Random plasma glucose in early pregnancy is a better predictor of gestational diabetes diagnosis than maternal obesity.

AIMS/HYPOTHESIS: Asymptomatic pregnant women are screened for gestational diabetes (GDM) at 24-28 weeks' gestation. Recent guidelines also recommend screening early in gestation to identify undiagnosed pre-existing overt diabetes. We assessed the performance of random plasma glucose (RPG) testing at antenatal booking in predicting GDM diagnosis later in pregnancy. METHODS: Data from 25,543 consecutive singleton pregnancies at the Rosie Hospital in Cambridge (UK) were obtained from hospital electronic records as a service evaluation. All women were invited for an antenatal RPG (12-16 weeks) and a 50 g glucose challenge test (GCT; 24-28 weeks) with a 75 g OGTT if GCT >7.7 mmol/l (139 mg/dl). RESULTS: At booking, 17,736 women had an RPG that was able to predict GDM (receiver operating characteristic AUC 0.8) according to various diagnostic criteria in common use. A cut-off point of ≥7.5 mmol/l (135 mg/dl) gave a sensitivity of 0.70 and a specificity of 0.90 for GDM diagnosis. Theoretically, using this screening policy, 13.2% of women would have been categorised at high risk (26.3% had GDM) and 86.8% of women at low risk (1.7% had GDM). RPG performed better than maternal age (AUC 0.60) or BMI (AUC 0.65) at predicting GDM diagnosis. CONCLUSIONS/INTERPRETATION: RPG at booking has reasonable performance as a screening test and is better than maternal age or BMI for identifying women at high risk of GDM. RPG cannot replace OGTT for diagnosis but it may be useful to exclude women who do not need further investigation for GDM and to identify women who could be prioritised for early diagnosis or lifestyle interventions.This project was not supported by any specific funding. Claire Meek receives salary funding from the European Union Seventh Framework Programme (FP7/2007-2013; grant agreement n° 266408) and from the Wellcome Trust Translational Medicine and Therapeutics Programme which is funded by the Wellcome Trust in association with Glaxo SmithKline.This is the final version of the article. It was first available from Springer via http://dx.doi.org/10.1007/s00125-015-3811-

Centrifuge modeling of rocking-isolated inelastic RC bridge piers

Experimental proof is provided of an unconventional seismic design concept, which is based on deliberately underdesigning shallow foundations to promote intense rocking oscillations and thereby to dramatically improve the seismic resilience of structures. Termed rocking isolation, this new seismic design philosophy is investigated through a series of dynamic centrifuge experiments on properly scaled models of a modern reinforced concrete (RC) bridge pier. The experimental method reproduces the nonlinear and inelastic response of both the soil-footing interface and the structure. To this end, a novel scale model RC (1:50 scale) that simulates reasonably well the elastic response and the failure of prototype RC elements is utilized, along with realistic representation of the soil behavior in a geotechnical centrifuge. A variety of seismic ground motions are considered as excitations. They result in consistent demonstrably beneficial performance of the rocking-isolated pier in comparison with the one designed conventionally. Seismic demand is reduced in terms of both inertial load and deck drift. Furthermore, foundation uplifting has a self-centering potential, whereas soil yielding is shown to provide a particularly effective energy dissipation mechanism, exhibiting significant resistance to cumulative damage. Thanks to such mechanisms, the rocking pier survived, with no signs of structural distress, a deleterious sequence of seismic motions that caused collapse of the conventionally designed pier. © 2014 The Authors Earthquake Engineering & Structural Dynamics Published by John Wiley & Sons Ltd

Bulk Density of a Sandy Loam: Traffic, Tillage, and Irrigation-Method Effects

Modern crop production creates a cycle between soil compaction caused by traffic and alleviation of this condition by tillage or natural processes such as freezing and thawing. The objective of this study was to evaluate important management practices as they relate to changes in bulk density of a tilled sandy loam soil. Practices evaluated were irrigation method, time between tillage and traffic, tire pressure and wheel load of applied traffic, and controlled traffic. Relationships among bulk density, penetration resistance, and infiltration rate were determined. Experiments were conducted in the San Joaquin Valley of California, on a sandy loam soil (Entisol) with an organic-matter content of <1%. After tillage, settling and trafficking of a soil resulted in rapid changes in its bulk density until a new equilibrium was reached. Tire pressure of 408 kPa and wheel weight of 2724 kg applied at moisture contents near field capacity resulted in a bulk density of 1.92 Mg m-3 , compared with a value of 1.67 for no traffic. The time interval between tillage and traffic did not affect final bulk density. Drip irrigation, which did not saturate the soil, resulted in a bulk density of ≈0.1 Mg m-3 lower than flood irrigation, which saturated the soil surface. Wheel traffic in the furrow resulted in only small changes in the bulk density within the row. When tillage did not occur between cropping seasons, traffic caused high bulk densities in the furrow but only small changes in the row. An increase in bulk density from 1.7 to 1.89 Mg m-3 decreased the infiltration rate by four times and increased resistance to penetration at the end of the season by three times. Knowledge of how management practices affect bulk density can aid growers in reducing recompaction following tillage

Somatosensory-evoked delta brush activity in very pre-term infants

INTRODUCTION: Delta brushes - slow waves with over-riding alpha-beta oscillations - are a hallmark of the pre-term EEG, and can be evoked by somatosensory stimulation (Whitehead et al., 2017). As such, they may be a biomarker of early sensory processing, with their attenuation indicating maturation of somatosensory circuits. In animal models, the somatosensory system is known to mature in a rostro-caudal progression, with hindlimb somatosensation last to develop, but little is known about the development of somatosensory processing in the human infant brain. Here we investigated the attenuation of delta brush activity following tactile stimulation of hands and feet over the pre-term period. METHODS: We recorded 16-channels EEG and evaluated the somatosensory evoked response following tactile mechanical stimulation of hands and feet in 38 pre-term infants at low-risk of adverse neurodevelopment (exclusion: (i) intra-ventricular haemorrhage ⩾ grade III; (ii) severe growth restriction (defined as <2nd birth weight centile)). We then looked at changes in the amplitude of the slow delta wave and of the over-riding alpha-beta oscillations in the evoked response between very pre-term (28 + 2 − 31 + 2 weeks + days, n = 13) and moderately pre-term (32 + 2 − 35 + 4 weeks + days, n = 25) infants using point-by-point t-tests (statistical significance set at p < 0.01 to account for multiple comparisons). RESULTS: Tactile stimulation of hands and feet evoked a long-lasting diffuse negative delta slow wave, with onset latency at ∼100 ms, peak latency at ∼500 ms, and peak amplitude of ∼100 μV and ∼50 μV for hand and foot stimulation respectively, and an increase in alpha-beta oscillations concurrent with the peak latency of this slow wave. We first looked at changes in the amplitude of the slow delta wave. This delta wave attenuated in amplitude in the older age group most prominently over the contralateral parietal-temporal region for hand stimulation, and most prominently over the midline parietal and bilateral temporal regions for foot stimulation. Next, we looked at changes in the amplitude of the alpha-beta oscillations which co-occurred with the peak latency of this slow delta wave. Alpha-beta oscillations attenuated in amplitude in the older age group over bilateral parietal regions for hand stimulation, while there was no difference between the age groups for foot stimulation. CONCLUSION: This is the first developmental study of delta brushes evoked by stimulation of the upper and lower limbs. Our results indicate that in very pre-term infants tactile stimulation evokes diffuse delta brush activity, which attenuates across development most markedly over the parietal-temporal regions. Interestingly, delta brush alpha-beta oscillations only decrease with development for hand stimulation, but not foot stimulation, suggesting that somatosensory maturation may occur earlier for the hands in line with studies of older infants (Whitehead et al., submitted for publication), and animal models

Effects of amino acids and glucose on mesangial cell aminopeptidase a and angiotensin receptors

Effects of amino acids and glucose on mesangial cell aminopeptidase a and angiotensin receptors.BackgroundHigh protein diets and diabetes increase renal renin angiotensin system (RAS) activity, which is associated with glomerular injury. Aminopeptidase A (APA) is a cell surface metalloprotease that degrades angiotensin II (AII) in the mesangium. Mesangial cells (MC) also possess receptors for AII; the type 1 (AT1 receptor) promotes proliferation and fibrosis, while the type 2 (AT2 receptor) opposes these effects. We evaluated whether amino acids and glucose alter expression of APA, AT1 receptor and AT2 receptor in a manner that further augments RAS activity.MethodsConfluent rat MC were grown in serum-free media for 48 hours prior to exposing to experimental conditions: control (C), high amino acids (HA, mixed amino acid solution added to raise concentrations 5- to 6-fold over C), high glucose (HG 30, mM glucose). Semi-quantitative RT-PCR was used to assess mRNA for APA, AT1 receptor, AT2 receptor, and β-actin. Values are expressed relative to βbgr; actin.ResultsBoth HA and HG reduced APA mRNA (HG 1.13 ± 0.19, HA 1.12 ± 0.16 versus C 1.27 ± 0.16 P < 0.05, N = 8). HA increased AT1 receptor mRNA (HA 2.11 ± 0.43 versus C 1.14 ± 0.28 P < 0.05, N = 8). HG increased AT2 receptor mRNA (HG 1.31 ± 0.43 versus C 0.82 ± 0.33 P < 0.05, N = 6).ConclusionsA reduction of APA, in response to high levels of amino acids or glucose, could contribute to increased AII as a result of decreased degradation in MC. The effect of amino acids to increase AT1 receptor expression may further enhance adverse hemodynamic and pro-fibrotic actions of AII. Conversely, glucose increased AT2 receptor expression, which could modulate responses mediated by the AT1 receptor

Sexual Ethics Training in Seminary: Preparing Students to Manage Feelings of Sexual Attraction

Sexual boundary violations by clergy have received heightened media attention in recent years with far reaching implications for the long-term well-being of the Church as an institution. While much has been written about the causes and implications of sexual misconduct by clergy, very little research has addressed preventative efforts. Prevention begins in graduate school or seminary. How do seminary alumni perceive the quality of their training in the areas of understanding and maintaining sexual health as well as in managing feelings of sexual attraction in professional contexts? In this survey, 585 alumni from 5 evangelical seminaries answered questions related to their graduate training with regard to their coursework and training environments. Results suggest that minimal attention is given to both. Respondents were more likely than other helping professionals (i.e., psychologists) to believe that the experience of sexual attraction is unethical and to deny experiencing it in their professional contexts. Survey respondents reported coping with feelings of sexual attraction in a private, internal manner. However, respondents reported a surprisingly low incidence of sexual misconduct compared to previous research of clergy. Implications and future research directions are discussed

Likelihood of 'falling through the net' relates to contemporary prevalence of gestational diabetes. Reply to Ikomi A, Mannan S, Anthony R, Kiss S [letter].

This project was not supported by any specific funding. Claire Meek receives salary funding from the European Union Seventh Framework Programme (FP7/2007-2013; grant agreement n° 266408) and from the Wellcome Trust Translational Medicine and Therapeutics Programme which is funded by the Wellcome Trust in association with Glaxo SmithKline.This is the author accepted manuscript. The final version is available from Springer via http://dx.doi.org/10.1007/s00125-015-3737-

A comparison of optical and radar measurements of mesospheric winds and tides

Optical measurements of mesospheric winds by Fabry‐Perot spectrometers, FPSs, at Mawson, 67.6°S 62.9°E, and Davis, 68.6°S 78.0°E, Antarctica are compared with similar measurements obtained using a spaced‐antenna MF radar at Davis. The FPSs observed the OH emission. Different analysis procedures, used to determine the mean wind, and amplitude and phase of the semidiurnal tide, have been compared. At these latitudes the diurnal tide is weak and the semi‐diurnal tide, although highly variable in amplitude, is usually the dominant periodicity. When comparing the amplitude and phase of the semidiurnal tide good agreement is obtained between measurements by the two instruments

The impact of parental contact upon cortical noxious-related activity in human neonates

BACKGROUND: Neonates display strong behavioural, physiological and cortical responses to tissue-damaging procedures. Parental contact can successfully regulate general behavioural and physiological reactivity of the infant, but it is not known whether it can influence noxious-related activity in the brain. Brain activity is highly dependent upon maternal presence in animal models, and therefore this could be an important contextual factor in human infant pain-related brain activity. METHODS: Global topographic analysis was used to identify the presence and inter-group differences in noxious-related activity in three separate parental contexts. EEG was recorded during a clinically required heel lance in three age and sex-matched groups of neonates (a) while held by a parent in skin-to-skin (n = 9), (b) while held by a parent with clothing (n = 9) or (c) not held at all, but in individualized care (n = 9). RESULTS: The lance elicited a sequence of 4-5 event-related potentials (ERPs), including the noxious ERP (nERP), which was smallest for infants held skin-to-skin and largest for infants held with clothing (p=0.016). The nERP was then followed by additional and divergent long-latency ERPs (> 750 ms post-lance), not previously described, in each of the groups, suggesting the engagement of different higher level cortical processes depending on parental contact. CONCLUSIONS: These results show the importance of considering contextual factors in determining infant brain activity and reveal the powerful influence of parental contact upon noxious-related activity across the developing human brain. SIGNIFICANCE: This observational study found that the way in which the neonatal brain processes a noxious stimulus is altered by the type of contact the infant has with their mother. Specifically, being held in skin-to-skin reduces the magnitude of noxious-related cortical activity. This work has also shown that different neural mechanisms are engaged depending on the mother/infant context, suggesting maternal contact can change how a baby's brain processes a noxious stimulus