A State-Level Analysis of Maternal and Child Health Partnerships among Indiana Local Health Departments

Background: As one of many organizations within a system of networks, numerous U.S. local health departments (LHDs) use partnerships as a structural intervention to address physical, mental, social concerns of women and infants. Purpose: This state level study examines current levels of maternal and child partnerships among Indiana LHDs and sectors in the public health system. Geography and organizational readiness (infant mortality listed as a goal in the strategic plan) were used as proxy measures to examine how likely LHDs work with these sectors. Methods: An eighteen-item online survey was administered to 93 LHDs collected between March and June 2014. Descriptive and Pearson Chi-Square analyses were conducted using SPSS 23.0. Results: LHDs reported having more formal (coordinating, cooperating, collaborating) partnerships with hospitals, the state health department, and physician practices/medical groups. LHDs less frequently reported partnerships with transportation, midwives, and parks and recreation. Furthermore, LHDs in non-metropolitan LHDs were more likely to have both informal and formal partnerships with non-public health sectors than LHDs in metropolitan jurisdictions. LHDs that did not have infant mortality as a goal in their strategic plan were more likely to have informal partnerships with health care, health insurance, and quasi-governmental organizations. Implications: This study presents opportunities to further explore the influence of contextual and functional characteristics in existing LHD partnerships that focus on women and infants

The effects of drought stress and type of fertiliser on generalist and specialist herbivores and their natural enemies

Abiotic stresses such as drought and nutrient availability can affect invertebrate herbivores feeding on plants, and potentially cascade up to impact their predators and parasitoids. Although these two factors separately been the subject of many studies, there are few tests of their combined effects in the context of pest species and their natural enemies on cultivated plants. Climate change models predict an increase in the frequency and severity of droughts, while the type and amount of fertiliser applied to crops is more under the control of growers. Understanding how these two abiotic factors may interact is key to utilising the potential of natural enemies to control pests under a future climate. To address this, a range of drought and fertiliser type treatments were applied to a model Brassica system in a factorial design, and the performance of two ubiquitous aphid species and their parasitoids was assessed. One aphid species was a specialist on Brassicas (Brevicoryne brassicae, with parasitoid Diaeretiella rapae) and the second a generalist aphid species (Myzus persicae, with parasitoid Aphidius colemani). The performance of both aphid species responded in a similar way to the treatments, and was maximised on plants growing in organic fertilisers under medium levels of drought stress. The strongest effects of drought and fertiliser cascaded up to affect parasitoids. Parasitoid performance responded in a broadly similar way to their aphid host performance in relation to fertiliser type. Some of the smaller effects of fertiliser treatments on aphid performance were not found for parasitoid performance. Aphid performance was greatest on plants under medium drought stress, but the parasitoids only responded consistently to the high drought stress treatment, on which their performance was reduced. Interactions between the drought and fertiliser did not have a large effect on aphid or parasitoid performance, compared with the strong main effects found for each treatment. These results are discussed in the context of previous and future research on the impacts of abiotic stresses on invertebrate herbivores and their natural enemies

Surgical Management of Inguinal Hernias at Bugando Medical Centre in Northwestern Tanzania: Our Experiences in a Resource-Limited Setting.

Inguinal hernia repair remains the commonest operation performed by general surgeons all over the world. There is paucity of published data on surgical management of inguinal hernias in our environment. This study is intended to describe our own experiences in the surgical management of inguinal hernias and compare our results with that reported in literature. A descriptive prospective study was conducted at Bugando Medical Centre in northwestern Tanzania. Ethical approval to conduct the study was obtained from relevant authorities before the commencement of the study. Statistical data analysis was done using SPSS software version 17.0. A total of 452 patients with inguinal hernias were enrolled in the study. The median age of patients was 36 years (range 3 months to 78 years). Males outnumbered females by a ratio of 36.7:1. This gender deference was statistically significant (P=0.003). Most patients (44.7%) presented late (more than five years of onset of hernia). Inguinoscrotal hernia (66.8%) was the commonest presentation. At presentation, 208 (46.0%) patients had reducible hernia, 110 (24.3%) had irreducible hernia, 84 (18.6%) and 50(11.1%) patients had obstructed and strangulated hernias respectively. The majority of patients (53.1%) had right sided inguinal hernia with a right-to-left ratio of 2.1: 1. Ninety-two (20.4%) patients had bilateral inguinal hernias. 296 (65.5%) patients had indirect hernia, 102 (22.6%) had direct hernia and 54 (11.9%) had both indirect and direct types (pantaloon hernia). All patients in this study underwent open herniorrhaphy. The majority of patients (61.5%) underwent elective herniorrhaphy under spinal anaesthesia (69.2%). Local anaesthesia was used in only 1.1% of cases. Bowel resection was required in 15.9% of patients. Modified Bassini's repair (79.9%) was the most common technique of posterior wall repair of the inguinal canal. Lichtenstein mesh repair was used in only one (0.2%) patient. Complication rate was 12.4% and it was significantly higher in emergency herniorrhaphy than in elective herniorrhaphy (P=0.002). The median length of hospital stay was 8 days and it was significantly longer in patients with advanced age, delayed admission, concomitant medical illness, high ASA class, the need for bowel resection and in those with surgical repair performed under general anesthesia (P<0.001). Mortality rate was 9.7%. Longer duration of symptoms, late hospitalization, coexisting disease, high ASA class, delayed operation, the need for bowel resection and presence of complications were found to be predictors of mortality (P<0.001). Inguinal hernias continue to be a source of morbidity and mortality in our centre. Early presentation and elective repair of inguinal hernias is pivotal in order to eliminate the morbidity and mortality associated with this very common problem

Prior consumption of a fat meal in healthy adults modulates the brain’s response to fat

Background: Consumption of fat is regulated by reward and homeostatic pathways, but no studies have examined the role of the intake of a high fat meal (HFM) on subsequent brain activation to oral stimuli. Objective: We evaluated how prior consumption of a HFM or water load (WL) modulates reward, homeostatic and taste brain responses to subsequent delivery of oral fat. Methods: A randomized 2-way crossover design (1-week apart) was used to compare prior consumption of a 250mL HFM (520kcal) (rapeseed oil (440kcal), emulsifier, sucrose, flavor cocktail) or non-caloric WL on brain activation to the delivery of repeated trials of an oral flavored no-fat control stimulus (CS) or flavored fat stimulus (FS) in 17 healthy adults (11 male, age=25±2 years, BMI=22.4±0.8kg/m2). Analyses tested differences in brain activation to the CS and FS, and baseline cerebral blood flow (CBF), following the HFM and WL. Individual’s plasma cholecystokinin (CCK) concentration following the HFM was correlated with their BOLD activation. Results: Prior consumption of the HFM compared to the WL led to decreased anterior insula taste activation in response to both the CS (36.3%,P<0.05) and FS (26.5%,P<0.05). The HFM caused reduced amygdala activation (25.1%,P<0.01) in response to the FS compared to the CS (fat-related satiety). Baseline CBF significantly reduced in taste (insula (5.7%,P<0.01)), homeostatic (hypothalamus (9.2%,P<0.01), thalamus (5.1%,P<0.05))), and reward areas (striatum (9.2%,P<0.01)) following the HFM. Individual’s plasma CCK concentration negatively correlated with brain activation in taste, oral somatosensory and reward areas. Conclusions: To reduce obesity, policy in industry is to lower the fat content of foods. Our results in healthy adults show that a HFM suppresses BOLD activation in taste and reward areas compared to a WL. This understanding will help inform the reformulation of reduced-fat foods that mimic the brain’s response to high fat counterparts, and guide future interventions to reduce obesity

Seed Germination Strategies of Mediterranean Halophytes Under Saline Condition

The study of the ecological strategies adopted by seed plants to ensure their success in different environments is closely related to germination ecology. This implies a careful knowledge of ecophysiology of seeds and, therefore, also of interaction between plants and the complexity of external factors. In particular, the environmental conditions of the area where a plant grows and produces seeds represent the main factors that influence successful seedling establishment. The physical-chemical features of habitats, and therefore their heterogeneity, affect the behavior of seeds in different ways. In addition to the timing of seed production, they can induce or terminate dormancy and/or germination and influence the germination pattern of different seeds in the same plant and so the composition and dispersal of soil seed banks. Salinity is a major abiotic stress affecting growth and plant productivity worldwide, constituting one of the main topics of study in the field of plant physiology. Halophytes are the plants that have the availability to survive and develop in different types of saline habitats. In this chapter, we consider some examples to illustrate the main adaptive strategies used by the seeds of halophytes on ecophysiological perspectives to survive in habitats affected by high levels of salinity. The focus is on the species that live in the brackish or salt coastal areas of the Mediterranean Basin. On these environments, the salt stress may act synergistically with intense anthropic pressure, generating profound alterations in the ecosystem and threatening the survival of the plant species very sensitive to the effects of climate change also. The results show the main diverse strategies, such as dormancy cycling, seed heteromorphism, and recovery capacity, from saline shock, favoring the chances of seed survival. The interaction between temperature and salinity during germination was also discussed assessing its crucial role as an ecological strategy

Energy autonomous wearable sensors for smart healthcare: a review

Energy Autonomous Wearable Sensors (EAWS) have attracted a large interest due to their potential to provide reliable measurements and continuous bioelectric signals, which help to reduce health risk factors early on, ongoing assessment for disease prevention, and maintaining optimum, lifelong health quality. This review paper presents recent developments and state-of-the-art research related to three critical elements that enable an EAWS. The first element is wearable sensors, which monitor human body physiological signals and activities. Emphasis is given on explaining different types of transduction mechanisms presented, and emerging materials and fabrication techniques. The second element is the flexible and wearable energy storage device to drive low-power electronics and the software needed for automatic detection of unstable physiological parameters. The third is the flexible and stretchable energy harvesting module to recharge batteries for continuous operation of wearable sensors. We conclude by discussing some of the technical challenges in realizing energy-autonomous wearable sensing technologies and possible solutions for overcoming them

Dissociation of CAK from Core TFIIH Reveals a Functional Link between XP-G/CS and the TFIIH Disassembly State

Transcription factor II H (TFIIH) is comprised of core TFIIH and Cdk-activating kinase (CAK) complexes. Here, we investigated the molecular and cellular manifestation of the TFIIH compositional changes by XPG truncation mutations. We showed that both core TFIIH and CAK are rapidly recruited to damage sites in repair-proficient cells. Chromatin immunoprecipitation against TFIIH and CAK components revealed a physical engagement of CAK in nucleotide excision repair (NER). While XPD recruitment to DNA damage was normal, CAK was not recruited in severe XP-G and XP-G/CS cells, indicating that the associations of CAK and XPD to core TFIIH are differentially affected. A CAK inhibition approach showed that CAK activity is not required for assembling pre-incision machinery in vivo or for removing genomic photolesions. Instead, CAK is involved in Ser5-phosphorylation and UV-induced degradation of RNA polymerase II. The CAK inhibition impaired transcription from undamaged and UV-damaged reporter, and partially decreased transcription of p53-dependent genes. The overall results demonstrated that a) XP-G/CS mutations affect the disassembly state of TFIIH resulting in the dissociation of CAK, but not XPD from core TFIIH, and b) CAK activity is not essential for global genomic repair but involved in general transcription and damage-induced RNA polymerase II degradation

Cross-tolerance to abiotic stresses in halophytes: Application for phytoremediation of organic pollutants

International audienceHalopytes are plants able to tolerate high salt concentrations but no clear definition was retained for them. In literature, there are more studies that showed salt-enhanced tolerance to other abiotic stresses compared to investigations that found enhanced salt tolerance by other abiotic stresses in halophytes. The phenomenon by which a plant resistance to a stress induces resistance to another is referred to as cross-tolerance. In this work, we reviewed cross-tolerance in halophytes at the physiological, biochemical, and molecular levels. A special attention was accorded to the cross-tolerance between salinity and organic pollutants that could allow halophytes a higher potential of xenobiotic phytoremediation in comparison with glycophytes

Female Institutional Directors on Boards and Firm Value

The aim of this research is to examine what impact female institutional directors on boards have on corporate performance. Previous research shows that institutional female directors cannot be considered as a homogeneous group since they represent investors who may or may not maintain business relations with the companies on whose corporate boards they sit. Thus, it is not only the effect of female institutional directors as a whole on firm value that has been analysed, but also the impact of pressure-resistant female directors, who represent institutional investors (investment, pension and mutual funds) that only invest in the company, and do not maintain a business relation with the firm. We hypothesize that there is a non-linear association, specifically quadratic, between institutional and pressure-resistant female directors on boards and corporate performance. Our results report that female institutional directors on boards enhance corporate performance, but when they reach a certain threshold on boards (11.72 %), firm value decreases. In line with female institutional directors, pressure-resistant female directors on boards also increase firm value, but only up to a certain figure (12.71 % on boards), above which they have a negative impact on firm performance. These findings are consistent with an inverted U-shaped relationship between female institutional directors and pressure-resistant female directors and firm performance

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability