Intervention strategies for preventing excessive gestational weight gain: systematic review and meta‐analysis

Background Interventions relevant to energy intake to prevent excessive gestational weight gain in pregnant overweight and obese women are important but scarce. This review synthesized healthy eating and physical activity strategies and their effects on excessive gestational weight gain prevention. Methods Twenty‐three randomized controlled trials that included healthy eating and/or physical activity as an intervention in healthy pregnant overweight or obese adult women and gestational weight gain as a primary or secondary outcome were reviewed. Findings Heathy eating and/or physical activity (21 studies, n = 6,920 subjects) demonstrated 1.81 kg (95% CI: −3.47, −0.16) of gestational weight gain reduction favouring intervention. Healthy eating (−5.77 kg, 95% CI: −9.34, −2.21, p = 0.02) had a larger effect size than combined healthy eating/physical activity (−0.82 kg, 95% CI: −1.28, −0.36, p = 0.0005) in limiting gestational weight gain. Physical activity did not show a significant pooled effect. Healthy eating with prescribed daily calorie and macronutrient goals significantly limited gestational weight gain by 4.28 kg and 4.23 kg, respectively. Conclusion Healthy eating and/or physical activity are effective in gestational weight gain control. Healthy eating with calorie and macronutrient goals are especially effective in limiting excessive gestational weight gain among pregnant overweight and obese women

Somatosensory-evoked delta brush activity in very pre-term infants

INTRODUCTION: Delta brushes - slow waves with over-riding alpha-beta oscillations - are a hallmark of the pre-term EEG, and can be evoked by somatosensory stimulation (Whitehead et al., 2017). As such, they may be a biomarker of early sensory processing, with their attenuation indicating maturation of somatosensory circuits. In animal models, the somatosensory system is known to mature in a rostro-caudal progression, with hindlimb somatosensation last to develop, but little is known about the development of somatosensory processing in the human infant brain. Here we investigated the attenuation of delta brush activity following tactile stimulation of hands and feet over the pre-term period. METHODS: We recorded 16-channels EEG and evaluated the somatosensory evoked response following tactile mechanical stimulation of hands and feet in 38 pre-term infants at low-risk of adverse neurodevelopment (exclusion: (i) intra-ventricular haemorrhage ⩾ grade III; (ii) severe growth restriction (defined as <2nd birth weight centile)). We then looked at changes in the amplitude of the slow delta wave and of the over-riding alpha-beta oscillations in the evoked response between very pre-term (28 + 2 − 31 + 2 weeks + days, n = 13) and moderately pre-term (32 + 2 − 35 + 4 weeks + days, n = 25) infants using point-by-point t-tests (statistical significance set at p < 0.01 to account for multiple comparisons). RESULTS: Tactile stimulation of hands and feet evoked a long-lasting diffuse negative delta slow wave, with onset latency at ∼100 ms, peak latency at ∼500 ms, and peak amplitude of ∼100 μV and ∼50 μV for hand and foot stimulation respectively, and an increase in alpha-beta oscillations concurrent with the peak latency of this slow wave. We first looked at changes in the amplitude of the slow delta wave. This delta wave attenuated in amplitude in the older age group most prominently over the contralateral parietal-temporal region for hand stimulation, and most prominently over the midline parietal and bilateral temporal regions for foot stimulation. Next, we looked at changes in the amplitude of the alpha-beta oscillations which co-occurred with the peak latency of this slow delta wave. Alpha-beta oscillations attenuated in amplitude in the older age group over bilateral parietal regions for hand stimulation, while there was no difference between the age groups for foot stimulation. CONCLUSION: This is the first developmental study of delta brushes evoked by stimulation of the upper and lower limbs. Our results indicate that in very pre-term infants tactile stimulation evokes diffuse delta brush activity, which attenuates across development most markedly over the parietal-temporal regions. Interestingly, delta brush alpha-beta oscillations only decrease with development for hand stimulation, but not foot stimulation, suggesting that somatosensory maturation may occur earlier for the hands in line with studies of older infants (Whitehead et al., submitted for publication), and animal models

Double jeopardy: the influence of excessive daytime sleepiness and impaired cognition on health‐related quality of life in adults with heart failure

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106066/1/ejhfhfs054.pd

Successful private–public funding of paediatric medicines research: lessons from the EU programme to fund research into off-patent medicines

The European Paediatric Regulation mandated the European Commission to fund research on off-patent medicines with demonstrated therapeutic interest for children. Responding to this mandate, five FP7 project calls were launched and 20 projects were granted. This paper aims to detail the funded projects and their preliminary results. Publicly available sources have been consulted and a descriptive analysis has been performed. Twenty Research Consortia including 246 partners in 29 European and non-European countries were created (involving 129 universities or public funded research organisations, 51 private companies with 40 SMEs, 7 patient associations). The funded projects investigate 24 medicines, covering 10 therapeutic areas in all paediatric age groups. In response to the Paediatric Regulation and to apply for a Paediatric Use Marketing Authorisation, 15 Paediatric Investigation Plans have been granted by the EMAPaediatric Committee, including 71 studies of whom 29 paediatric clinical trials, leading to a total of 7,300 children to be recruited in more than 380 investigational centres. Conclusion: Notwithstanding the EU contribution for each study is lower than similar publicly funded projects, and also considering the complexity of paediatric research, these projects are performing high-quality research and are progressing towards the increase of new paediatric medicines on the market. Private–public partnerships have been effectively implemented, providing a good example for future collaborative actions. Since these projects cover a limited number of offpatent drugs and many unmet therapeutic needs in paediatrics remain, it is crucial foreseeing new similar initiatives in forthcoming European funding programmes

Comparing the harmful effects of nontuberculous mycobacteria and Gram negative bacteria on lung function in patients with cystic fibrosis

BACKGROUND: To better understand the relative effects of infection with nontuberculous mycobacteria and Gram negative bacteria on lung function decline in cystic fibrosis, we assessed the impact of each infection in a Danish setting. METHODS: Longitudinal registry study of 432 patients with cystic fibrosis contributing 53,771 lung function measures between 1974 and 2014. We used a mixed effects model with longitudinally structured correlation, while adjusting for clinically important covariates. RESULTS: Infections with a significant impact on rate of decline in %FEV1 were Mycobacterium abscessus complex with -2.22% points per year (95% CI -3.21 to -1.23), Burkholderia cepacia complex -1.95% (95% CI -2.51 to -1.39), Achromobacterxylosoxidans -1.55% (95% CI -2.21 to -0.90), and Pseudomonas aeruginosa -0.95% (95% CI -1.24 to -0.66). Clearing M. abscessus complex was associated with a change to a slower decline, similar in magnitude to the pre-infection slope. CONCLUSIONS: In a national population we have demonstrated the impact on lung function of each chronic CF pathogen. M. abscessus complex was associated with the worst impact on lung function. Eradication of M. abscessus complex may significantly improve lung function

Influence of depression and gender on symptom burden among patients with advanced heart failure: Insight from the pain assessment, incidence and nature in heart failure study

Introduction Patients with advanced heart failure (HF) experience many burdensome symptoms that increase patient suffering. Methods Comparative secondary analysis of 347 patients with advanced HF. Symptom burden was measured with the Memorial Symptom Assessment Scale-HF. Depression was measured using the Patient Health Questionnaire-9. Results Mean number of symptoms was 13.6. The three most frequent symptoms were non-cardiac pain, shortness of breath, and lack of energy. Patients with depression reported higher symptom burden. Symptom burden differed when compared by gender. Women reported higher symptom burden for other pain, dry mouth, swelling of the arms and legs, sweats, feeling nervous, nausea, and vomiting. Men reported higher symptom burden with sexual problems. Conclusions Given the high rates of symptoms and distress, interventions are needed to alleviate the symptom burden of patients with advanced HF. Reported symptom burden in patients with advanced heart failure was higher when depressive symptoms were present. Women reported varied number and severity of symptoms than men

Quantitative study of hydration of C3S and C2S by thermal analysis. Evolution and composition of C-S-H gels formed

This research is part of a European project (namely, CODICE project), main objective of which is modelling, at a multi-scale, the evolution of the mechanical performance of non-degraded and degraded cementitious matrices. For that, a series of experiments were planned with pure synthetic tri-calcium silicate (C3S) and bi-calcium silicate (C2S) (main components of the Portland cement clinker) to obtain different calcium–silicate–hydrate (C–S–H) gel structures during their hydration. The characterization of those C–S–H gels and matrices will provide experimental parameters for the validation of the multi-scale modelling scheme proposed. In this article, a quantitative method, based on thermal analyses, has been used for the determination of the chemical composition of the C–S–H gel together with the degree of hydration and quantitative evolution of all the components of the pastes. Besides, the microstructure and type of silicate tetrahedron and mean chain length (MCL) were studied by scanning electron microscopy (SEM) and 29Si magic-angle-spinning (MAS) NMR, respectively. The main results showed that the chemical compositions for the C–S–H gels have a CaO/SiO2 M ratio almost constant of 1.7 for both C3S and C2S compounds. Small differences were found in the gel water content: the H2O/SiO2 M ratio ranged from 2.9 ± 0.2 to 2.6 ± 0.2 for the C3S (decrease) and from 2.4 ± 0.2 to 3.2 ± 0.2 for the C2S (increase). The MCL values of the C–S–H gels, determined from 29Si MAS NMR, were 3.5 and 4 silicate tetrahedron, for the hydrated C3S and C2S, respectively, remaining almost constant at all hydration periods

Three Gram Sodium Intake is Associated With Longer Event-Free Survival Only in Patients With Advanced Heart Failure

There is limited evidence to support the recommendation that patients with heart failure (HF) restrict sodium intake. The purpose of this study was to compare differences in cardiac event-free survival between patients with sodium intake above and below 3g

Depressive symptoms and inflammatory biomarkers in patients with heart failure

Inflammation may be a link between depressive symptoms and outcomes in patients with heart failure (HF). It is not clear whether inflammatory markers are independently related to depressive symptoms in this population