Gestational Weight Gain and Body Mass Index in Children: Results from Three German Cohort Studies

Previous studies suggested potential priming effects of gestational weight gain (GWG) on offspring's body composition in later life. However, consistency of these effects in normal weight, overweight and obese mothers is less clear. We combined the individual data of three German cohorts and assessed associations of total and excessive GWG (as defined by criteria of the Institute of Medicine) with offspring's mean body mass index (BMI) standard deviation scores (SDS) and overweight at the age of 5-6 years (total: n = 6,254). Quantile regression was used to examine potentially different effects on different parts of the BMI SDS distribution. All models were adjusted for birth weight, maternal age and maternal smoking during pregnancy and stratified by maternal pre-pregnancy weight status. In adjusted models, positive associations of total and excessive GWG with mean BMI SDS and overweight were observed only in children of non- overweight mothers. For example, excessive GWG was associated with a mean increase of 0.08 (95% CI: 0.01, 0.15) units of BMI SDS (0.13 (0.02, 0.24) kg/m(2) of 'real' BMI) in children of normal-weight mothers. The effects of total and excessive GWG on BMI SDS increased for higher- BMI children of normal-weight mothers. Increased GWG is likely to be associated with overweight in offspring of non-overweight mothers

The National Early Warning Score and its subcomponents recorded within ±24 hours of emergency medical admission are poor predictors of hospital-acquired acute kidney injury

YesBackground: Hospital-acquired Acute Kidney Injury (H-AKI) is a common cause of avoidable morbidity and mortality. Aim: To determine if the patients’ vital signs data as defined by a National Early Warning Score (NEWS), can predict H-AKI following emergency admission to hospital. Methods: Analyses of emergency admissions to York hospital over 24-months with NEWS data. We report the area under the curve (AUC) for logistic regression models that used the index NEWS (model A0), plus age and sex (A1), plus subcomponents of NEWS (A2) and two-way interactions (A3). Likewise for maximum NEWS (models B0,B1,B2,B3). Results: 4.05% (1361/33608) of emergency admissions had H-AKI. Models using the index NEWS had the lower AUCs (0.59 to 0.68) than models using the maximum NEWS AUCs (0.75 to 0.77). The maximum NEWS model (B3) was more sensitivity than the index NEWS model (A0) (67.60% vs 19.84%) but identified twice as many cases as being at risk of H-AKI (9581 vs 4099) at a NEWS of 5. Conclusions: The index NEWS is a poor predictor of H-AKI. The maximum NEWS is a better predictor but seems unfeasible because it is only knowable in retrospect and is associated with a substantial increase in workload albeit with improved sensitivity.The Health Foundatio

Thermal conductivity measurements of nearshore sediments in Eckernförde Bay, Baltic Sea aquired during ALKOR cruise AL584

Thermal conductivity data of nearshore sediments were collected during ALKOR cruise AL584 in November 2022 using the VibroHeat system developed by FIELAX GmbH. This system combines a vibrocorer with a sensor string that contains 22 negative temperature coefficient thermistors (NTCs) and a heating wire over which a defined heat pulse is released. In-situ temperature and thermal conductivity of the sediment are calculated for each thermistor using the inversion method according to Hartmann & Villinger (2002)

Sediment echosounder raw data (Innomar SES-2000 working area dataset) of RV ALKOR during cruise AL584, Eckernförde Bay

Around Mittelgrund, a sandbank of glacial origin in the western Baltic Sea, subbottom profiles were conducted with the German research vessel "Alkor" on the cruise AL584 in November 2022. Subbottom profiles were collected using the sediment echosounder SES-2000 from Innomar. The system was operated in a single frequency mode of 6 kHz with a vessel speed below 5 knots. This dataset contains the raw data (*.raw), the envelope (*.ses), converted for Kingdom or similar (*.sgy), navigation (UTM_X, UTM_Y, shot point, date, time) (*.txt), the motion (*motion.txt) and header information (*Header.txt) for two profiles. - Profile north - south (20221110): A transect at the western margin of the Mittelgrund, with the transition from sandy to muddy sediments. - Profile east – west (20221109): A profile south of Mittelgrund crosses the transition between muddy sediments with and without acoustic disturbance

Students’ Conceptions as Diversity Dimension in the Discourse on Heterogeneity: Goals, Attitudes and Best Practice Examples for a Heterogeneity-Sensitive Reflective Pre-Service Teacher Education

Schüler*innen erschließen und erklären sich beobachtete naturwissenschaftliche und technische Phänomene mithilfe individueller Vorerfahrungen, die in der jeweiligen Situation sinnvoll erscheinen. Aus fachdidaktischer Sicht laufen die Schüler*innen dadurch allerdings Gefahr, Schlüsse zu ziehen, die für alltägliche Situationen geeignet, für erfolgreiches fachbezogenes Lernen jedoch hinderlich sein können. Vielfältige Schüler*innenvorstellungen, die in den Unterricht eingebracht werden, können die individuellen Lernprozesse im Fach fördern, sie jedoch ebenfalls erschweren, wodurch einzelne Schüler*innen u.U. benachteiligt werden können. Daher sollte aus fachdidaktischer Perspektive ein zentrales Ziel einer heterogenitätssensiblen reflexiven Lehrkräftebildung in naturwissenschaftlichen und technischen Fächern darin bestehen, dass angehende Lehrkräfte sich der Vorstellungen individueller Schüler*innen bewusst sind, sie in ihrer Vielfalt identifizieren und lernförderlich für alle Lernenden in ihre Unterrichtsplanungen einbeziehen können. Ein Ziel dieses Beitrags ist es, diese Vielfalt der Schüler*innenvorstellungen aus einer fachdidaktischen Perspektive als eine Differenzlinie im Diskurs um Heterogenität zu diskutieren. Es wird dargestellt, welchen Einfluss Vorstellungen auf fachliche Lernprozesse haben können und welche Unterschiede und Gemeinsamkeiten zu anderen Differenzlinien bestehen. Basierend darauf und in Anlehnung an das Leitbild der Reflexiven Handlungsfähigkeit werden aus einer fachdidaktischen Perspektive exemplarisch Ziele, Haltungen und Anwendungsbeispiele für eine heterogenitätssensible reflexive Lehrkräftebildung abgeleitet. Die Ausbildung der vorgeschlagenen Ziele soll angehende Lehrkräfte für das Vorhandensein vielfältiger Vorstellungen beim Erschließen naturwissenschaftlicher und technischer Phänomene sensibilisieren und sie auf einen reflektierten Umgang damit im Schulalltag vorbereiten.Students explain observed scientific and technical phenomena with the help of individual prior experiences and ideas that seem to make sense in the respective situation. From the perspective of science education, however, students run the risk of drawing conclusions that are suitable for everyday situations but may be a barrier to successful subject-related learning. The diverse conceptions that students bring to the classroom can promote individual learning processes in science education, but they can also make them more difficult. Therefore, a central goal of heterogeneity-sensitive reflective pre-service teacher education should be that future teachers are aware of the diversity of students’ subject-related conceptions and their influence on learning processes. Heterogeneity-sensitive reflective teachers should also be able to identify different conceptions of their students and incorporate them into their lesson plans in a way that is supportive for all learners. In this article, we will discuss the diversity of students’ conceptions as a diversity dimension in the discourse on heterogeneity from the perspective of science education. First, the influence of students’ conceptions on subject-related learning and the differences and similarities to other diversity dimensions will be presented. Based on these theories and following the principle of reflective disposition, we present goals, attitudes, and best practice examples for a heterogeneity-sensitive reflective science pre-service teacher education

Sphingosine 1-Phosphate- and C-C Chemokine Receptor 2-Dependent Activation of CD4+ Plasmacytoid Dendritic Cells in the Bone Marrow Contributes to Signs of Sepsis-Induced Immunosuppression

Sepsis is the dysregulated response of the host to systemic, mostly bacterial infection, and is associated with an enhanced susceptibility to life-threatening opportunistic infections. During polymicrobial sepsis, dendritic cells (DCs) secrete enhanced levels of interleukin (IL) 10 due to an altered differentiation in the bone marrow and contribute to the development of immunosuppression. We investigated the origin of the altered DC differentiation using murine cecal ligation and puncture (CLP), a model for human polymicrobial sepsis. Bone marrow cells (BMC) were isolated after sham or CLP operation, the cellular composition was analyzed, and bone marrow-derived DCs (BMDCs) were generated in vitro. From 24 h on after CLP, BMC gave rise to BMDC that released enhanced levels of IL-10. In parallel, a population of CD11chiMHCII+CD4+ DCs expanded in the bone marrow in a MyD88-dependent manner. Prior depletion of the CD11chiMHCII+CD4+ DCs from BMC in vitro reversed the increased IL-10 secretion of subsequently differentiating BMDC. The expansion of the CD11chiMHCII+CD4+ DC population in the bone marrow after CLP required the function of sphingosine 1-phosphate receptors and C-C chemokine receptor (CCR) 2, the receptor for C-C chemokine ligand (CCL) 2, but was not associated with monocyte mobilization. CD11chiMHCII+CD4+ DCs were identified as plasmacytoid DCs (pDCs) that had acquired an activated phenotype according to their increased expression of MHC class II and CD86. A redistribution of CD4+ pDCs from MHC class II− to MHC class II+ cells concomitant with enhanced expression of CD11c finally led to the rise in the number of CD11chiMHCII+CD4+ DCs. Enhanced levels of CCL2 were found in the bone marrow of septic mice and the inhibition of CCR2 dampened the expression of CD86 on CD4+ pDCs after CLP in vitro. Depletion of pDCs reversed the bias of splenic DCs toward increased IL-10 synthesis after CLP in vivo. Thus, during polymicrobial sepsis, CD4+ pDCs are activated in the bone marrow and induce functional reprogramming of differentiating BMDC toward an immunosuppressive phenotype

Linear regression estimates [95% confidence intervals] for the association of total, excessive and inadequate gestational weight gain (GWG) with offspring’s BMI SDS at 5–6 years.

<p>Models were calculated both unadjusted and adjusted for birth weight, maternal age and maternal smoking during pregnancy, and were additionally stratified by maternal pre-pregnancy BMI. Estimates written in bold font denote significant associations (p<0.05).</p

Odds ratios [95% confidence intervals] for the associations of total, excessive and inadequate gestational weight gain (GWG) with offspring’s overweight (including obesity) at 5–6 years.

<p>Models were calculated both unadjusted and adjusted for birth weight, maternal age and maternal smoking during pregnancy, and were additionally stratified by maternal pre-pregnancy BMI. Estimates written in bold font denote significant associations (p<0.05).</p

Description of the study population (total: n = 6,254).

<p>Description of the study population (total: n = 6,254).</p

Risk of Surgical Site Infection (SSI) following Colorectal Resection Is Higher in Patients With Disseminated Cancer: An NCCN Member Cohort Study.

BACKGROUNDSurgical site infections (SSIs) following colorectal surgery (CRS) are among the most common healthcare-associated infections (HAIs). Reduction in colorectal SSI rates is an important goal for surgical quality improvement.OBJECTIVETo examine rates of SSI in patients with and without cancer and to identify potential predictors of SSI risk following CRSDESIGNAmerican College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data files for 2011-2013 from a sample of 12 National Comprehensive Cancer Network (NCCN) member institutions were combined. Pooled SSI rates for colorectal procedures were calculated and risk was evaluated. The independent importance of potential risk factors was assessed using logistic regression.SETTINGMulticenter studyPARTICIPANTSOf 22 invited NCCN centers, 11 participated (50%). Colorectal procedures were selected by principal procedure current procedural technology (CPT) code. Cancer was defined by International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes.MAIN OUTCOMEThe primary outcome of interest was 30-day SSI rate.RESULTSA total of 652 SSIs (11.06%) were reported among 5,893 CRSs. Risk of SSI was similar for patients with and without cancer. Among CRS patients with underlying cancer, disseminated cancer (SSI rate, 17.5%; odds ratio [OR], 1.66; 95% confidence interval [CI], 1.23-2.26; P=.001), ASA score ≥3 (OR, 1.41; 95% CI, 1.09-1.83; P=.001), chronic obstructive pulmonary disease (COPD; OR, 1.6; 95% CI, 1.06-2.53; P=.02), and longer duration of procedure were associated with development of SSI.CONCLUSIONSPatients with disseminated cancer are at a higher risk for developing SSI. ASA score &gt;3, COPD, and longer duration of surgery predict SSI risk. Disseminated cancer should be further evaluated by the Centers for Disease Control and Prevention (CDC) in generating risk-adjusted outcomes.Infect Control Hosp Epidemiol 2018;39:555-562