Postpartum diet quality: a cross-sectional analysis from the Australian Longitudinal Study on Women's Health

Reproductive-aged women are at high risk of developing obesity, and diet quality is a potential modifiable risk factor. There is limited research exploring diet quality and its association with time since childbirth. Using data from the Australian Longitudinal Study on Women's Health (ALSWH) survey 5 (2009) of women born between 1973-1978, who reported having previously given birth, we investigated the association between time since childbirth and diet quality, and differences in energy, macronutrients, micronutrient intake, and diet quality assessed by the dietary guideline index (DGI) in women stratified by time from last childbirth, early (0-6 months; n = 558) and late (7-12 months; n = 547), and all other women with children (>12 months post childbirth n = 3434). From this cohort, 8200 participants were eligible, of which 4539 participants completed a food frequency questionnaire (FFQ) and were included in this analysis. Overall, diet quality was higher in early and late postpartum women (mean DGI score 89.8 (SD 10.5) and mean DGI score 90.0 (SD 10.2), respectively) compared to all other women with children (>12 months post childbirth), mean DGI score 85.2 (SD 11.7), p 12 months), smoking compared with non-smoking and medium income level compared with no income was negatively associated with diet quality. A lower diet quality in women greater than 12 months post childbirth may be reflective of increased pressures, balancing childrearing and return to work responsibilities. This highlights the need to support women beyond the postpartum period to improve modifiable factors associated with weight gain, including diet quality, to optimize health and reduce chronic disease risk.Julie C. Martin, Anju E. Joham, Gita D. Mishra, Allison M. Hodge, Lisa J. Moran, and Cheryce L. Harriso

Clinical management of pregnancy in women with polycystic ovary syndrome: An expert opinion

First published: 05 April 2022Polycystic ovary syndrome (PCOS) is associated with a higher risk for pregnancy and birth complications according to the specific features associated with PCOS. The features include obesity before and during pregnancy, hyperandrogenism, insulin resistance, infertility, cardiometabolic risk factors, and poor mental health. PCOS is not often recognized as a risk factor for poor pregnancy and birth outcomes in pregnancy care guidelines, while its associated features are. Pregnancy‐related risk profile should ideally be assessed for modifiable risk factors (e.g., lifestyle and weight management) at preconception in women with PCOS. Hyperglycaemia should be screened using a 75‐g oral glucose tolerance test at preconception or within the first 20 weeks of pregnancy if it has not been performed at preconception and should be repeated at 24–28 weeks of pregnancy. In the absence of evidence of benefit for strategies specific to women with PCOS, the international evidencebased guidelines for the assessment and management of PCOS recommend screening, optimizing, and monitoring risk profile in women with PCOS (at preconception, during and postpregnancy) consistent with the recommendations for the general population. Recommended factors include blood glucose, weight, blood pressure, smoking, alcohol, diet, exercise, sleep and mental health, emotional, and sexual health among women with PCOS. The guidelines recommend Metformin in addition to lifestyle for assisting with weight management and improving cardiometabolic risk factors, particularly in those with overweight or obesity. Letrozole is considered the first‐line pharmacological treatment for anovulatory infertility in PCOS. Individualized approach should be considered in the management of pregnancy in PCOS.Mahnaz Bahri Khomami, Helena J Teede, Anju E. Joham, Lisa J. Moran, Terhi T. Piltonen, Jacqueline A. Boyl

Updated adolescent diagnostic criteria for polycystic ovary syndrome: impact on prevalence and longitudinal body mass index trajectories from birth to adulthood

Background: Polycystic ovary syndrome (PCOS) is challenging to diagnose. While the 2003 Rotterdam criteria are widely used for adults, the 2018 international PCOS guideline recommended updated Rotterdam criteria with both hyperandrogenism and oligo-anovulation for adolescents based on evidence-informed expert consensus. This study compared the prevalence of PCOS using updated and original Rotterdam criteria in community-based adolescents and explored long-term body mass index (BMI) trajectories across different diagnostic phenotypes. Methods: Overall, 227 postmenarchal adolescent females from the prospective cohort Raine Study undertook comprehensive PCOS assessment at age 14–16 years. Detailed anthropometric measurements were collected from birth until age 22 years. Cross-sectional and longitudinal BMI were analyzed using t tests and generalized estimating equations. Results: PCOS was diagnosed in 66 (29.1%) participants using original criteria versus 37 (16.3%) participants using updated Rotterdam criteria. Using updated criteria, participants with PCOS had higher BMI than participants without PCOS from prepubertal. Only the phenotype meeting the updated criteria was significantly associated with higher long-term BMI gain whereas other PCOS phenotypes had similar BMI trajectories to participants without PCOS (p < 0.001). Conclusions: The use of the 2018 updated Rotterdam criteria reduces over-diagnosis of PCOS in adolescents and identifies those at the greatest risk of long-term weight gain, a key contributor to disease severity and long-term health implications. The BMI trajectories of females with PCOS on updated criteria diverge prepubertally compared to those without PCOS. This work supports targeting adolescents diagnosed with PCOS on the 2018 updated criteria for early lifestyle interventions to prevent long-term health complications.Chau Thien Tay, Roger J. Hart, Martha Hickey, Lisa J. Moran, Arul Earnest, Dorota A. Doherty, Helena J. Teede and Anju E. Joha

Topological Orthoalgebras

We define topological orthoalgebras (TOAs) and study their properties. While every topological orthomodular lattice is a TOA, the lattice of projections of a Hilbert space is an example of a lattice-ordered TOA that is not a toplogical lattice. On the other hand, we show that every compact Boolean TOA is a topological Boolean algebra. We also show that a compact TOA in which 0 is an isolated point is atomic and of finite height. We identify and study a particularly tractable class of TOAs, which we call {\em stably ordered}: those in which the upper-set generated by an open set is open. This includes all topological OMLs, and also the projection lattices of Hilbert spaces. Finally, we obtain a topological version of the Foulis-Randall representation theory for stably ordered TOAsComment: 16 pp, LaTex. Minor changes and corrections in sections 1; more substantial corrections in section

Low energy scattering cross section ratios of N 14 (p,p) N 14

Background: The slowest reaction in the first CNO cycle is N14(p,γ)O15, therefore its rate determines the overall energy production efficiency of the entire cycle. The cross section presents several strong resonance contributions, especially for the ground-state transition. Some of the properties of the corresponding levels in the O15 compound nucleus remain uncertain, which affects the uncertainty in extrapolating the capture cross section to the low energy range of astrophysical interest. Purpose: The N14(p,γ)O15 cross section can be described by using the phenomenological R matrix. Over the energy range of interest, only the proton and γ-ray channels are open. Since resonance capture makes significant contributions to the N14(p,γ)O15 cross section, resonant proton scattering data can be used to provide additional constraints on the R-matrix fit of the capture data. Methods: A 4 MV KN Van de Graaff accelerator was used to bombard protons onto a windowless gas target containing enriched N14 gas over the proton energy range from Ep=1.0 to 3.0 MeV. Scattered protons were detected at θlab=90, 120°, 135°, 150°, and 160° using ruggedized silicon detectors. In addition, a 10 MV FN Tandem Van de Graaff accelerator was used to accelerate protons onto a solid Adenine (C5H5N5) target, of natural isotopic abundance, evaporated onto a thin self-supporting carbon backing, over the energy range from Ep=1.8 to 4.0 MeV. Scattered protons were detected at 28 angles between θlab=30.4° and 167.7° by using silicon photodiode detectors. Results: Relative cross sections were extracted from both measurements. While the relative cross sections do not provide as much constraint as absolute measurements, they greatly reduce the dependence of the data on otherwise significant systematic uncertainties, which are more difficult to quantify. The data are fit simultaneously using an R-matrix analysis and level energies and proton widths are extracted. Even with relative measurements, the statistics and large angular coverage of the measurements result in more confident values for the energies and proton widths of several levels; in particular, the broad resonance at Ec.m.=2.21 MeV, which corresponds to the 3/2+ level at Ex=9.51 MeV in O15. In particular, the s- and d-wave angular-momentum channels are separated. Conclusion: The relative cross sections provide a consistent set of data that can be used to better constrain a full multichannel R-matrix extrapolation of the capture data. It has been demonstrated how the scattering data reduce the uncertainty through a preliminary Monte Carlo uncertainty analysis, but several other issues remain that make large contributions to the uncertainty, which must be addressed by further capture and lifetime measurements

X-ray Survey Results on Active Galaxy Physics and Evolution

This "pedagogical" review describes the key Chandra and XMM-Newton extragalactic surveys to date and details some of their implications for AGN physics and evolution. We additionally highlight two topics of current widespread interest: (1) X-ray constraints on the AGN content of luminous submillimeter galaxies, and (2) the demography and physics of high-redshift (z > 4) AGN as revealed by X-ray observations. Finally, we discuss prospects for future X-ray surveys with Chandra, XMM-Newton, and upcoming missions.Comment: 26 pages, in Physics of Active Galactic Nuclei at All Scales, eds. Alloin D., Johnson R., Lira P. (Springer-Verlag, Berlin), version with all figures at http://www.astro.psu.edu/users/niel/papers/papers.htm

An Integrated TCGA Pan-Cancer Clinical Data Resource to Drive High-Quality Survival Outcome Analytics

For a decade, The Cancer Genome Atlas (TCGA) program collected clinicopathologic annotation data along with multi-platform molecular profiles of more than 11,000 human tumors across 33 different cancer types. TCGA clinical data contain key features representing the democratized nature of the data collection process. To ensure proper use of this large clinical dataset associated with genomic features, we developed a standardized dataset named the TCGA Pan-Cancer Clinical Data Resource (TCGA-CDR), which includes four major clinical outcome endpoints. In addition to detailing major challenges and statistical limitations encountered during the effort of integrating the acquired clinical data, we present a summary that includes endpoint usage recommendations for each cancer type. These TCGA-CDR findings appear to be consistent with cancer genomics studies independent of the TCGA effort and provide opportunities for investigating cancer biology using clinical correlates at an unprecedented scale. Analysis of clinicopathologic annotations for over 11,000 cancer patients in the TCGA program leads to the generation of TCGA Clinical Data Resource, which provides recommendations of clinical outcome endpoint usage for 33 cancer types