Finding the Silver Linings of the Cyberattack

Our project aimed to identify the effects of the UVM Health Network cyberattack and subsequent month-long network downtime on the South Burlington Family Medicine providers and clinic staff. We interviewed staff members about positive adaptations made by the team during the downtime, and inquired whether they planned to keep maintaining any of these changes once the electronic systems returned.https://scholarworks.uvm.edu/fmclerk/1703/thumbnail.jp

The Conserved G-Protein Coupled Receptor FSHR-1 Regulates Protective Host Responses to Infection and Oxidative Stress

The innate immune system’s ability to sense an infection is critical so that it can rapidly respond if pathogenic microorganisms threaten the host, but otherwise maintain a quiescent baseline state to avoid causing damage to the host or to commensal microorganisms. One important mechanism for discriminating between pathogenic and non-pathogenic bacteria is the recognition of cellular damage caused by a pathogen during the course of infection. InCaenorhabditis elegans, the conserved G-protein coupled receptor FSHR-1 is an important constituent of the innate immune response. FSHR-1 activates the expression of antimicrobial infection response genes in infected worms and delays accumulation of the ingested pathogenPseudomonas aeruginosa. FSHR-1 is central not only to the worm’s survival of infection by multiple pathogens, but also to the worm’s survival of xenobiotic cadmium and oxidative stresses. Infected worms produce reactive oxygen species to fight off the pathogens; FSHR-1 is required at the site of infection for the expression of detoxifying genes that protect the host from collateral damage caused by this defense response. Finally, the FSHR-1 pathway is important for the ability of worms to discriminate pathogenic from benign bacteria and subsequently initiate an aversive learning program that promotes selective pathogen avoidance

Susceptibility of the Endangered Karner Blue Butterfly (Lepidoptera: Lycaenidae) to \u3ci\u3eBacillus Thuringiensis\u3c/i\u3e Var. \u3ci\u3eKurstaki\u3c/i\u3e Used for Gypsy Moth Suppression in Michigan

We investigated the phenological and physiological susceptibility of the endangered Karner blue butterfly (Lycaeides melissa samuelis) to Bacillus thuringiensis var. kurstaki (Bt), a product widely used for gypsy moth (Lymantria dispar) suppression in Michigan and other infested states. We monitored phenology of the bivoltine Karner blue in two regions of Michigan from 1993 to 1995 to determine if larval stages overlapped temporally with the period of Bt application for gypsy moth suppression. Karner blue larvae of the spring generation were found during the period that Bt was applied in nearby areas in 1993 only. However, spring-generation adults or newly laid eggs were observed up to 11 days before applications in 1994 and 1995. Since Karner blue eggs develop within one week, summer-generation larvae were most likely present during or shortly after 1994 and 1995 Bt application periods. These larvae would have been at risk, assuming Bt persistence of 4 to 6 days. Physiological susceptibility of Karner blue larvae to Bt was determined in a laboratory bioassay. Larvae were reared on wild lupine (Lupinus perennis) foliage that was untreated, or sprayed with Bt formulations at rates of 30-37 or 90 BIU/ha. A similar bioassay with second instar gypsy moth larvae on similarly treated white oak (Quercus alba) foliage was conducted concurrently. Karner blue survival was 100%, 27% and 14% on control, low and high Bt treatments, respectively. Early and late Karner blue instars were equally susceptible to Bt. Survival of gypsy moth was 80%, 33% and 5% on control, low and high Bt treatments, respectively, and did not differ significantly from Karner blue survival. We conclude that Karner blue is both phenologically and physiologically susceptible to Bt used for gypsy moth suppression, although the larval generation at risk and extent of phenological overlap may vary from year to year

\u3ci\u3eAnoplophora Glabripennis\u3c/i\u3e Within-Tree Distribution, Seasonal Development, and Host Suitability in China and Chicago

Established populations of the Asian longhorned beetle, Anoplophora glabripennis (Motschulsky) (Coleoptera: Cerambycidae), were first reported in the United States in New York in 1996, Illinois in 1998, and New Jersey in 2002. A federal quarantine and an eradication program were implemented in 1997, involving tree surveys and removal of infested trees. We recorded the number of A. glabripennis life stages found at several locations along the main trunk and major branches of naturally infested trees in China (species of Populus, Salix, and Ulmus) and Chicago, Illinois (species of Acer, Fraxinus, and Ulmus) during 1999 to 2002. Typically, A. glabripennis initiated attack near the crown base along both the trunk and main branches. The one exception to this pattern was on Populus trees in China that had branches along the entire trunk, in which case A. glabripennis initiated attack along the lower trunk. Larvae were the dominant overwintering stage in both countries. A host suitability index for A. glabripennis was calculated for each tree with the formula: (number of living life stages + number of exit holes) / number of oviposition pits. The mean host suitability index was higher on Populus and Salix than Ulmus in China, and generally higher on Acer and Ulmus than Fraxinus in Chicago. Eleven genera of trees (N = 1465 trees) were infested by A. glabripennis in Chicago; in decreasing order of tree frequency they included Acer, Ulmus, Fraxinus, Aesculus, Betula, Salix, Celtis, Malus, Pyrus, Sorbus, and Tilia. When the proportion of each genus of infested street trees (N = 958 trees in 7 genera) was compared to its proportion of all Chicago street trees based on a 2003 inventory (N = 539,613 trees in 45 genera), A. glabripennis showed a significant preference to infest the genera Acer and Ulmus. Based on our results, inspectors should focus their efforts on upper trunks and lower branches of Acer and Ulmus trees

Novel mutation in CCBE 1 as a cause of recurrent hydrops fetalis from Hennekam lymphangiectasia-lymphedema syndrome-1.

Whole exome sequencing (WES) was used to determine the etiology of recurrent hydrops fetalis in this case of Hennekam lymphangiectasia-lymphedema syndrome-1. WES is a useful approach for diagnosing rare single-gene conditions with nonspecific phenotypes and should be considered early in the diagnostic process of investigating fetal abnormalities

The association between number of children and weight loss outcomes among individuals undergoing bariatric surgery

BACKGROUND: Existing research demonstrates that parity is associated with risk for obesity. The majority of those who undergo bariatric surgery are women, yet little is known about whether having children before bariatric surgery is associated with pre- and postsurgical weight outcomes. OBJECTIVES: We aim to evaluate presurgical body mass index (BMI) and postsurgical weight loss among a racially diverse sample of women with and without children. SETTING: Metropolitan hospital system. METHODS: Women (n = 246) who underwent bariatric surgery were included in this study. Participants self-reported their number of children. Presurgical BMI and postsurgical weight outcomes at 1 year, including change in BMI (ΔBMI), percentage excess weight loss (%EWL), and percentage total weight loss (%TWL) were calculated from measured height and weight. RESULTS: Those with children had a lower presurgical BMI (P = .01) and had a smaller ΔBMI (P = .01) at 1 year after surgery than those without children, although %EWL and %TWL at 1 year did not differ by child status or number of children. After controlling for age, race, and surgery type, the number of children a woman had was related to smaller ΔBMI at 1 year post surgery (P = .01). CONCLUSIONS: Although women with children had lower reductions in BMI than those without children, both women with and without children achieved successful postsurgical weight loss. Providers should assess for number of children and be cautious not to deter women with children from having bariatric surgery

Disordered eating and eating disorders among women seeking fertility treatment: A systematic review

The purpose of this systematic review is to evaluate the prevalence of disordered eating and eating disorders among women seeking fertility treatment. Observational studies were searched in Ovid MEDLINE, Web of Science, Embase, and PsycInfo. Studies published prior to September 2020 when the search was conducted were considered. Inclusion criteria included (1) original and empirical research, (2) published in a peer-reviewed journal, and (3) reported on disordered eating among women seeking fertility treatment in the sample or reported on prevalence of eating disorders among women seeking fertility treatment in the sample. Independent screening of abstracts was conducted by two authors (LH and AH). Ten studies met the inclusion criteria. Sample size, study location, measures, and results for each study in this review were reported. Among women pursuing fertility treatment, rates of current eating disorders ranged from 0.5 to 16.7%, while past eating disorder prevalence rates ranged from 1.4 to 27.5%. Current anorexia nervosa or bulimia nervosa was reported by up to 2% and 10.3% of women, respectively, while history of anorexia nervosa or bulimia nervosa was reported by up to 8.5% and 3.3% of women, respectively. Binge eating disorder or other eating disorders were reported by up to 18.5% and 9.1% of women, respectively. Disordered eating pathology was endorsed by 1.6 to 48% of women seeking fertility treatment. Endorsement of pathological eating attitudes was generally higher among women seeking fertility treatment with current or past eating disorders as compared to community samples, with the exception of dietary restraint. Rates of current and past eating disorders are higher among women seeking fertility treatment than in the general population. Providers treating women with infertility should be cognizant of these prevalence rates and consider screening for eating pathology in their patients as this may contribute to their likelihood of successful conception and/or subsequent pregnancy outcomes

Predictors of Alcohol Use after Bariatric Surgery

Patients undergoing bariatric surgery are at risk for devloping an alcohol use disorder (AUD). The purpose of this study was to investigate pre-surgical psychosocial risk factors for post-surgical alcohol consumption and hazardous drinking. Participants (N = 567) who underwent bariatric surgery between 2014 and 2017 reported their post-surgical alcohol use. Information was collected from the pre-surgical evaluation including history of alcohol use, psychiatric symptoms, and maladaptive eating behaviors (i.e., binge eating, purging, and emotional eating). Younger age and pre-surgical alcohol use predicted post-surgical alcohol use and hazardous drinking. In addition, higher levels of depressive symptoms and maladaptive eating patterns predicted post-surgical binge drinking. Clinicians conducting pre-surgical psychosocial evaluations should be aware of the multiple risk factors related to post-surgical problematic alcohol use. Future research should evaluate whether preventive interventions for high-risk patients decrease risk for post-surgical alcohol misuse

Considering sex as a biological variable in preclinical research

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154390/1/fsb2fj201600781r.pd

Weighing the Association Between BMI Change and Suicide Mortality

OBJECTIVE: Suicide rates continue to rise, necessitating the identification of risk factors. Obesity and suicide mortality rates have been examined, but associations among weight change, death by suicide, and depression among adults in the United States remain unclear. METHODS: Data from 387 people who died by suicide in 2000-2015 with a recorded body mass index (BMI) in the first and second 6 months preceding their death ( index date ) were extracted from the Mental Health Research Network. Each person was matched with five people in a control group (comprising individuals who did not die by suicide) by age, sex, index year, and health care site (N=1,935). RESULTS: People who died by suicide were predominantly male (71%), White (69%), and middle aged (mean age=57 years) and had a depression diagnosis (55%) and chronic health issues (57%) (corresponding results for the control group: 71% male, 66% White, 14% with depression diagnosis, and 43% with chronic health issues; mean age=56 years). Change in BMI within the year before the index date statistically significantly differed between those who died by suicide (mean change=-0.72±2.42 kg/m(2)) and the control group (mean change=0.06±4.99 kg/m(2)) (p\u3c0.001, Cohen\u27s d=0.17). A one-unit BMI decrease was associated with increased risk for suicide after adjustment for demographic characteristics, mental disorders, and Charlson comorbidity score (adjusted odds ratio=1.11, 95% confidence interval=1.05-1.18, p\u3c0.001). For those without depression, a BMI change was significantly associated with suicide (p\u3c0.001). CONCLUSIONS: An increased suicide mortality rate was associated with weight loss in the year before a suicide after analyses accounted for general and mental health indicators