressively alongside CHA2DS2-VASc risk score strata (mean [SD] scores: low risk, 0.4 [1.0]; high risk 2, 4.1 [2.9]). The crude incidence of stroke and systemic embolism generally progressed alongside risk score strata (low risk, 0.25 events per 100 person-years [95% CI, 0.18-0.34 events]; high risk 2, 3.43 events per 100 person-years [95% CI, 3.06-4.20 events]); patients at the second-highest risk strata with thromboembolic event history had higher stroke incidence vs patients at the highest risk score strata without event history (2.06 events per 100 person-years [95% CI, 2.00-3.12 events] vs 1.18 events per 100 person-years [95% CI, 1.14-1.30 events]). Major bleeding and composite incidence also increased progressively alongside risk score strata (major bleeding: low risk, 0.68 events per 100 person-years [95% CI, 0.56-0.82 events]; high risk 2, 6.29 events per 100 person-years [95% CI, 6.21-6.62 events]; composite incidence: 1.22 events per 100 person-years [95% CI, 1.06-1.41 events]; high risk 2, 10.67 events per 100 person-years [95% CI, 10.26-11.48 events]). The 12-month cumulative incidence proportions for stroke and systemic embolism, major bleeding, and composite outcomes progressed alongside risk score strata (stroke or systemic embolism, 0.30%-1.85%; major bleeding, 0.55%-5.55%; composite, 1.05%-8.23%). Age subgroup analysis followed similar trends. Conclusions and Relevance The observed incidence of stroke or systemic embolism and major bleeding events generally conformed to an expected increasing incidence by risk score, adding insight into the importance of specific risk score range, thromboembolic event history, and age group strata. These results can help inform clinical decision-making, research, and policy

Constitutive intestinal NF-κB does not trigger destructive inflammation unless accompanied by MAPK activation

Constitutive NF-κB activation in IECs induces inflammatory cytokines and chemokines in the lamina propria, but does not result in overt tissue damage unless acute inflammatory insults are present, causing TNF-dependent destruction and barrier disruption

Expressions 2001

https://openspace.dmacc.edu/expressions/1020/thumbnail.jp

The Precision nEDM Measurement with UltraCold Neutrons at TRIUMF

The TRIUMF Ultra-Cold Advanced Neutron (TUCAN) collaboration aims at a precision neutron electric dipole moment (nEDM) measurement with an uncertainty of $10^{-27}\,e\cdot\mathrm{cm}$, which is an order-of-magnitude better than the current nEDM upper limit and enables us to test Supersymmetry. To achieve this precision, we are developing a new high-intensity ultracold neutron (UCN) source using super-thermal UCN production in superfluid helium (He-II) and a nEDM spectrometer. The current development status of them is reported in this article.Comment: Proceedings of the 24th International Spin Symposium (SPIN 2021), 18-22 October 2021, Matsue, Japa

Exposure to GSM RF fields does not affect calcium homeostasis in human endothelial cells, rat pheocromocytoma cells or rat hippocampal neurons

In the course of modern daily life, individuals are exposed to numerous sources of electromagnetic radiation that are not present in the natural environment. The strength of the electromagnetic fields from sources such as hairdryers, computer display units and other electrical devices is modest. However, in many home and office environments, individuals can experience perpetual exposure to an "electromagnetic smog", with occasional peaks of relatively high electromagnetic field intensity. This has led to concerns that such radiation can affect health. In particular, emissions from mobile phones or mobile phone masts have been invoked as a potential source of pathological electromagnetic radiation. Previous reports have suggested that cellular calcium (Ca2+) homeostasis is affected by the types of radiofrequency fields emitted by mobile phones. In the present study, we used a high-throughput imaging platform to monitor putative changes in cellular Ca2+ during exposure of cells to 900 MHz GSM fields of differing power (specific absorption rate 0.012-2 W/Kg), thus mimicking the type of radiation emitted by current mobile phone handsets. Data from cells experiencing the 900 Mhz GSM fields were compared with data obtained from paired experiments using continuous wave fields or no field. We employed three cell types (human endothelial cells, PC-12 neuroblastoma and primary hippocampal neurons) that have previously been suggested to be sensitive to radiofrequency fields. Experiments were designed to examine putative effects of radiofrequency fields on resting Ca2+, in addition to Ca2+ signals evoked by an InsP(3)-generating agonist. Furthermore, we examined putative effects of radiofrequency field exposure on Ca2+ store emptying and store-operated Ca2+ entry following application of the Ca2+ATPase inhibitor thapsigargin. Multiple parameters (e.g., peak amplitude, integrated Ca2+ signal, recovery rates) were analysed to explore potential impact of radiofrequency field exposure on Ca2+ signals. Our data indicate that 900 MHz GSM fields do not affect either basal Ca2+ homeostasis or provoked Ca2+ signals. Even at the highest field strengths applied, which exceed typical phone exposure levels, we did not observe any changes in cellular Ca2+ signals. We conclude that under the conditions employed in our experiments, and using a highly-sensitive assay, we could not detect any consequence of RF exposure

Envision Caldwell: Public and Stakeholder Engagement Summary

The Caldwell engagement process, a collaborative, semester-long project between the PLAN 661 course, Texas Target Communities, and several dedicated residents, delineates the purpose, process, and findings of the public engagement process within the community of Caldwell. Stakeholder groups were formed, and various meetings were held to determine community issues, assets, challenges, and opportunities through the scope of each stakeholder group. Additionally, several different engagement activities were taken to gather ideas, thoughts, and opinions from the general community. All of these efforts culminated in the collection of valuable data that will be used to influence policies and recommendations within the final Comprehensive Plan

Characterization of Bipolar Disorder Patient-Specific Induced Pluripotent Stem Cells from a Family Reveals Neurodevelopmental and mRNA Expression Abnormalities

Bipolar disorder (BD) is a common neuropsychiatric disorder characterized by chronic recurrent episodes of depression and mania. Despite evidence for high heritability of BD, little is known about its underlying pathophysiology. To develop new tools for investigating the molecular and cellular basis of BD we applied a family-based paradigm to derive and characterize a set of 12 induced pluripotent stem cell (iPSC) lines from a quartet consisting of two BD-affected brothers and their two unaffected parents. Initially, no significant phenotypic differences were observed between iPSCs derived from the different family members. However, upon directed neural differentiation we observed that CXCR4 (CXC chemokine receptor-4) expressing central nervous system (CNS) neural progenitor cells (NPCs) from both BD patients compared to their unaffected parents exhibited multiple phenotypic differences at the level of neurogenesis and expression of genes critical for neuroplasticity, including WNT pathway components and ion channel subunits. Treatment of the CXCR4+ NPCs with a pharmacological inhibitor of glycogen synthase kinase 3 (GSK3), a known regulator of WNT signaling, was found to rescue a progenitor proliferation deficit in the BD-patient NPCs. Taken together, these studies provide new cellular tools for dissecting the pathophysiology of BD and evidence for dysregulation of key pathways involved in neurodevelopment and neuroplasticity. Future generation of additional iPSCs following a family-based paradigm for modeling complex neuropsychiatric disorders in conjunction with in-depth phenotyping holds promise for providing insights into the pathophysiological substrates of BD and is likely to inform the development of targeted therapeutics for its treatment and ideally prevention