Nutritional, inflammatory, and ecological correlates of maternal retinol allocation to breast milk in agroâ pastoral Ariaal communities of northern Kenya

ObjectivesVitamin A (VA) is an essential micronutrient required for a range of biological functions throughout life. VA deficiency (VAD) claims an estimated 1 million preschool children’s lives annually. Human milk is enriched with VA (retinol) from the maternal blood, which originates from the hepatic reserve and dietary intake. Secreting retinol into milk will benefit the nursing infant through breast milk, but retaining retinol is also important for the maternal health. Previous studies found that the public health intervention of highâ dose VA supplementation to lactating mothers did not significantly lower child mortality. The World Health Organization (WHO) recently acknowledged that our understanding about the principle of VA allocation within the maternal system and the secretion into milk is too incomplete to devise an effective intervention.MethodsWe present a secondary analysis of data collected among lactating mothers in VAD endemic northern Kenya (nâ =â 171), examining nutritional, inflammatory, and ecological factors that might associate with maternal retinol allocation. Regression models were applied using the outcome milkâ retinol allocation index: milk retinol/(milk retinolâ +â serum retinol).ResultsTen percent of the sample was identified as VAD. The average milk retinol concentration was 0.1 μmo/L, grossly below what is considered minimally necessary for an infant (1 μmol/L). VAD mothers and mothers with inflammation did not seem to compromise their milk retinol even though their serum retinol was lower than nonâ VAD and noninflammation mothers. Breast milk fat concentration positively correlated with milk retinol but not with serum retinol.ConclusionsThis exploratory study contributes toward an understanding of maternal retinol allocation.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/137751/1/ajhb22961.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/137751/2/ajhb22961_am.pd

SWING MECHANICS OF COLLEGIATE BASEBALL PLAYERS IN DIFFERENT BATTING HEIGHT

The purpose of this study was to understand the batting stability of baseball player in different divisions during three batting height. Eight division I and eight division II baseball players served as the subjects in this study. The 3D motion analysis system was used to collect the kinematics data. The swing plane was calculated and the error between the trajectory and the plane was considered as outcomes. Two-way mixed design ANOVA (? = .05) was used for statistics. Dbh were smaller in low (79.79±54.05) than that in high (160.80±98.35, p= .001) and middle (150.58±67.07, p= .000) batting conditions. Dsholder in low (4.72±3.01) was smaller than middle (16.04±7.21, p= .006) and high (16.04±7.21, p= .000) conditions, and Dsholder in middle was smaller than high (p= .001) condition. From the point of view of deviation of bat head and shoulder, the swing performents were more stable in low condition than other conditions

Nutrient intakes associated with elevated serum C‐reactive protein concentrations in normal to underweight breastfeeding women in Northern K enya

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/109338/1/ajhb22600.pd

KINEMATICS OF SOCCER DRIBBLING IN DIFFERENT TASKS

The purpose of this study was to find the differences in kinematics between different speeds and cutting directions. Ten male university division 1 soccer players served as the subjects in this study. The Vicon Motion System and the KISTLER force platform were used synchronously to collect data. The length of projection vector was normalized by leg length. 2way ANOVA was used for statistics. Simple main effect was tested if no significant interaction effect was noted. The significant level was set as .05. The length of projection vector between COM and the heel of pivot leg onto X-Y plane in high speed tasks were longer than that in low speed tasks (p \u3c .05). The angle between the X axis and the projection vector between COM and the heel of pivot leg onto X-Y plane had significant interaction effect (p \u3c .05). In low speed tasks, players’ pivot legs landed more laterally and that might enhance lateral motion of body, especially when players cut to the dominate side (right). It was concluded that players would change their cutting tactics at different speeds and in different directions. Landing position of pivot leg might be a factor that would help defender to know the cutting side of attacker at low dribbling speed

Comparison of the Adherence to the American Diabetes Association Guidelines of Diabetes Care in Primary Care and Subspecialty Clinics

Abstract Background Diabetes mellitus is a major public health problem with significant morbidity and mortality. Evidence based guidelines have been proposed to reduce the micro and macrovascular complications, but studies have shown that these goals are not being met. We sought to compare the adherence to the American Diabetes Association guidelines for measurement and control of glycohemoglobin (A1c), blood pressure (BP), lipids (LDL) and microalbuminuria (MA) by subspecialty and primary care clinics in an academic medical center. Methods 390 random charts of patients with diabetes from Family Practice (FP), Internal Medicine (IM) and Diabetes (DM) clinics at Michigan State University were reviewed. Results We reviewed 131, 134 and 125 charts from the FP, IM and DM clinics, respectively. DM clinic had a higher percentage of patients with type 1 diabetes 43/125 (34.4%) compared with 7/131 (5.3%) in FP and 7/134 (5.2%) in IM clinics. A1c was measured in 99%, 97.8% and 100% subjects in FP, IM and DM clinics respectively. B.P. was measured in all subjects in all three clinics. Lipids were checked in 97.7%, 95.5% and 92% patients in FP, IM and DM clinics respectively. MA was measured at least once during the year preceding the office visit in 85.5%, 82.8% and 76.8% patients in FP, IM and DM clinics respectively. A1C was controlled (<7%) in 38.9, 43.3, 28.8% of patients in the FP, IM and DM clinics, respectively (p = 0.034). LDL was controlled (<100 mg/dl or 2.586 mmol/l) in 71.8, 64.9, 64% of patients in the FP, IM and DM clinics, respectively. MA was controlled (<30 mg/gm creatinine) in 60.3%, 51.5% and 60% patients in FP, IM and DM clinics respectively (P = 0.032). BP was controlled (<130/80) in 59.5, 67.2 and 52.8% patients in the FP, IM and DM clinics, respectively. Conclusion Testing rates for A1C, LDL, and MA were high, in both subspecialty and primary care clinics. However, the degree of control was not optimal. Significantly fewer patients in the DM clinic had A1c <7%, the cause of which may be multifactorial.http://deepblue.lib.umich.edu/bitstream/2027.42/111055/1/40200_2015_Article_158.pd

Linking development to climate adaptation: Leveraging generic and specific capacities to reduce vulnerability to drought in NE Brazil

AbstractTo respond to climate impact, poor agricultural households in less developed regions rely on different types of assets that define their overall adaptive capacity (AC). However not all assets build capacity equally. In this study we argue that building AC requires a combination of interventions that address not only climate-related risks (specific capacity) but also the structural deficits (e.g., lack of income, education, health, political power) (generic capacity) that shape vulnerability. Focusing on rainfed agriculture in NE Brazil, we investigate how households leverage and combine generic and specific capacities to reduce vulnerability. Particularly we explore: 1) the relative importance of different kinds of capacity in shaping vulnerability on these households and 2) how the level of generic capacities (particularly as a result of Brazil’s anti-poverty program Bolsa Família) influences the adoption of specific ones. We find that both kinds of capacity matter, as relatively higher levels of generic capacity (in terms of income in general, and climate-neutral income specifically) are associated with higher levels of specific capacity (irrigation). In addition we find that while Bolsa Família has been positive in increasing income, it has not been sufficient to manage the risk of food insecurity during drought events, suggesting a 'poverty trap' in which families are constantly coping with drought but failing to overcome the conditions that make them vulnerable. Our findings indicate that in order to decrease climate vulnerability of poor agricultural households, development interventions, such as anti-poverty programs, have to go beyond cash transfer and should incorporate risk management policies that enhance synergies between generic and specific capacities

Aqua­dinitrato(quioxalino[2,3-f][1,10]phenanthroline)nickel(II) monohydrate

In the crystal of the title compound, [Ni(NO3)2(C18H10N4)(H2O)]·H2O, the NiII ion is coordinated in a distorted octahedral geometry by two N atoms of the 1,10-phenanthroline moiety of the ligand, three O atoms from two nitrate anions and an O atom from one water mol­ecule. O—H⋯O hydrogen bonds between the coordinated and the solvent water molecules and between these water molecules and the nitrate O atoms help to establish the crystal packing

Association of Female Menopause With Atrioventricular Mechanics and Outcomes

BACKGROUND: Despite known sex differences in cardiac structure and function, little is known about how menopause and estrogen associate with atrioventricular mechanics and outcomes. OBJECTIVE: To study how, sex differences, loss of estrogen in menopause and duration of menopause, relate to atrioventricular mechanics and outcomes. METHODS: Among 4051 asymptomatic adults (49.8 ± 10.8 years, 35%women), left ventricular (LV) and left atrial (LA) mechanics were assessed using speckle-tracking. RESULTS: Post-menopausal (vs. pre-menopausal) women had similar LV ejection fraction but reduced GLS, reduced PALS, increased LA stiffness, higher LV sphericity and LV torsion (all p < 0.001). Multivariable analysis showed menopause to be associated with greater LV sphericity (0.02, 95%CI 0.01, 0.03), higher indexed LV mass (LVMi), lower mitral e’, lower LV GLS (0.37, 95%CI 0.04–0.70), higher LV torsion, larger LA volume, worse PALS (∼2.4-fold) and greater LA stiffness (0.028, 95%CI 0.01–0.05). Increasing years of menopause was associated with further reduction in GLS, markedly worse LA mechanics despite greater LV sphericity and higher torsion. Lower estradiol levels correlated with more impaired LV diastolic function, impaired LV GLS, greater LA stiffness, and increased LV sphericity and LV torsion (all p < 0.05). Approximately 5.5% (37/669) of post-menopausal women incident HF over 2.9 years of follow-up. Greater LV sphericity [adjusted hazard ratio (aHR) 1.04, 95%CI 1.00–1.07], impaired GLS (aHR 0.87, 95%CI 0.78–0.97), reduced peak left atrial longitudinal strain (PALS, aHR 0.94, 95%CI 0.90–0.99) and higher LA stiffness (aHR 10.5, 95%CI 1.69–64.6) were independently associated with the primary outcome of HF hospitalizations in post-menopause. Both PALS < 23% (aHR:1.32, 95%CI 1.01–3.49) and GLS < 16% (aHR:5.80, 95%CI 1.79–18.8) remained prognostic for the incidence of HF in post-menopausal women in dichotomous analyses, even after adjusting for confounders. Results were consistent with composite outcomes of HF hospitalizations and 1-year all-cause mortality as well. CONCLUSION: Menopause was associated with greater LV/LA remodeling and reduced LV longitudinal and LA function in women. The cardiac functional deficit with menopause and lower estradiol levels, along with their independent prognostic value post-menopause, may elucidate sex differences in heart failure further

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London