Editorial: Early Avian Evolution

The study of early avian evolution—how birds evolved from dinosaurs and radiated into the most diverse group of amniotes on the planet—is one of the most dynamic areas of research in paleontology, fueled not only by the rapid rate of discovery of new specimens (see Foth et al.; Musser and Clarke; and Xing et al.) and sheer volume of available material (see Zheng et al.) but also by the innovative application of new analytical methods to key evolutionary questions (see Heers et al.; Liu et al.). Also critical to our understanding is the exceptional level of preservation of many Mesozoic and early Cenozoic bird fossils, which not uncommonly preserve soft tissues and other indicators that may provide key insights into the biology of these organisms (see articles by Clark and O’Connor; Foth et al.; Xing et al.; Zheng et al.). In putting together this research topic, our aim was to further expand our understanding of early avian evolution by gathering a body of work highlighting the diversity of research currently being undertaken in this area. As such, articles published in this topic have augmented our understanding of a variety of important areas related to early avian evolution, including the recognition of new taxonomic diversity (see Clark and O’Connor and Musser and Clarke), insights into the evolution of key avian traits such as flight (Heers et al.) and a toothless beak (see Louchart et al. and Zheng et al.), and the piecemeal evolution of crown avian biology (see Atterholt et al. and Heers et al.)

Sibling Mother-Infant Attachment: Different Patterns of Interaction Lead to Similar Relationships

PURPOSE: To investigate the role of maternal sensitivity and interactive behavior in sibling attachment non-/concordance. RESULTS:1) Global measures of sensitivity suggest that mothers of concordant-secure and non-concordant infants demonstrate a similar degree of sensitivity towards each child. 2) Mothers with non-concordant infants interact more similarly with each child on domains of maternal sensitivity, compared to mothers whose infants are concordant. CONCLUSION: The quality of the attachment relationship in families with non-concordant mother-infant relationships –in contrast to families with concordant dyads –does not appear to be systematically affected by maternal sensitivity as typically assessed. More detailed assessment of the interactions suggest that mothers with non-concordant relationships with their infants may be unable to adapt their behaviour to suit the unique needs of each child

Characteristics of High-Risk Groups: Analysis of Norwalk Student Body Mass Index (BMI) Data

1 in 3 children in the United States is currently classified as overweight or obese, and this prevalence increases as age rises. Obesity varies by racial, environmental, ethnic and socioeconomic factors as well as genetic factors. Childhood obesity is more prevalent among African Americans, American Indians, and Mexican-Americans than in whites, as well as in lower income families.1 2 3 Connecticut has one of the lowest childhood obesity rates in the nation (~11%), yet Norwalk’s childhood obesity rate is well above this mark at 22%4. This project reflects a partnership between the Norwalk Health Department and Norwalk Public Schools to create a report on childhood obesity in Norwalk stratified by age, gender, race, and free and reduced-price lunch eligibility. The objectives of this project were to 1) Analyze BMI data to determine if disparities in obesity prevalence in Norwalk Public Schools exist by demographic characteristics and understand how trends in obesity prevalence have changed over time. 2) Conduct qualitative analyses to identify areas for improvement by both the Norwalk Health Department and the Norwalk Public School System.https://elischolar.library.yale.edu/ysph_pbchrr/1027/thumbnail.jp

Common Ground: A Place to Grow

Common Ground (CG) High School is a public charter school in New Haven, CT with approximately 200 students. CG’s mission is to cultivate habits of healthy living and sustainable environmental practices within its community. The school maintains an urban farm that provides food for students, staff, and approximately 2,500 residents of low-income neighborhoods in the area. The current literature suggests that CG’s programming should have positive health outcomes for its students and their families. CG has data on these outcomes via an online survey distributed to students, but does not yet have the internal capacity to analyze this data. This project aims to develop a protocol that enables CG faculty to autonomously analyze data and determine key impacts and outcomes. A current YSPH student-led team analyzed data from the student surveys in order to provide feedback on CG’s health-related programs and understand students’ health behaviors. Results from analysis were then used to conduct Community Data Discussion Groups to garner feedback from students and parents about how Common Ground has impacted their health and leadership behaviors. Detailed analysis protocols were created to enable CG faculty to independently analyze data. CG faculty was trained to implement protocol, which will allow for future independent data analysis. Overall, the results suggest that Common Ground’s programming and curriculum has had a positive impact on students’ health behaviors. We recommend that Common Ground expand its health-related and farm-based programming as much as possible, paying special attention to improving school lunch and allowing for physical activity. We encourage Common Ground to continue using a mixed methods approach to evaluate its programs, use the provided data analysis protocol, and work in conjunction with CARE and YSPH as they transition into independent research.https://elischolar.library.yale.edu/ysph_pbchrr/1047/thumbnail.jp

Levels of fatigue and distress in senior prostate cancer survivors enrolled in a 12-week randomized controlled trial of Qigong

Fatigue is a commonly reported symptom by prostate cancer survivors and is associated with significant distress and declines in quality of life. Qigong is a mind-body activity that consists of both physical activity and meditative aspects. This 12-week Randomized Controlled Trial (RCT) examined the feasibility and efficacy of a Qigong intervention for improving older prostate cancer survivors’ levels of fatigue and distress

Quality indicators for Palliative Day Services: A modified Delphi study

BACKGROUND: The goal of Palliative Day Services is to provide holistic care that contributes to the quality of life of people with life threatening-illness and their families. Quality indicators provide a means by which to describe, monitor and evaluate the quality of Palliative Day Services provision, and act as a starting point for quality improvement. However, currently, there are no published quality indicators for Palliative Day Services. AIM: To develop and provide the first set of quality indicators that describe and evaluate the quality of Palliative Day Services. DESIGN AND SETTING: A modified Delphi technique was used to combine best available research evidence derived from a systematic scoping review with multi-disciplinary expert appraisal of the appropriateness and feasibility of candidate indicators. The resulting indicators were compiled into ‘toolkit’, and tested in five UK Palliative Day Service settings. RESULTS: A panel of experts independently reviewed evidence summaries for 182 candidate indicators and provided ratings on appropriateness, followed by a panel discussion and further independent ratings of appropriateness, feasibility, and necessity. This exercise resulted in the identification of 30 indicators which were used in practice testing. The final indicator set comprised 7 structural indicators, 21 process indicators, and 2 outcome indicators. CONCLUSIONS: The indicators fulfil a previously unmet need among Palliative Day Service providers by delivering an appropriate and feasible means to assess, review, and communicate the quality of care, and to identify areas for quality improvement

The actinobacterial transcription factor RbpA binds to the principal sigma subunit of RNA polymerase

RbpA is a small non-DNA-binding transcription factor that associates with RNA polymerase holoenzyme and stimulates transcription in actinobacteria, including Streptomyces coelicolor and Mycobacterium tuberculosis. RbpA seems to show specificity for the vegetative form of RNA polymerase as opposed to alternative forms of the enzyme. Here, we explain the basis of this specificity by showing that RbpA binds directly to the principal σ subunit in these organisms, but not to more diverged alternative σ factors. Nuclear magnetic resonance spectroscopy revealed that, although differing in their requirement for structural zinc, the RbpA orthologues from S. coelicolor and M. tuberculosis share a common structural core domain, with extensive, apparently disordered, N- and C-terminal regions. The RbpA-σ interaction is mediated by the C-terminal region of RbpA and σ domain 2, and S. coelicolor RbpA mutants that are defective in binding σ are unable to stimulate transcription in vitro and are inactive in vivo. Given that RbpA is essential in M. tuberculosis and critical for growth in S. coelicolor, these data support a model in which RbpA plays a key role in the σ cycle in actinobacteria

Predictive utility of an adapted Marshall head CT classification scheme after traumatic brain injury

Objective: To study the predictive relationship among persons with traumatic brain injury (TBI) between an objective indicator of injury severity (the adapted Marshall computed tomography [CT] classification scheme) and clinical indicators of injury severity in the acute phase, functional outcomes at inpatient rehabilitation discharge, and functional and participation outcomes at 1 year after injury, including death.Participants: The sample involved 4895 individuals who received inpatient rehabilitation following acute hospitalization for TBI and were enrolled in the Traumatic Brain Injury Model Systems National Database between 1989 and 2014.Design: Head CT variables for each person were fit into adapted Marshall CT classification categories I through IV.Main Measures: Prediction models were developed to determine the amount of variability explained by the CT classification categories compared with commonly used predictors, including a clinical indicator of injury severity.Results: The adapted Marshall classification categories aided only in the prediction of craniotomy or craniectomy during acute hospitalization, otherwise making no meaningful contribution to variance in the multivariable models predicting outcomes at any time point after injury.Conclusion: Results suggest that head CT findings classified in this manner do not inform clinical discussions related to functional prognosis or rehabilitation planning after TBI

Association between sex steroid hormones and subsequent hyperglycemia during pregnancy

ObjectiveSex steroid hormones may play a role in insulin resistance and glucose dysregulation. However, evidence regarding associations between early-pregnancy sex steroid hormones and hyperglycemia during pregnancy is limited. The primary objective of this study was to assess the relationships between first trimester sex steroid hormones and the subsequent development of hyperglycemia during pregnancy; with secondary evaluation of sex steroid hormones levels in mid-late pregnancy, concurrent with and subsequent to diagnosis of gestational diabetes.MethodsRetrospective analysis of a prospective pregnancy cohort study was conducted. Medically low-risk participants with no known major endocrine disorders were recruited in the first trimester of pregnancy (n=319). Sex steroid hormones in each trimester, including total testosterone, free testosterone, estrone, estradiol, and estriol, were assessed using high-performance liquid chromatography and tandem mass spectrometry. Glucose levels of the 1-hour oral glucose tolerance test and gestational diabetes diagnosis were abstracted from medical records. Multivariable linear regression models were fitted to assess the associations of individual first trimester sex steroids and glucose levels.ResultsIn adjusted models, first trimester total testosterone (β=5.24, 95% CI: 0.01, 10.46, p=0.05) and free testosterone (β=5.98, 95% CI: 0.97, 10.98, p=0.02) were positively associated with subsequent glucose concentrations and gestational diabetes diagnosis (total testosterone: OR=3.63, 95% CI: 1.50, 8.78; free testosterone: OR=3.69; 95% CI: 1.56, 8.73). First trimester estrone was also positively associated with gestational diabetes (OR=3.66, 95% CI: 1.56, 8.55). In mid-late pregnancy, pregnant people with gestational diabetes had lower total testosterone levels (β=-0.19, 95% CI: -0.36, -0.02) after adjustment for first trimester total testosterone.ConclusionEarly-pregnancy sex steroid hormones, including total testosterone, free testosterone, and estrone, were positively associated with glucose levels and gestational diabetes in mid-late pregnancy. These hormones may serve as early predictors of gestational diabetes in combination with other risk factors

Idiopathic Pulmonary Fibrosis and Lung Cancer: Future Directions and Challenges

Idiopathic pulmonary fibrosis (IPF) is a progressive disease of pulmonary scarring. New treatments slow disease progression and allow pulmonary fibrosis patients to live longer. Persistent pulmonary fibrosis increases a patient’s risk of developing lung cancer. Lung cancer in patients with IPF differs from cancers that develop in the non-fibrotic lung. Peripherally located adenocarcinoma is the most frequent cell type in smokers who develop lung cancer, while squamous cell carcinoma is the most frequent in pulmonary fibrosis. Increased fibroblast foci in IPF are associated with more aggressive cancer behaviour and shorter doubling times. Treatment of lung cancer in fibrosis is challenging because of the risk of inducing an exacerbation of fibrosis. In order to improve patient outcomes, modifications of current lung cancer screening guidelines in patients with pulmonary fibrosis will be necessary to avoid delays in treatment. 2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) computed tomography (CT) imaging can help identify cancer earlier and more reliably than CT alone. Increased use of wedge resections, proton therapy and immunotherapy may increase survival by decreasing the risk of exacerbation, but further research will be necessary