Relative incidence and predictors of pulmonary arterial hypertension complicating type 2 diabetes: The Fremantle Diabetes Study Phase I

Aims: To determine the relative incidence and predictors of pulmonary arterial hypertension (PAH) in type 2 diabetes. Methods: Hospitalizations for/with and death from/with PAH, and all-cause mortality, were ascertained from validated databases for participants from the longitudinal, community-based Fremantle Diabetes Study Phase I (FDS1; n = 1287) and age-, sex- and zip code-matched people without diabetes (n = 5153) between entry (1993–1996) and end-2017. Incidence rates (IRs) and IR ratios (IRRs) were calculated. Cox proportional hazards and competing risk models generated cause-specific (cs) and subdistribution (sd) hazard ratios (HRs) for incident PAH. Results: In the pooled cohort (mean age 64.0 years, 49% males), 49 (3.8%) of the type 2 diabetes participants and 133 (2.6%) of those without diabetes developed PAH during 106,556 person-years of follow-up (IRs (95% CI) 262 (194– 346) and 151 (127–179) /100,000 person-years, respectively; IRR 1.73 (1.22–2.42), P = 0.001). Type 2 diabetes was associated with an unadjusted csHR of 1.97 (1.42–2.74) and sdHR of 1.44 (1.04–2.00) (P ≤ 0.03); after adjustment for age, sex, and co-morbidities, these were 1.43 (0.83–2.47) and 1.36 (0.97–1.91), respectively (P ≥ 0.07). Conclusions: Type 2 diabetes is associated with an increased risk of PAH but this is no longer significant after adjustment for other explanatory variables and the competing risk of death. © 2020 Elsevier Inc. All rights reserved

Prenatal Lead Exposure Risk Assessment by Vermont Maternity Care Providers

Introduction. One percent of women of childbearing age in the U.S. have blood lead levels ≥ 5 ug/dL, which are associated with maternal hypertension during pregnancy, neural tube and cardiac defects in infants, low birth weight, prematurity, and spontaneous abortion. It is unknown whether obstetrics providers in Vermont are screening their pregnant patients for lead levels and educating them on lead exposure risks. Objective. To gain an understanding of current lead screening practices in Vermont and issue recommendations for disseminating lead screening information. Methods. We developed and e-mailed a survey to practicing OB/GYN physicians, maternity care focused family medicine physicians, nurse midwives, and professional midwives. The survey assessed current screening practices for lead exposure in their pregnant patients, interest in receiving statewide guidelines, and guideline dissemination preferences. Results. Of the 41 respondents, 12% currently conduct risk assessments for lead exposure with all of their pregnant patients. Fifty four percent of maternity providers give all of their patients educational materials about lead exposure and risk of toxicity. Seventy one percent of maternity providers think that having guidelines provided by the Vermont Department of Health would encourage them to begin or continue lead exposure screening. The two preferred methods of communicating guidelines to physicians were grand rounds and email whereas non-physician providers preferred email and webinar. Discussion. The majority of pregnant patients in Vermont are not properly assessed or educated about lead risks. However, there is interest in having statewide standardized lead risk assessment guidelines, with dissemination preferences differing by provider type.https://scholarworks.uvm.edu/comphp_gallery/1248/thumbnail.jp

Gestational Hormone Profiles Predict Human Maternal Behavior at 1-Year Postpartum

In many non-human species, including primates, gestational reproductive hormones play an essential role in the onset of maternal motivation and behaviors. We investigated the associations between prepartum estradiol and progesterone and maternal behavior at 1-year postpartum in 177 women. Blood was obtained at five gestational time points and an index of quality of maternal care was determined using a well-validated mother-child interaction protocol. Women who exhibited higher quality maternal care at 1-year postpartum were characterized by unique gestational profiles of estradiol, progesterone and the estrogen to progesterone ratio; specifically by slower accelerations and levels of these hormone trajectories beginning in midgestation. Further, it appeared that both fetal sex and parity moderated these findings, with first time mothers and mothers of females showing stronger associations. In sum, these data document persisting associations between prepartum hormone profiles and human maternal behavior. More broadly, these findings add to the growing literature highlighting the perinatal period as one of critical neurodevelopment in the lifespan of the human female

Reviews

Review of Jurisdiction under the Industrial Relations Act 1973: Some Problems and Issues, Employment: Towards an Active Employment Policy, Labor in the American Economy, Strikes and Participation, Democracy in the Work Place

Common Data Acquisition Systems (DAS) Software Development for Rocket Propulsion Test (RPT) Test Facilities

The advent of the commercial space launch industry and NASA's more recent resumption of operation of Stennis Space Center's large test facilities after thirty years of contractor control resulted in a need for a non-proprietary data acquisition systems (DAS) software to support government and commercial testing. The software is designed for modularity and adaptability to minimize the software development effort for current and future data systems. An additional benefit of the software's architecture is its ability to easily migrate to other testing facilities thus providing future commonality across Stennis. Adapting the software to other Rocket Propulsion Test (RPT) Centers such as MSFC, White Sands, and Plumbrook Station would provide additional commonality and help reduce testing costs for NASA. Ultimately, the software provides the government with unlimited rights and guarantees privacy of data to commercial entities. The project engaged all RPT Centers and NASA's Independent Verification & Validation facility to enhance product quality. The design consists of a translation layer which provides the transparency of the software application layers to underlying hardware regardless of test facility location and a flexible and easily accessible database. This presentation addresses system technical design, issues encountered, and the status of Stennis development and deployment

Parity, mode of birth, and long-term gynecological health: A follow-up study of parous and nonporous women in the Australian Longitudinal Study on Women's Health cohort

Background:Although gynecological health issues are common and cause considerable distress, little is known about their causes. We examined how birth history is associated with urinary incontinence (UI), severe period pain, heavy periods, and endometriosis. Methods:We studied 7700 women in the Australian Longitudinal Study on Women's Health with an average follow-up of 10.9 years after their last birth. Surveys every third year provided information about birth history and gynecological health. Logistic regression was used to estimate how parity, mode of birth, and vaginal tears were associated with gynecological health issues. Presented results are adjusted odds ratios (OR) with 95% confidence intervals. Results:UI was reported by 16%, heavy periods by 31%, severe period pain by 28%, and endometriosis by 4%. Compared with women with two children, nonparous women had less UI (OR 0.35 [0.26–0.47]) but tended to have more endometriosis (OR 1.70 [0.97–2.96]). Also, women with only one child had less UI (OR 0.77 [0.61–0.98]), but more severe period pain (OR 1.24 [1.01–1.51]). Women with 4+ children had more heavy periods (OR 1.42 [1.07–1.88]). Compared with women with vaginal birth(s) only, women with only cesarean sections or vaginal birth after cesarean section had less UI (ORs 0.44 [0.34–0.58] and 0.55 [0.40–0.76]), but more endometriosis (ORs 1.91 [1.16–3.16] and 2.31 [1.25–4.28]) and heavy periods (ORs 1.21 [1.00–1.46] and 1.35 [1.06–1.72]). Vaginal tear(s) did not increase UI after accounting for parity and birth mode. Conclusion:While women with vaginal childbirth(s) reported more urinary incontinence, they had less menstrual complaints and endometriosis.</p