Monitoring serum insulin-like growth factor-I (IGF-I), IGF binding protein-3 (IGFBP-3), IGF-I/IGFBP-3 molar ratio and leptin during growth hormone treatment for disordered growth

OBJECTIVE: Serum IGF-I levels are monitored during GH replacement treatment in adults with GH defi- ciency (GHD) to guide GH dose adjustment and to minimize occurrence of GH-related side-effects. This is not routine practice in children treated with GH. The aim of this study was to evaluate changes in (1) serum IGF-I, IGFBP-3 and IGF-I/IGFBP-3 molar ratio, and (2) serum leptin, an indirect marker of GH response, during the first year of GH treatment in children with disordered growth. DESIGN: An observational prospective longitudinal study with serial measurements at five time points during the first year of GH treatment was carried out. Each patient served as his/her own control. PATIENTS The study included 31 patients, grouped as (1) GHD (n=20) and (2) non-GHD (Turner syndrome n=7; Noonan syndrome n=4), who had not previously received GH treatment. MEASUREMENTS: Serum IGF-I, IGFBP-3 and leptin levels were measured before treatment and after 6 weeks, 3 months, 6 months and 12 months of GH treatment, with a mean dose of 0.5 IU/kg/wk in GHD and 0.7 IU/kg/wk in non-GHD groups. IGF-I, IGFBP-3 and the calculated IGF-I/IGFBP-3 molar ratio were expressed as SD scores using reference values from the local population. RESULTS: In the GHD group, IGF-I SDS before treatment was lower compared with the non-GHD (-5.4 ± 2.5 vs. -1.8 ± 1.0; P < 0.001). IGF-I (-1.8 SDS ± 2.2) and IGFBP-3 (-1.1 SDS ± 0.6) levels and their molar ratios were highest at 6 weeks and remained relatively constant thereafter. In the non-GHD group, IGF-I levels increased throughout the year and were maximum at 12 months (0.3 SDS ± 1.4) while IGFBP-3 (1.1 SDS ± 0.9) and IGF-I/IGFBP-3 molar ratio peaked at 6 months. In both groups, IGF-I SDS and IGF-I/IGFBP-3 during treatment correlated with the dose of GH expressed as IU/m2/week (r-values 0.77 to 0.89; P = 0.005) but not as IU/kg/week. Serum leptin levels decreased significantly during GH treatment in the GHD (median before treatment 4.0 g/l; median after 12 months treatment 2.4 g/l; P = 0.02) but not the non-GHD (median before treatment 3.0 g/l; median after 12 months treatment 2.6 g/l). In the GHD group, serum leptin before treatment correlated with 12 month change in height SDS (r = 0.70, P = 0.02). CONCLUSIONS: The pattern of IGF-I, IGFBP-3 and their molar ratio during the first year of GH treatment differed between the GHD and non-GHD groups. Calculation of GH dose by surface area may be preferable to calculating by body weight. As a GH dose-dependent increase in serum IGF-I and IGF-I/IGFBP-3 may be associated with adverse effects, serum IGF-I and IGFBP-3 should be monitored routinely during longterm GH treatment. Serum leptin was the only variable that correlated with first year growth response in GHD

Engaging parents to promote girls\u27 transition to secondary education: Evidence from a cluster randomised trial in rural Gujarat, India

The Population Council and partners, with the support of the Human Dignity Foundation and the John D. and Catherine T. MacArthur Foundation, implemented a pilot intervention in India─Project Sankalp─to assess the acceptability and feasibility of engaging parents and communities to promote girls’ secondary education. The project\u27s aim was to measure its effectiveness in improving adolescent girls’ transition to secondary education, their attendance at school, and learning outcomes. Findings show that the effect of Project Sankalp on creating an enabling environment for girls to pursue secondary education was mixed. On the positive side, the project showed success in raising girls’ educational aspirations; improving parental support for their secondary education; and raising girls’ awareness of school management committees. However, there was no evidence of any effect on girls’ agency in matters concerning their schooling, awareness and utilization of the benefits available from school, and the time committed to school-related activities. These findings underscore the need for a longer-term engagement with girls and their parents than was possible in Project Sankalp, or for more intensive efforts that will enable girls to make effective use of the knowledge and skills they gain, and give parents more time to translate the messages they receive into real life practices

Associations of inflammatory and hemostatic variables with the risk of recurrent stroke

&lt;p&gt;&lt;b&gt;Background and Purpose:&lt;/b&gt; Several prospective studies have shown significant associations between plasma fibrinogen, viscosity, C-reactive protein (CRP), fibrin D-dimer, or tissue plasminogen activator (tPA) antigen and the risk of primary cardiovascular events. Little has been published on the associations of these variables with recurrent stroke. We studied such associations in a nested case-control study derived from the Perindopril Protection Against Recurrent Stroke Study (PROGRESS).&lt;/p&gt; &lt;p&gt;&lt;b&gt;Methods:&lt;/b&gt; Nested case-control study of ischemic (n=472) and hemorrhagic (n=83) strokes occurring during a randomized, placebo-controlled multicenter trial of perindopril-based therapy in 6105 patients with a history of stroke or transient ischemic attack. Controls were matched for age, treatment group, sex, region, and most recent qualifying event at entry to the parent trial.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Results:&lt;/b&gt; Fibrinogen and CRP were associated with an increased risk of recurrent ischemic stroke after accounting for the matching variables and adjusting for systolic blood pressure, smoking, peripheral vascular disease, and statin and antiplatelet therapy. The odds ratio for the last compared with the first third of fibrinogen was 1.34 (95% CI, 1.01 to 1.78) and for CRP was 1.39 (95% CI, 1.05 to 1.85). After additional adjustment for each other, these 2 odds ratios stayed virtually unchanged. Plasma viscosity, tPA, and D-dimer showed no relationship with recurrent ischemic stroke, although tPA was significant for lacunar and large artery subtypes. Although each of these variables showed a negative relationship with recurrent hemorrhagic stroke, none of these relationships achieved statistical significance.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Conclusions:&lt;/b&gt; Fibrinogen and CRP are risk predictors for ischemic but not hemorrhagic stroke, independent of potential confounders.&lt;/p&gt

Isolated pores dissected from human two-pore channel 2 are functional

Multi-domain voltage-gated ion channels appear to have evolved through sequential rounds of intragenic duplication from a primordial one-domain precursor. Whereas modularity within one-domain symmetrical channels is established, little is known about the roles of individual regions within more complex asymmetrical channels where the domains have undergone substantial divergence. Here we isolated and characterised both of the divergent pore regions from human TPC2, a two-domain channel that holds a key intermediate position in the evolution of voltage-gated ion channels. In HeLa cells, each pore localised to the ER and caused Ca2+ depletion, whereas an ER-targeted pore mutated at a residue that inactivates full-length TPC2 did not. Additionally, one of the pores expressed at high levels in E. coli. When purified, it formed a stable, folded tetramer. Liposomes reconstituted with the pore supported Ca2+ and Na+ uptake that was inhibited by known blockers of full-length channels. Computational modelling of the pore corroborated cationic permeability and drug interaction. Therefore, despite divergence, both pores are constitutively active in the absence of their partners and retain several properties of the wild-type pore. Such symmetrical ‘pore-only’ proteins derived from divergent channel domains may therefore provide tractable tools for probing the functional architecture of complex ion channels

Synthesis, structural and physical properties of δ′\delta'-FeSe1−x_{1-x}

We report on synthesis, structural characterization, resistivity, magnetic and thermal expansion measurements on the as yet unexplored $\delta'$-phase of FeSe$_{1-x}$, here synthesized under ambient- (AP) and high-pressure (HP) conditions. We show that in contrast to $\beta$-FeSe$_{1-x}$, monophasic superconducting $\delta'$-FeSe$_{1-x}$ can be obtained in off-stoichiometric samples with excess Fe atoms preferentially residing in the van der Waals gap between the FeSe layers. The AP $\delta'$-FeSe$_{1-x}$ sample studied here ($T_c$ $\simeq$ 8.5\,K) possesses an unprecedented residual resistivity ratio RRR $\simeq$ 16. Thermal expansion data reveal a small feature around $\sim$90\,K, which resembles the anomaly observed at the structural and magnetic transitions for other Fe-based superconductors, suggesting that some kind of "magnetic state" is formed also in FeSe. %indicative of a fluctuating magnetic ordering. For HP samples (RRR $\simeq$ 3), the disorder within the FeSe layers is enhanced through the introduction of vacancies, the saturated magnetic moment of Fe is reduced and only spurious superconductivity is observed.Comment: 7 pages, 8 figures, published versio

Investigating genome wide dna methylation in airway smooth muscle cells from asthmatic and non-asthmatic donors

Rationale: Genetic mechanisms fail to fully explain asthma pathogenesis and environmental factors are considered to play an important role. Environmental factors may lead to permanent changes in epigenetic patterns and contribute to asthma. Epigenetics is the study of heritable changes in gene expression that are not due to changes in DNA sequence. DNA methylation is a reversible modification of DNA structure in which a methyl group is added to cytosine residues. Parental smoking affects the methylation of buccal cell DNA from children and children with early onset wheeze have an altered blood DNA methylation profile to healthy individuals. No studies have compared DNA methylation profiles in the disease relevant cell type of airway smooth muscle (ASM) cells. Methods: DNA was isolated from ASM cells at passage 5 and bisulphite treated to convert epigenetic information into sequence-based information. Site specific, quantitative genome wide methylation was determined using the Illumina 450K Infinium Methylation BeadChip array. Hits were validated by Pyrosequencing. RNA was extracted simultaneously for mRNA expression analysis by real time PCR. Results: There were no independent CpG sites associated with asthmatic status of ASM cells following multiple test correction. Without correction over 13000 CpG sites showed a significant difference in methylation (linear modelling, p value >0.05) between asthmatic and non-asthmatic cells, and a biologically relevant difference in methylation of greater that 10% (β value >0.1 ). 10 of these sites were selected as top hits. 7 sites positively validated by pyrosequencing. They were associated with 7 different genes; LGALS3BP, ATP11A, ZNF696, KLF6, TBX1, RUNX3, and SPINT2. Expression of these genes was measured in ASM cells isolated from asthmatic and non-asthmatic donors. LGALS3BP expression was undetectable while ATP11A and ZNF696 displayed no difference in expression between cells from asthmatic and non-asthmatic donors. KLF6 and SPINT2 showed a trend towards increased expression in cells from asthmatic donors while RUNX3 and TBX1 showed a trend towards decreased expression. Conclusions: Differences in CpG methylation exist between ASM isolated from asthmatic and non-asthmatic donors. Future work will focus on identifying differentially methylated regions of DNA and further defining the association to gene and protein expression

COVID-19-related knowledge, attitudes, and practices among adolescents and young people in Bihar and Uttar Pradesh, India: Study description

To control the spread of COVID-19 in India and to aid the efforts of the Ministry of Health and Family Welfare (MOHFW), the Population Council and other non-governmental organizations are conducting research to assess residents’ ability to follow sanitation and social distancing precautions under a countrywide lockdown. The Population Council COVID-19 study team is implementing rapid phone-based surveys to collect information on knowledge, attitudes and practices, as well as needs, among 2,041 young people (ages 19-23 years) and/or an adult household member, sampled from an existing prospective cohort study with a total sample size of 20,574 in Bihar (n=10,433) and Uttar Pradesh (n=10,141). Baseline was conducted from April 3-22; subsequent iterations of the survey are planned to be conducted on a monthly basis. Baseline findings on awareness of COVID-19 symptoms, perceived risk, awareness of and ability to carry out preventive behaviors, misconceptions, and fears will inform the development of government and other stakeholders’ interventions and/or strategies. We are committed to openly sharing the latest versions of the study description, questionnaires, deidentified or aggregated datasets, and preliminary results. Data and findings can also be shared with partners working in COVID-19 response

Modelling and control of a multi-stage interleaved DC-DC converter with coupled inductors for super-capacitor energy storage system

Interleaved converters with coupled inductors are widely used to share load current in high power applications. It offers high equivalent switching frequency and reduced output current ripples using small size magnetic components. Due to smaller common-mode inductance, control system can be designed to achieve fast dynamic response. This paper proposes 8 channel interleaved DC/DC converter for interfacing super-capacitor energy storage system to a 400V DC voltage bus. Multi-stage interleaving magnetic circuit with two-phase coupling inductor as a building block is proposed. A methodology is developed to construct the model of the multi-stage magnetic circuit from the basic two-phase coupled inductor model. The derived model is successfully used to evaluate the system power losses and to design the magnetic circuit parameters and its current controller to fulfil the DC/DC converter steady state and dynamic performance specifications. A 20kW/four stage/8 channel DC/DC converter laboratory prototype has been built to connect a super-capacitor stack to 400V DC voltage bus. Experimental investigation validates the modeling, the system losses calculations and the design specifications of the system

A new urban landscape in East–Southeast Asia, 2000–2010

East–Southeast Asia is currently one of the fastest urbanizing regions in the world, with countries such as China climbing from 20 to 50% urbanized in just a few decades. By 2050, these countries are projected to add 1 billion people, with 90% of that growth occurring in cities. This population shift parallels an equally astounding amount of built-up land expansion. However, spatially-and temporally-detailed information on regional-scale changes in urban land or population distribution do not exist; previous efforts have been either sample-based, focused on one country, or drawn conclusions from datasets with substantial temporal/spatial mismatch and variability in urban definitions. Using consistent methodology, satellite imagery and census data for &gt;1000 agglomerations in the East–Southeast Asian region, we show that urban land increased &gt;22% between 2000 and 2010 (from 155 000 to 189 000 km2), an amount equivalent to the area of Taiwan, while urban populations climbed &gt;31% (from 738 to 969 million). Although urban land expanded at unprecedented rates, urban populations grew more rapidly, resulting in increasing densities for the majority of urban agglomerations, including those in both more developed (Japan, South Korea) and industrializing nations (China, Vietnam, Indonesia). This result contrasts previous sample-based studies, which conclude that cities are universally declining in density. The patterns and rates of change uncovered by these datasets provide a unique record of the massive urban transition currently underway in East–Southeast Asia that is impacting local-regional climate, pollution levels, water quality/availability, arable land, as well as the livelihoods and vulnerability of populations in the regio

Barosinusitis: comprehensive review and proposed new classification system

Background: Barosinusitis, or sinus barotrauma, may arise from changes in ambient pressure that are not compensated by force equalization mechanisms within the paranasal sinuses. Barosinusitis is most commonly seen with barometric changes during flight or diving. Understanding and better classifying the pathophysiology, clinical presentation, and management of barosinusitis are essential to improve patient care. Objectives: To perform a comprehensive review of the available literature regarding sinus barotrauma. Methods: A comprehensive literature search that used the terms "barosinusitis," "sinus barotrauma," and "aerosinusitis" was conducted, and all identified titles were reviewed for relevance to the upper airway and paranasal sinuses. All case reports, series, and review articles that were identified from this search were included. Selected cases of sinus barotrauma from our institution were included to illustrate classic signs and symptoms. Results: Fifty-one articles were identified as specifically relevant to, or referencing, barosinusitis and were incorporated into this review. The majority of articles focused on barosinusitis in the context of a single specific etiology rather than independent of etiology. From analysis of all the publications combined with clinical experience, we proposed that barosinusitis seemed to fall within three distinct subtypes: (1) acute, isolated barosinusitis; (2) recurrent acute barosinusitis; and (3) chronic barosinusitis. We introduced this terminology and suggested independent treatment recommendations for each subtype. Conclusion: Barosinusitis is a common but potentially overlooked condition that is primed by shifts in the ambient pressure within the paranasal sinuses. The pathophysiology of barosinusitis has disparate causes, which likely contribute to its misdiagnosis and underdiagnosis. Available literature compelled our proposed modifications to existing classification schemes, which may allow for improved awareness and management strategies for barosinusitis.Reza Vaezeafshar, Alkis J. Psaltis, Vidya K. Rao, David Zarabanda, Zara M. Patel and Jayakar V. Naya