Dietary patterns of lactating women in central North Carolina evaluated using three validated assessment tools.

Background: During lactation, there is an increased maternal need for almost all nutrients. It has been reported that maternal status of some nutrients (i.e. vitamin A, C and DHA) can affect breast milk composition. Data about dietary patterns of lactating women in the United States are scarce and only a small number of studies evaluated micronutrient intake. Objectives: The primary objective of this pilot study is to describe the dietary patterns of lactating women in central North Carolina using established and emerging dietary assessment tools, with a particular focus on fruits and vegetables (F&V). A secondary objective is to explore the relationship between maternal intake of fruits, vegetables, and vitamin A, with breast milk vitamin A and carotenoid concentrations. Methods: In this cross-sectional study, 40 lactating women residing in central North Carolina were recruited between July 2018 and April 2019. We collected dietary information using three assessment methods: 24-hour Food Record, REAP dietary screener, and Veggie Meter™, a non-invasive biomarker of F&V intake that has been validated in non-lactating individuals. A single breast milk sample was also collected. Results: Thirty-one participants (78%) were flagged for referral to a Registered Dietitian based on their REAP scores. There was a significant correlation between the Food Record F&V servings and the Veggie Meter™ for subjects who reported that the 24-hour food record was reflective of their usual intake (n=9; p=0.031; R=0.71). The relationship of breast milk beta-carotene and the Veggie Meter™ scores was also statistically significant (n=12; p=0.022; R=0.65). Conclusion: F&V intake in lactating women is often below recommendations. The Veggie Meter™ scores correlated positively with breast milk beta-carotene and F&V intake which can provide an objective method of assessing F&V intake in lactating women in future studies

The Development, Implementation And Enduring Impact Of John Dewey's Philosophy Of History

John Dewey was an American philosopher, psychologist, and leading figure in the progressive education movement that took place in the late nineteenth and early twentieth centuries. While many are familiar with Dewey’s educational philosophy and its aim to promote and improve America’s democratic experience, few are familiar with the integral role that Dewey’s philosophy of history played in his perceived need for a reconstruction in and of philosophy, in the development of his philosophy of education, and in the implementation of his philosophy of education at the Laboratory School. The focus of this thesis centers on this gap in our understanding of Dewey’s philosophy of history and its implementation at the Laboratory School. Through a four-fold inquiry, I argue that at the heart of Dewey’s approach to philosophy and education lay an intelligent understanding of past human growth, progress, and intellectual development with an overarching emphasis on knowledge as an experimental, experiential, and reconstructive process rather than as a product. This paper examines Dewey’s unique history of philosophy, the development of his philosophy of history, the application of his ideas at the Laboratory School, and the trajectory of his philosophies of history and education over the last one hundred years

Does the new International Diabetes Federation Definition of Metabolic Syndrome Improve Prediction of Coronary Artery Disease and Carotid Intima-Media Thickening

BACKGROUND: Metabolic syndrome (MS) is associated with increased incidence of diabetes and atherosclerotic complications. The new definition of the International Diabetes Federation (IDF) increases the population with this entity, compared to the NCEP ATP III definition. OBJECTIVES: To study the prevalence of coronary artery disease (CAD) and carotid intima-media thickness (IMT) in patients with and without MS, according to the NCEP ATP III and IDF definitions, and the predictive ability of carotid IMT for CAD. METHODS: We studied 270 consecutive patients admitted for elective coronary angiography due to suspicion of CAD. All patients underwent ultrasound study of the carotid arteries to measure IMT (the highest value between the right and left common carotid arteries was used in the analysis). Coronary stenosis of > or =70% (or 50% for the left main coronary artery) was considered significant. RESULTS: By the ATP III definition, 14% of the patients had MS, and these patients had a higher prevalence of CAD (87% vs. 63%, p = 0.004), but no significant difference was found for carotid IMT (1.03 +/- 0.36 mm vs. 0.95 +/- 0.35 mm, p=NS). With the IDF definition, 61% of the patients had MS; this group was slightly older and included more women. There were no differences in terms of CAD (68% vs. 63%) or carotid IMT (0.97 +/- 0.34 vs. 0.96 +/- 0.39 mm). On multivariate analysis, the ATP III definition of MS predicts CAD (OR 4.76, 95% CI 1.71-13.25, p = 0.003), but the IDF definition does not (OR 1.29, 95% CI 0.74-2.27, p = 0.37). On ROC curve analysis, an IMT of > or = 0.95 mm predicts CAD (AUC 0.66, p < 0.001), with a sensitivity of 52% and specificity of 75%. CONCLUSIONS: The new IDF definition increases the population with MS, decreasing the capacity to predict the presence of CAD. In our population, neither the ATP III nor the IDF definition showed differences in terms of carotid IMT. Carotid IMT can predict CAD, but with only modest sensitivity

Peripheral biomarkers to diagnose obstructive sleep apnea in adults: A systematic review and meta-analysis

Background: Obstructive Sleep Apnea (OSA) has been recognized as a major health concern worldwide, given its increasing prevalence, difficulties in diagnosis and treatment, and impact on health, economy, and society. Clinical guidelines highlight the need of biomarkers to guide OSA clinical decision-making, but so far, without success. In this systematic review and meta-analysis, registered on the International Prospective Register of Systematic Reviews database (ID CRD42020132556), we proposed to gather and further explore candidates identified in the literature as potential OSA biomarkers. Methods: Search strategies for eight different databases (PubMed/Medline, Cochrane Library, Biblioteca Virtual da Saúde, Web of Science, EMBASE, World Intellectual Property Organization database, and bioRxiV and medRxiV Preprint Servers) were developed. We identified studies exploring potential biomarkers of OSA, in peripheral samples of adults, with and without OSA, with no comorbidities defined in study inclusion criteria, published after the last systematic review and meta-analysis conducted on OSA biomarkers, until May 31st, 2020. Risk of bias was assessed through the 14-item Quality Assessment Tool for Diagnostic Accuracy Studies. Demographic, clinical, and candidate biomarkers' data were collected and analyzed via random effects meta-analyses. Findings: Among the 1512 unique studies screened, 120 met the inclusion criteria and 16 studies with low risk of bias were selected for meta-analyses. The selected 16 studies enrolled a total of 2156 participants, from which 1369 were diagnosed with OSA and 787 were disease-free controls. The assessed variables showed high heterogeneity. From the 38 biomarker candidates evaluated, only two were evaluated in more than one study. Most studies pinpointed candidates with more potential for OSA prognosis. ADAM29, FLRT2 and SLC18A3 mRNA levels in PBMCs, Endocan and YKL-40 levels in serum, and IL-6 and Vimentin levels in plasma revealed the most promising candidates for OSA diagnosis. Interpretation: Although the current systematic review and meta-analysis allowed us to identify candidates to further explore as potential biomarkers in future studies, it is evident that OSA biomarkers research is still at an early stage. Most findings derive from small-size single-center study cohorts and single-candidate studies. We point several gaps in current OSA biomarker research that may guide into new directions and approaches towards the identification of OSA biomarkers.info:eu-repo/semantics/publishedVersio

MHJ-0461 is a multifunctional leucine aminopeptidase on the surface of Mycoplasma hyopneumoniae

© 2015 The Authors. Published. Aminopeptidases are part of the arsenal of virulence factors produced by bacterial pathogens that inactivate host immune peptides. Mycoplasma hyopneumoniae is a genome-reduced pathogen of swine that lacks the genetic repertoire to synthesize amino acids and relies on the host for availability of amino acids for growth. M. hyopneumoniae recruits plasmin(ogen) onto its cell surface via the P97 and P102 adhesins and the glutamyl aminopeptidase MHJ-0125. Plasmin plays an important role in regulating the inflammatory response in the lungs of pigs infected with M. hyopneumoniae. We show that recombinant MHJ-0461 (rMHJ-0461) functions as a leucine aminopeptidase (LAP) with broad substrate specificity for leucine, alanine, phenylalanine, methionine and arginine and that MHJ-0461 resides on the surface of M. hyopneumoniae. rMHJ-0461 also binds heparin, plasminogen and foreign DNA. Plasminogen bound to rMHJ-0461 was readily converted to plasmin in the presence of tPA. Computational modelling identified putative DNA and heparin-binding motifs on solvent-exposed sites around a large pore on the LAP hexamer. We conclude that MHJ-0461 is a LAP that moonlights as a multifunctional adhesin on the cell surface of M. hyopneumoniae

Right Atrial Aneurysm after Chest Trauma: Late Presentation

Relata-se o caso de um paciente de 59 anos de idade, com história de traumatismo torácico grave com fratura de vários arcos costais aos 20 anos, com início recente de cansaço e palpitações, a quem foi detetada taquicardia auricular, convertida farmacologicamente. Os estudos imagiológicos (ecocardiografia transtorácica e RMN) realizados inicialmente levantaram a hipótese de se tratar de cor triatriatum ou anomalia de Ebstein. Posteriormente, por recorrência da arritmia, foi efetuada nova avaliação ecocardiográfica transtorácica que estabeleceu o diagnóstico de aneurisma da aurícula direita. A arritmia foi convertida eletricamente. Durante o seguimento de 18 meses o paciente encontra-se assintomático, sem recorrência de arritmias, medicado com carvedilol (após período sob amiodarona) e varfarina

Enhanced Dispersion of Atrial Refractoriness as an Electrophysiological Substrate for Vulnerability to Atrial Fibrillation in Patients with Paroxysmal Atrial Fibrillation

Atrial electrical remodeling plays a part in recurrence of atrial fibrillation (AF). It has been related to an increase in heterogeneity of atrial refractoriness that facilitates the occurrence of multiple reentry wavelets and vulnerability to AF. AIM: To examine the relationship between dispersion of atrial refractoriness (Disp_A) and vulnerability to AF induction (A_Vuln) in patients with clinical paroxysmal AF (PAF). METHODS: Thirty-six patients (22 male; age 55+/-13 years) with > or =1 year of history of PAF (no underlying structural heart disease--n=20, systemic hypertension--n=14, mitral valve prolapse--n=1, surgically corrected pulmonary stenosis--n=1), underwent electrophysiological study (EPS) while off medication. The atrial effective refractory period (AERP) was assessed at five different sites--high (HRA) and low (LRA) lateral right atrium, high interatrial septum (IAS), proximal (pCS) and distal (dCS) coronary sinus--during a cycle length of 600 ms. AERP was taken as the longest S1-S2 interval that failed to initiate a propagation response. Disp_A was calculated as the difference between the longest and shortest AERP. A_Vuln was defined as the ability to induce AF with 1-2 extrastimuli or with incremental atrial pacing (600-300 ms) from the HRA or dCS. The EPS included analysis of focal electrical activity based on the presence of supraventricular ectopic beats (spontaneous or with provocative maneuvers). The patients were divided into group A--AF inducible (n=25) and group B--AF not inducible (n=11). Disp_A was analyzed to determine any association with A_Vuln. Disp_A and A_Vuln were also examined in those patients with documented repetitive focal activity. Logistic regression was used to determine any association of the following variables with A_Vuln: age, systemic hypertension, left ventricular hypertrophy, left atrial size, left ventricular function, duration of PAF, documented atrial flutter/tachycardia and Disp_A. RESULTS: There were no significant differences between the groups with regard to clinical characteristics and echocardiographic data. AF was inducible in 71% of the patients and noninducible in 29%. Group A had greater Disp_A compared to group B (105+/-78 ms vs. 49+/-20 ms; p=0.01). Disp_A was >40 ms in 50% of the patients without A_Vuln and in 91% of those with A_Vuln (p=0.05). Focal activity was demonstrated in 14 cases (39%), 57% of them with A_Vuln. Disp_A was 56+/-23 ms in this group and 92+/-78 ms in the others (p=0.07). Using logistic regression, the only predictor of A_Vuln was Disp_A (p=0.05). CONCLUSION: In patients with paroxysmal AF, Disp_A is a major determinant of A_Vuln. Nevertheless, the degree of nonuniformity of AERP appears to be less important as an electrophysiological substrate for AF due to focal activation

Head-Up Tilt Testing with Different Nitroglycerin Dosages: Experience in Elderly Patients with Unexplained Syncope

AIMS: Protocols using sublingual nitrates have been increasingly used to improve diagnostic accuracy of head-up tilt testing (HUT). Nevertheless, exaggerated responses to nitrates have been frequently described, particularly in elderly patients. The aim of this article is to evaluate, in an elderly population with unexplained syncope, whether the impact of sublingual nitroglycerin (NTG) used as a provocative agent is dose-dependent. METHODS AND RESULTS: One hundred and twenty consecutive elderly patients submitted to HUT using NTG after an asymptomatic drug-free phase were studied. Patients were divided into three groups according to the NTG dosage: 500, 375 and 250 microg. The test was considered positive when there was reproduction of symptoms with bradycardia and/or arterial hypotension. A gradual decrease in the blood pressure after NTG was considered an exaggerated response to nitrates. There were no differences in the clinical characteristics of the different subgroups. A positive test was obtained in 50% of the patients in each group. The rate of exaggerated responses was identical in all groups and ranged between 15 and 17%. CONCLUSION: In an elderly population with syncope of unknown origin submitted to HUT, the response to NTG is not dose-dependent, and no difference was found in the rate of exaggerated responses to nitrates with different NTG dosages

Jogando e crescendo em comunidade : a critical autoethnography of integrating sociological mindfulness, critical consciousness and social change in a capoeira-based youth development program

If contemporary youth sports development models are to be particularly supportive of youth in underserved communities, they may require extra steps in practice and analysis. This qualitative thesis examines whether an intersection of Sports-Based Youth Development (SBYD) with critical pedagogy committed to social justice could be an agent for social change. Based on my own experiences combining the critical pedagogy of Capoeira Angola with SBYD program development I explore whether program outcomes may extend from social responsibility to social justice advocacy. Extending the work of Dr. Martinek’s Social responsibility in sports programming, this dissertation offers an understanding of how youth sports can provide tools for empowering youth to navigate educational and other social systems. To study will focus on these goals: reflection on the importance experiences that have contributed to my Capoeira Angola program development; examining events, persons and places that have shaped my approach to program development; naming the major challenges, I have faced in the conceptualizing and enacting social justice in program development; and imagine new directions in progra This auto-ethnography draws on my own 20 years of experience as a capoeira practitioner, which has contributed to my critical interpretive frameworks in developing a community Capoeira and SBYD program in Durham, North Carolina. My own experience demonstrates that Capoeira programming and SBYD are not exempt from the terrain of cultural politics dialogue and ripe for development of critical consciousness. I argue that while Capoeira practice and pedagogy can contribute to the SBYD literature it can also benefit from lessons from SBYD. This critical autoethnography offers the Capoeira community and the SBYD literature ideas about the importance of our Relationships, the necessity of advancing critical pedagogy in Capoeira and Youth Sports Development, and a way for decoloniality and transforming harm. I offer my own experiences and reflections in the hope that they serve the Capoeira and SBYD communities to navigate the terrain of cultural politics dialogue and the development of critical consciousness

Inducibility of Atrial Fibrillation During Electrophysiologic Evaluation is Associated with Increased Dispersion of Atrial Refractoriness

The impact of atrial dispersion of refractoriness (Disp_A) in the inducibility and maintenance of atrial fibrillation (AF) has not been fully resolved. AIM: To study the Disp_A and the vulnerability (A_Vuln) for the induction of self-limited (<60 s) and sustained episodes of AF. METHODS AND RESULTS: Forty-seven patients with paroxysmal AF (PAF): 29 patients without structural heart disease and 18 with hypertensive heart disease. Atrial effective refractory period (ERP) was assessed at five sites--right atrial appendage and low lateral right atrium, high interatrial septum, proximal and distal coronary sinus. We compared three groups: group A - AF not inducible (n=13); group B - AF inducible, self-limited (n=18); group C - AF inducible, sustained (n=16). Age, lone AF, hypertension, left atrial and left ventricular (LV) dimensions, LV systolic function, duration of AF history, atrial flutter/tachycardia, previous antiarrhythmics, and Disp_A were analysed with logistic regression to determine association with A_Vuln for AF inducibility. The ERP at different sites showed no differences among the groups. Group A had a lower Disp_A compared to group B (47+/-20 ms vs 82+/-65 ms; p=0.002), and when compared to group C (47+/-20 ms vs 80+/-55 ms; p=0.008). There was no significant difference in Disp_A between groups B and C. By means of multivariate regression analysis, the only predictor of A_Vuln was Disp_A (p=0.04). Conclusion: In patients with PAF, increased Disp_A represents an electrophysiological marker of A_Vuln. Inducibility of both self-limited and sustained episodes of AF is associated with similar values of Disp_A. These findings suggest that the maintenance of AF is influenced by additional factors