The Youngest Victims of the Opioid Epidemic

When babies are born to opioid-addicted mothers, they often develop Neonatal Abstinence Syndrome (NAS). NAS is characterized by symptoms associated with abrupt opioid withdrawal (“Neonatal Abstinence”, 2015). By preventing NAS in babies before they are born and properly caring for a baby with NAS after birth, we will aim to decrease the incidence of this condition and as its harmful effects in the lives of babies. In Ohio, there are many neonates suffering from NAS. The rates for babies born with NAS have quadrupled since 2011 when 2.2 out of every 1000 babies had NAS to 2015, where 12.3 out of 1000 babies suffer from NAS (“Number”, nd). NAS not only affects the baby immediately after birth, but also throughout the course of their lives. Babies with NAS are more likely to experience things like chronic stress, inconsistent caregiving, out-of-home placements, and long-term health issues. (“Long-Term Outcomes”, nd). To counter the problem of NAS, we would like to propose a two-part solution. This solution consists of medical care that first focuses on preventing NAS, and secondly treating its effects. Two treatments that show great promise in the prevention of NAS include the use of Ondansetron while the baby is in utero (“Ondansetron Pharmacokinetics”, 2014), and vaccination against opioids (“Novel pharmacotherapeutic”, 2012). The second part of the solution is used if these preventative treatments are not possible. In this case, the goal of treatment becomes to mitigate the effects of NAS. In this situation, promising interventions include stabilizing the baby in the NICU and admitting the baby to a facility specializing in NAS. In order to solve the ongoing health effects of NAS, we have two recommendations. The first is that specialized facilities enroll parents in counseling and parenting classes, reducing the chance that the child will experience out of home placement (“Assessment of”, 2014). Secondly, we propose that specialized facilities expand their scope of care to treat babies with NAS until age 18 with the goal of decreasing the incidence of common NAS-related health issues by providing more consistency in healthcare

Development of geometric specifications for a small female anthropomorphic test device pelvis

Target surface geometry for the small female anthropomorphic test device pelvis was predicted by a statistical pelvis geometry model developed through analysis of medical imaging data. The resulting geometry was compared to the Hybrid III small female pelvis geometry and an estimate of female pelvis geometry obtained by length scaling the midsize male pelvis based on bispinous breadth. Differences were found in the shape of the pubic rami, ischial tuberosities, and anterior superior iliac wings between the small female pelvis model and the Hybrid III pelvis, which may affect interactions with seat belts and vehicle structures.National Highway Traffic Safety Administrationhttp://deepblue.lib.umich.edu/bitstream/2027.42/117574/1/103243.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/117574/4/103243-1.pdfDescription of 103243.pdf : This file has been superceded. The new file, current as of June 20, 2016, is named 103243-1.pdf.Description of 103243-1.pdf : Final report; supercedes all versions downloaded prior to June 20, 2016

Proximal Strength and Functional Testing Applicable to Patellofemoral Instability: A Preliminary Study

Background: Much of the current literature around risk factors for patellar instability directs attention to anatomical/structural features such as femoral antero-version, patellar alignment, Q-angle, and MPFL disruption. There is limited research indicating clinically relevant tests to identify functional and strength-associated risk factors for patients with patellar instability. Purpose: To determine reliability and validity of lower extremity functional tests applicable to patients with patellofemoral instability in a healthy control group. Methods: Twenty-four healthy subjects underwent hip strength, endurance, and lower extremity functional tests on their dominant and non-dominant lower extremities. Hip abduction, extension, and external rotation strength were assessed with hand-held dynamometry utilizing reinforcing straps. Functional endurance tests were assessed bilaterally. Functional assessments were videotaped and assessed at a later date. Each subject completed the International Physical Activity Questionnaire (IPAQ) to determine his or her weekly activity levels. Independent t-tests were used to assess differences between subjects who tested positive versus negative on the functional tests. Inter-rater reliability for functional tests was assessed using kappa and Pearson correlations were used to assess relationships among the strength, endurance, and functional tests. Results: Inter-rater reliability for the single leg squat and step down test was determined to have fair-moderate agreement among 5 raters. The side plank endurance test was significantly lower for subjects who were positive for knee medial to toe on the single leg squat test. Low correlations were found between hip strength and functional endurance testing. Scores on the IPAQ had moderate correlation with the side plank. Conclusions: Single leg squat showed adequate reliability and demonstrated good construct validity with the lateral plank endurance test. The low correlation between hip strength and functional endurance suggests that these measurements identify different aspects of muscle function in healthy controls. Given these findings, it is recommended that clinicians utilize both strength measurements and endurance tests along with lower extremity functional testing in the assessment of individuals with lower extremity dysfunction. Further testing is needed in a patient population with patellofemoral instability

Developing parametric human models representing various vulnerable populations in motor vehicle crashes

Children, small female, elderly, and obese occupants are vulnerable populations and may sustain increased risk of death and serious injury in motor-vehicle crashes compared with mid-size young male occupants. Unfortunately, current injury assessment tools do not account for immature and growing body structures for children, nor the body shape and composition changes that are thought make female/aging/obese adults more vulnerable. The greatest opportunity to broaden crash protection to encompass all vehicle occupants lies in improved, parametric human models that can represent a wide range of human attributes. In this study, a novel approach to develop such models is proposed. The method includes 1) developing statistical skeleton and human body surface contour models based on medical images and body scan data using Mimics and a series of statistical methods, and 2) linking the statistical geometry model to a baseline human finite element (FE) model through an automated mesh morphing algorithm using radial basis functions, so that the FE model can represent population variability. Examples of using this approach to develop parametric pediatric head model, adult thorax and lower extremity models, and whole-body human models representing various populations were represented. The method proposed in this study enables future safety design optimizations targeting at various vulnerable populations that cannot be considered with current injury assessment tools.http://deepblue.lib.umich.edu/bitstream/2027.42/113667/1/103204.pdf-

Development and validation of statistical models of femur geometry for use with parametric finite element models

Statistical models from a previous study that predict male and female femur geometry as functions of age, body mass index (BMI), and femur length were updated as part of an effort to develop lower-extremity finite element models with geometries that are parametric with subject characteristics. The process for updating these models involved extracting femur geometry from clinical CT scans of an additional 8 men and 36 women (previous models used CT scans from 62 men and 36 women for a new total of 70 men and 72 women), using all of the scans for fitting a template finite element femur mesh to the surface geometry of each patient, and then programmatically determining thickness at each nodal location. Principal component analysis was then performed on the thickness and geometry nodal coordinates, and linear regression models were developed to predict principal component scores as functions of age, BMI, and femur length. The results from the updated models were compared to the previous study, and the only improvement was in the R2 value for the female models (0.74 to 0.82). The largest differences between the original models and the previous models occurred in the ends of the femur, where the largest errors in model predictions occurred.National Highway Traffic Safety Administrationhttp://deepblue.lib.umich.edu/bitstream/2027.42/116208/1/103222.pdfDescription of 103222.pdf : Final repor

Maternal Restricted- and Over-Feeding During Gestation Result in Distinct Lipid and Amino Acid Metabolite Profiles in the Longissimus Muscle of the Offspring

Maternal over- and restricted-feeding during gestation have similar negative consequences for the offspring, including decreased muscularity, increased adiposity, and altered metabolism. Our objective was to determine the effects of poor maternal nutrition during gestation (over- and restricted-feeding) on the offspring muscle metabolite profile. Pregnant ewes (n = 47) were fed 60% (RES), 100% (CON), or 140% (OVER) of NRC requirements starting at day 30.2 ± 0.2 of gestation. Offspring sample collection occurred at days 90 and 135 of gestation, and within 24 h of birth. C2C12 myoblasts were cultured in serum collected from offspring at birth (n = 18; 6 offspring per treatment) for analysis of oxidative and glycolytic capacity. Unbiased metabolite analysis of longissimus muscle samples (n = 72; 8 fetuses per treatment per time point) was performed using mass spectrometry. Data were analyzed by ANOVA for main effects of treatment, time point, and their interaction. Cells cultured in serum from RES offspring exhibited increased proton leak 49% (p = 0.01) compared with CON, but no other variables of mitochondrial respiration or glycolytic function were altered. Mass spectrometry identified 612 metabolites. Principle component analysis identified day of gestation as the primary driver of metabolic change; however, maternal diet also altered the lipid and amino acid profiles in offspring. The abundance of 53 amino acid metabolites and 89 lipid metabolites was altered in RES compared with CON (p ≤ 0.05), including phospholipids, sphingolipids, and ceramides within the lipid metabolism pathway and metabolites involved in glutamate, histidine, and glutathione metabolism. Similarly, abundance of 63 amino acid metabolites and 70 lipid metabolites was altered in OVER compared with CON (p ≤ 0.05). These include metabolites involved in glutamate, histidine, lysine, and tryptophan metabolism and phosphatidylethanolamine, lysophospholipids, and fatty acids involved in lipid metabolism. Further, the amino acid and lipid profiles diverged between RES and OVER, with 69 amino acid and 118 lipid metabolites differing (p ≤ 0.05) between groups. Therefore, maternal diet affects metabolite abundance in offspring longissimus muscle, specifically metabolites involved in lipid and amino metabolism. These changes may impact post-natal skeletal muscle metabolism, possibly altering energy efficiency and long-term health

Masculinity and engagement in HIV care among male fisherfolk on HIV treatment in Uganda.

This study explored the intersection of masculinity and HIV care engagement among fishermen and other male fisherfolk on antiretroviral therapy (ART) in Wakiso District, Uganda. We conducted 30 in-depth interviews with men on ART recruited from HIV treatment sites and used a thematic analysis approach. Since HIV diagnosis and ART initiation, men had adopted masculine identities more conducive to HIV care engagement. The masculine roles of worker and provider, husband and sexual partner and the appearance of physical strength were compromised by HIV, but restored by ART's positive effects on health. Peers also emerged as facilitators to HIV care, with men supporting each other to seek testing and treatment. However, structural and occupational barriers to HIV care associated with the masculine role of worker remained a barrier to care engagement. Findings suggest that emphasising the benefits of ART in bolstering men's ability to fulfil the roles important to them may improve the effectiveness of HIV testing and treatment messaging for men. Differentiated care models that address structural-level barriers to care, and community-level gender-transformative programming to help fishermen engage in HIV care, may be beneficial

Maternal Restricted- and Over-Feeding During Gestation Result in Distinct Lipid and Amino Acid Metabolite Profiles in the Longissimus Muscle of the Offspring

Maternal over- and restricted-feeding during gestation have similar negative consequences for the offspring, including decreased muscularity, increased adiposity, and altered metabolism. Our objective was to determine the effects of poor maternal nutrition during gestation (over- and restricted-feeding) on the offspring muscle metabolite profile. Pregnant ewes (n = 47) were fed 60% (RES), 100% (CON), or 140% (OVER) of NRC requirements starting at day 30.2 ± 0.2 of gestation. Offspring sample collection occurred at days 90 and 135 of gestation, and within 24 h of birth. C2C12 myoblasts were cultured in serum collected from offspring at birth (n = 18; 6 offspring per treatment) for analysis of oxidative and glycolytic capacity. Unbiased metabolite analysis of longissimus muscle samples (n = 72; 8 fetuses per treatment per time point) was performed using mass spectrometry. Data were analyzed by ANOVA for main effects of treatment, time point, and their interaction. Cells cultured in serum from RES offspring exhibited increased proton leak 49% (p = 0.01) compared with CON, but no other variables of mitochondrial respiration or glycolytic function were altered. Mass spectrometry identified 612 metabolites. Principle component analysis identified day of gestation as the primary driver of metabolic change; however, maternal diet also altered the lipid and amino acid profiles in offspring. The abundance of 53 amino acid metabolites and 89 lipid metabolites was altered in RES compared with CON (p ≤ 0.05), including phospholipids, sphingolipids, and ceramides within the lipid metabolism pathway and metabolites involved in glutamate, histidine, and glutathione metabolism. Similarly, abundance of 63 amino acid metabolites and 70 lipid metabolites was altered in OVER compared with CON (p ≤ 0.05). These include metabolites involved in glutamate, histidine, lysine, and tryptophan metabolism and phosphatidylethanolamine, lysophospholipids, and fatty acids involved in lipid metabolism. Further, the amino acid and lipid profiles diverged between RES and OVER, with 69 amino acid and 118 lipid metabolites differing (p ≤ 0.05) between groups. Therefore, maternal diet affects metabolite abundance in offspring longissimus muscle, specifically metabolites involved in lipid and amino metabolism. These changes may impact post-natal skeletal muscle metabolism, possibly altering energy efficiency and long-term health

Planets Around Low-Mass Stars (PALMS). V. Age-Dating Low-Mass Companions to Members and Interlopers of Young Moving Groups

Copyright © 2015. The American Astronomical Society. All rights reserved.We present optical and near-infrared adaptive optics (AO) imaging and spectroscopy of 13 ultracool (>M6) companions to late-type stars (K7-M4.5), most of which have recently been identified as candidate members of nearby young moving groups (YMGs; 8-120 Myr) in the literature. The inferred masses of the companions (~10-100 Mjup) are highly sensitive to the ages of the primary stars so we critically examine the kinematic and spectroscopic properties of each system to distinguish bona fide YMG members from old field interlopers. 2MASS J02155892-0929121 C is a new M7 substellar companion (40-60 Mjup) with clear spectroscopic signs of low gravity and hence youth. The primary, possibly a member of the ~40 Myr Tuc-Hor moving group, is visually resolved into three components, making it a young low-mass quadruple system in a compact (1 Gyr) tidally-locked spectroscopic binaries without convincing kinematic associations with any known moving group. The high rate of false positives in the form of old active stars with YMG-like kinematics underscores the importance of radial velocity and parallax measurements to validate candidate young stars identified via proper motion and activity selection alone. Finally, we spectroscopically confirm the cool temperature and substellar nature of HD 23514 B, a recently discovered M8 benchmark brown dwarf orbiting the dustiest-known member of the Pleiades.NASANSFMt. Cuba Astronomical FoundationSamuel OschinAlfred P. Sloan Foundatio