Lesser than diabetes hyperglycemia in pregnancy is related to perinatal mortality: a cohort study in Brazil

Results: We ascertained 97 perinatal deaths (67 fetal and 31 early neonatal). Odds of dying increased according to glucose levels, statistically significantly so only for women delivering at gestational age ≥34 weeks (p < 0.05 for glycemia-gestational age interaction). ORs for a 1 standard deviation difference in glucose, when analyzed continuously, were for fasting 1.47 (95% CI 1.12, 1.92); 1-h 1.55 (95% CI 1.15, 2.07); and 2-h 1.53 (95% CI 1.15, 2.02). The adjusted OR for IADPSG criteria gestational diabetes was 2.21 (95% CI 1.15, 4.27); and for WHO criteria gestational diabetes, 3.10 (95% CI 1.39, 6.88). Conclusions: In settings of limited detection and treatment of gestational diabetes mellitus, women across a spectrum of lesser than diabetes hyperglycemia, experienced a continuous rise in perinatal death with increasing levels of glycemia after 34 weeks of pregnancy. Current GDM diagnostic criteria identified this increased risk of mortality

Chiminey: Reliable Computing and Data Management Platform in the Cloud

The enabling of scientific experiments that are embarrassingly parallel, long running and data-intensive into a cloud-based execution environment is a desirable, though complex undertaking for many researchers. The management of such virtual environments is cumbersome and not necessarily within the core skill set for scientists and engineers. We present here Chiminey, a software platform that enables researchers to (i) run applications on both traditional high-performance computing and cloud-based computing infrastructures, (ii) handle failure during execution, (iii) curate and visualise execution outputs, (iv) share such data with collaborators or the public, and (v) search for publicly available data.Comment: Preprint, ICSE 201

Diabetes in Socioeconomically Vulnerable Populations

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Validity of self-reported weight: a study of urban brazilian adults

Para avaliar a validade do peso auto-referido em inquéritos de prevalência de obesidade, o mesmo foi comparado com o peso medido de 659 adultos, residentes em Porto Alegre, RS, Brasil, em 1986-87. Ambos os pesos foram obtidos por entrevistador, na casa do participante, na mesma ocasião. A média das diferenças entre peso auto-referido e peso medido foi pequena (-0,06 +/-3,16 kg; média +/- desvio padrão) e a correlação entre eles alta (r=0,97). Sessenta e dois por cento dos participantes referiram seu peso com erro < 2 kg, 87% com erro menor do que 4 kg e 95% com erro < 6 kg. Indivíduos de baixo peso hiperestimaram seu peso, o oposto ocorrendo com indivíduos obesos (p; 30) por peso referido, foi de 10% e a por peso medido, de 11%. Concluindo, a validade do peso auto-referido é aceitável para inquéritos de prevalência realizados em contextos similares.In order to evaluate the validity of self-reported weight for use in obesity prevalence surveys, self-reported weight was compared to measured weight for 659 adults living in the Porto Alegre county, RS Brazil in 1986-87, both weights being obtained by a technician in the individual's home on the same visit. The mean difference between self-reported and measured weight was small (-0.06 +/- 3.16 kg; mean +/- standard deviation), and the correlation between reported and measured weight was high (r=0.97). Sixty-two percent of participants reported their weight with an error of < 2 kg, 87% with an error of < 4 kg, and 95% with an error of < 6 kg. Underweight individuals overestimated their weight, while obese individuals underestimated theirs (p; 30) by reported weight was 10%, by measured weight 11%. Thus, the validity of reported weight is acceptable for surveys of the prevalence of ponderosity in similar settings

Common mental disorders and sociodemographic characteristics: baseline findings of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Introduction: the patients admitted to the Crisis Intervention Unit (UIC) have not been characterized in the "Luis Ramírez López" Provincial Psychiatric Hospital of the Guantánamo province.Objective: to characterize hospital admissions in said unit in the period 2015-2017.Method: a descriptive and retrospective study of the patients admitted to this unit was carried out (n=538). The variables were studied: age, sex, origin, diagnosis and stay.Results: the highest proportion of admitted patients was between 18 and 23 years old (21.9%), they were female (53.9%), they came from the Guantanamo municipality (42.0%), the most frequent diagnosis was Depressive adjustment disorder (27.9%) and 66.4% had a hospital stay of less than 7 days.Conclusions: Patients in the productive stage of life were admitted to the Crisis Intervention Unit, especially women with depressive disorders, which shows the social relevance of their study.Introducción: en el Hospital Psiquiátrico Provincial "Luis Ramírez López" de la provincia Guantánamo no se han caracterizado los pacientes ingresados en la Unidad de Intervención en Crisis (UIC).Objetivo: caracterizar las admisiones hospitalarias en la citada unidad en el periodo comprendido 2015-2017.Método: se realizó un estudio descriptivo y retrospectivo de los pacientes que ingresaron en esta unidad (n=538). Se estudiaron las variables: edad, sexo, procedencia, diagnóstico y estadía.Resultados: la mayor proporción de los pacientes admitidos tenía entre 18 y 23 años (21,9 %), eran del sexo femenino (53,9 %), procedieron del municipio Guantánamo (42,0 %), el diagnóstico más frecuente fue el trastorno de adaptación depresivo (27,9 %) y el 66,4 % tuvo una estadía hospitalaria menor de 7 días.Conclusiones: en la Unidad de Intervención en Crisis se admitieron pacientes en la etapa productiva de la vida, sobre todo mujeres con trastornos depresivos, lo que muestra la pertinencia social de su estudio.Introdução: os pacientes admitidos na Unidade de Intervenção de Crise (UIC) não foram caracterizados no Hospital Psiquiátrico Provincial "Luis Ramírez López" da Província de Guantánamo.Objetivo: caracterizar internações hospitalares na referida unidade no período 2015-2017.Método: estudo descritivo e retrospectivo dos pacientes admitidos nesta unidade (n=538). As variáveis foram estudadas: idade, sexo, origem, diagnóstico e permanência.Resultados: a maior proporção de pacientes internados foi entre 18 e 23 anos (21,9%), eram do sexo feminino (53,9%), procedentes do município de Guantánamo (42,0%), o diagnóstico mais frequente foi Transtorno de ajuste depressivo (27,9%) e 66,4% tiveram internação hospitalar inferior a 7 dias.Conclusões: pacientes em estágio produtivo de vida foram admitidos na Unidade de Intervenção à Crise, especialmente mulheres com transtornos depressivos, o que mostra a relevância social de seu estudo

Updated data on Litopterna from the Huayquerian Stage/Age (Late Miocene-Early Pliocene) of central-east Argentina

Hitherto, only the Proterotheriidae Ameghino, 1887 litopterns from the Cerro Azul Formation (Chasicoan-Huayquerian Stages/Ages; Late Miocene-Early Pliocene) in La Pampa Province had been studied, recognizing Proterotheriidae indet. at Cerro La Bota, Diplasiotherium pampa Soria, 2001 at several localities, Eoauchenia primitiva Ameghino, 1887 at El Guanaco, and cf. Brachytherium cuspidatum Ameghino, 1883 at Salinas Grandes de Hidalgo, which added to Epecuenia thoatherioides Cabrera, 1939 from Laguna Epecuén in Buenos Aires Province; this locality also yielded the Macraucheniidae Gervais, 1855 Huayqueriana cristata (Rovereto, 1914). Now, we enlarge the study to both litoptern families and to the outcrops of the Cerro Azul Formation in Buenos Aires Province. Concerning Macraucheniidae, we recognize: Scalabrinitherium bravardi Ameghino, 1883 at Salinas Grandes de Hidalgo, Telén, and Guatraché (La Pampa), and Laguna Epecuén (Buenos Aires); Paranauchenia denticulata Ameghino, 1891, Promacrauchenia sp., and Cullinia sp. at Salinas Grandes de Hidalgo and Laguna Chillhué (La Pampa); cf. Oxyodontherium zeballosi Ameghino, 1883b at Laguna del Monte (Buenos Aires); and Promacrauchenia sp. at Cantera Relleno Sanitario (Buenos Aires). Referring to Proterotheriidae, new results reveal the first record of Diplasiotherium pampa in Buenos Aires (Arroyo El Venado) and Neobrachytherium sp. at Laguna Epecuén and Laguna La Paraguaya (Buenos Aires). The litoptern diversity is close to that from the Lower Member of the Ituzaingó Formation, Late Miocene, Entre Ríos Province. The litoptern record does not provide confident data to support or reject the established relative biostratigraphic succession of localities of the Cerro Azul Formation, which is mainly based on some rodent lineages.Fil: Schmidt, Gabriela Ines. Provincia de Entre Ríos. Centro de Investigaciones Científicas y Transferencia de Tecnología a la Producción. Universidad Autónoma de Entre Ríos. Centro de Investigaciones Científicas y Transferencia de Tecnología a la Producción. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Centro de Investigaciones Científicas y Transferencia de Tecnología a la Producción; ArgentinaFil: Montalvo, Claudia I.. Universidad Nacional de la Pampa. Facultad de Ciencias Exactas y Naturales. Departamento de Ciencias Naturales; ArgentinaFil: Cerdeño Serrano, Maria Esperanza. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Provincia de Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Universidad Nacional de Cuyo. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales; ArgentinaFil: Sostillo, Renata. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de La Pampa. Facultad de Ciencias Exactas y Naturales; ArgentinaFil: Tomassini, Rodrigo Leandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto Geológico del Sur. Universidad Nacional del Sur. Departamento de Geología. Instituto Geológico del Sur; ArgentinaFil: Bonini, Ricardo Adolfo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil. Investigaciones Arqueológicas y Paleontológicas del Cuaternario Pampeano. Universidad Nacional del Centro de la Provincia de Buenos Aires. Investigaciones Arqueológicas y Paleontológicas del Cuaternario Pampeano; Argentin

Tumor necrosis factor-mediated inhibition of interleukin-18 in the brain: a clinical and experimental study in head-injured patients and in a murine model of closed head injury.

Tumor necrosis factor (TNF) and interleukin-(IL)-18 are important mediators of neuroinflammation after closed head injury (CHI). Both mediators have been previously found to be significantly elevated in the intracranial compartment after brain injury, both in patients as well as in experimental model systems. However, the interrelation and regulation of these crucial cytokines within the injured brain has not yet been investigated. The present study was designed to assess a potential regulation of intracranial IL-18 levels by TNF based on a clinical study in head-injured patients and an experimental model in mice. In the first part, we investigated the interrelationship between the daily TNF and IL-18 cerebrospinal fluid levels in 10 patients with severe CHI for up to 14 days after trauma. In the second part of the study, the potential TNF-dependent regulation of intracerebral IL-18 levels was further characterized in an experimental set-up in mice: (1) in a standardized model of CHI in TNF/lymphotoxin-α gene-deficient mice and wild-type (WT) littermates, and (2) by intracerebro-ventricular injection of mouse recombinant TNF in WT C57BL/6 mice. The results demonstrate an inverse correlation of intrathecal TNF and IL-18 levels in head-injured patients and a TNF-dependent inhibition of IL-18 after intracerebral injection in mice. These findings imply a potential new anti-inflammatory mechanism of TNF by attenuation of IL-18, thus confirming the proposed "dual" function of this cytokine in the pathophysiology of traumatic brain injury

Glucose and triglyceride excursions following a standardized meal in individuals with diabetes: ELSA-Brasil study

Objective: To assess glucose and triglyceride excursions 2 hours after the ingestion of a standardized meal and their associations with clinical characteristics and cardiovascular complications in individuals with diabetes. Research design and methods: Blood samples of 898 subjects with diabetes were collected at fasting and 2 hours after a meal containing 455 kcal, 14 g of saturated fat and 47 g of carbohydrates. Self-reported morbidity, socio-demographic characteristics and clinical measures were obtained by interview and exams performed at the baseline visit of the ELSA-Brasil cohort study. Results: Median (interquartile range, IQR) for fasting glucose was 150.5 (123–198) mg/dL and for fasting triglycerides 140 (103–199) mg/dL. The median excursion for glucose was 45 (15–76) mg/dL and for triglycerides 26 (11–45) mg/dL. In multiple linear regression, a greater glucose excursion was associated with higher glycated hemoglobin (10.7, 95% CI 9.1–12.3 mg/dL), duration of diabetes (4.5; 2.6–6.4 mg/dL, per 5 year increase), insulin use (44.4; 31.7–57.1 mg/dL), and age (6.1; 2.5–9.6 mg/dL, per 10 year increase); and with lower body mass index (−5.6; −8.4– -2.8 mg/dL, per 5 kg/m2 increase). In adjusted logistic regression models, a greater glucose excursion was marginally associated with the presence of cardiovascular comorbidities (coronary heart disease, myocardial infarction and angina) in those with obesity. Conclusions: A greater postprandial glycemic response to a small meal was positively associated with indicators of a decreased capacity for insulin secretion and negatively associated with obesity. No pattern of response was observed with a greater postprandial triglyceride excursion

Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2016 : a systematic analysis for the Global Burden of Disease Study 2016

Background Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI). Interpretation At a global level, DALYs and HALE continue to show improvements. At the same time, we observe that many populations are facing growing functional health loss. Rising SDI was associated with increases in cumulative years of life lived with disability and decreases in CMNN DALYs offset by increased NCD DALYs. Relative compression of morbidity highlights the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning. The analysis of DALYs and HALE and their relationship to SDI represents a robust framework with which to benchmark location-specific health performance. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform health policies, health system improvement initiatives, targeted prevention efforts, and development assistance for health, including financial and research investments for all countries, regardless of their level of sociodemographic development. The presence of countries that substantially outperform others suggests the need for increased scrutiny for proven examples of best practices, which can help to extend gains, whereas the presence of underperforming countries suggests the need for devotion of extra attention to health systems that need more robust support

In vivo electrophysiological characterization of TASK-1 deficient mice

Background/Aims: TASK-1 is a potassium channel predominantly expressed in heart and brain. We have previously shown that anesthetized TASK-1(-/-) mice have prolonged QT intervals in surface electrocardiograms (ECGs). In addition, heart rate variability quantified by time and frequency domain parameters was significantly altered in TASK-1(-/-) mice with a sympathetic preponderance. Aims of the present study were the analysis of QT intervals by telemetric ECGs, to determine potential influences of anesthesia and beta-adrenergic stimulation on repolarization in surface ECGs, to investigate in vivo electrophysiological parameters by intracardiac electrical stimulation and to quantify heart rate turbulence after ischemia/reperfusion or ventricular pacing in TASK-1(+/+) and TASK-1(-/-) mice. Methods: Rate corrected QT intervals (QTc) were recorded in conscious mice by telemetry and in surface ECGs following administration of various anesthetics (tribromoethanol (Avertin (R)), pentobarbital and isoflurane). TASK-1(+/+) and TASK-1(-/-) mice were characterized by programmed electrical stimulation using an intracardiac octapolar catheter. The baroreceptor reflex was analyzed by heart rate turbulence (turbulence onset and slope) after ischemia/reperfusion and by stimulated premature ventricular contractions