Successful Outcome and Biliary Drainage in an Infant with Concurrent Alpha-1-Antitrypsin Deficiency and Biliary Atresia

We describe the rare instance of concomitant biliary atresia and alpha-1-antitrypsin deficiency and the first documented successful portoenterostomy in this scenario. The potential for dual pathology must be recognized and underscores that prompt diagnosis of biliary atresia, despite concomitant alpha-1-antitrypsin deficiency, is essential to afford potential longstanding native liver function

Tobacco Use among Adult Muslims in the United States.

Compared with the general United States (US) population, Muslims in the US exhibit elevated rates of tobacco use. As a result, they might be at a higher risk for preventive disease and premature death as compared with the general US population. This study investigated the Social Cognitive Theory (SCT) factors that are associated with tobacco use among a sample of adult Muslims in the US. Data were collected (November 2016-March 2017) using a cross-sectional, on-line survey from a convenience sample of adult (≥ 18 years) US Muslims. Participants with a lung cancer history were excluded. Associations between SCT factors and tobacco use were investigated with bivariate analyses and multinomial logistic regression models. Eligible participants (n = 271) from 30 states completed the survey; 52.8% reported current tobacco use. A higher rate of current tobacco use was reported by men (62.8%) as compared to women (41.3%), x(1, N = 271) = 12.49, p < .001. In terms of cognitive factors, individuals who (1) expected more personal consequences for tobacco use on health, and (2) had more confidence regarding ability to abstain from tobacco use, were less likely to report current tobacco use. In terms of environmental factors, individuals whose family members did not use tobacco were less likely to report current tobacco use. The study findings suggest that family-oriented interventions emphasizing self-efficacy and personal consequences to prevent tobacco use can potentially be effective in reducing tobacco use rates in the adult US Muslim population

Longitudinal assessment of high blood pressure in children with nonalcoholic fatty liver disease.

ObjectiveNonalcoholic fatty liver disease (NAFLD) affects 9.6% of children and may put these children at elevated risk of high blood pressure and subsequent cardiovascular morbidity and mortality. Therefore, we sought to determine the prevalence of and risk factors for high blood pressure in children with NAFLD.MethodsCohort study performed by the NIDDK NASH Clinical Research Network. There were 484 children with NAFLD ages 2 to 17 at enrollment; 382 children were assessed both at enrollment and 48 weeks afterwards. The main outcomes were high blood pressure at baseline and persistent high blood pressure at both baseline and 48 weeks.ResultsPrevalence of high blood pressure at baseline was 35.8% and prevalence of persistent high blood pressure was 21.4%. Children with high blood pressure were significantly more likely to have worse steatosis than children without high blood pressure (mild 19.8% vs. 34.2%, moderate 35.0% vs. 30.7%, severe 45.2% vs. 35.1%; P = 0.003). Higher body mass index, low-density lipoprotein, and uric acid were independent risk factors for high blood pressure (Odds Ratios: 1.10 per kg/m2, 1.09 per 10 mg/dL, 1.25 per mg/dL, respectively). Compared to boys, girls with NAFLD were significantly more likely to have persistent high blood pressure (28.4% vs.18.9%; P = 0.05).ConclusionsIn conclusion, NAFLD is a common clinical problem that places children at substantial risk for high blood pressure, which may often go undiagnosed. Thus blood pressure evaluation, control, and monitoring should be an integral component of the clinical management of children with NAFLD

Interest in Lung Screening among a Sample of Adult Muslims in the United States

  Objectives. Muslims in the United States exhibit high rates of tobacco use, which make them highly vulnerable to lung cancer. Lung cancer could be avoided by regularly undergoing preventive lung screening. This study investigated the associations between Social Cognitive Theory factors and being interested in preventive lung screening in a sample of adult US Muslims. Methods. We examined a convenience sample of adult US Muslims. A cross-sectional online survey was used to collect data. Binomial logistic regression analyses were conducted to identify the factors related to interest in preventive lung screening. Key Findings. Two hundred seventy-one eligible participants (≥18 years old Muslim individuals who live in the US) from 30 states completed the questionnaire. Individuals were more likely to express an interest in lung cancer screening if they had 1) more positive attitudes about lung screening, 2) a higher perceived value of screening, and 3) greater self-efficacy regarding the ability to undergo lung screening. Conclusion. Addressing attitudes, perceived value, and self-efficacy in future interventions could increase interest in preventive lung screening amongst adult US Muslims

Low and High Birth Weights Are Risk Factors for Nonalcoholic Fatty Liver Disease in Children

OBJECTIVES: To examine the distribution of birth weight in children with nonalcoholic fatty liver disease (NAFLD) compared with the general US population, and to investigate the relationship between birth weight and severity of NAFLD. STUDY DESIGN: A multicenter, cross-sectional study of children with biopsy-proven NAFLD enrolled in the Nonalcoholic Steatohepatitis Clinical Research Network Database. Birth weight was categorized as low birth weight (LBW), normal birth weight (NBW), or high birth weight (HBW) and compared with the birth weight distribution in the general US population. The severity of liver histology was assessed by birth weight category. RESULTS: Children with NAFLD (n = 538) had overrepresentation of both LBW and HBW compared with the general US population (LBW, 9.3%; NBW, 75.8%; HBW, 14.9% vs LBW, 6.1%; NBW, 83.5%; HBW 10.5%; P < .0001). Children with HBW had significantly greater odds of having more severe steatosis (OR, 1.82, 95% CI. 1.15-2.88) and nonalcoholic steatohepatitis (OR, 2.03; 95% CI, 1.21-3.40) compared with children with NBW. In addition, children with NAFLD and LBW had significantly greater odds of having advanced fibrosis (OR, 2.23; 95% CI, 1.08-4.62). CONCLUSION: Birth weight involves maternal and in utero factors that may have long-lasting consequences. Children with both LBW and HBW may be at increased risk for developing NAFLD. Among children with NAFLD, those with LBW or HBW appear to be at increased risk for more severe disease

A Physical Model of Warped Galaxy Disks

Warped H I gas layers in the outer regions of spiral galaxies usually display a noticeably twisted structure. This structure almost certainly arises primarily as a result of differential precession in the H I disk as it settles toward a preferred orientation in an underlying dark halo potential well that is not spherically symmetric. In an attempt to better understand the structure and evolution of these twisted, warped disk structures, we have adopted the "twist-equation" formalism originally developed by Petterson (1977) to study accretion onto compact objects. Utilizing more recent treatments of this formalism, we have generalized the twist-equation to allow for the treatment of non-Keplerian disks and from it have derived a steady-state structure of twisted disks that develops from free precession in a nonspherical, logarithmic halo potential. We have used this steady-state solution to produce H I maps of five galaxies (M83, NGC 300, NGC 2841, NGC 5033, NGC5055), which match the general features of the observed maps of these galaxies quite well. In addition, the model provides an avenue through which the kinematical viscosity of the H I disk and the quadrupole distortion of the dark halo in each galaxy can be quantified. This generalized equation can also be used to examine the time-evolutionary behavior of warped galaxy disks.Comment: 22 pages, 5 figures, to be published in The Astrophysical Journa

An Open Label, Randomized, Multicenter Study of Elafibranor in Children With Nonalcoholic Steatohepatitis

ObjectivesNonalcoholic fatty liver disease is the most common chronic liver disease in children. Elafibranor, a dual peroxisome proliferator-activated receptor α/δ agonist, has been proposed as a treatment for nonalcoholic steatohepatitis (NASH). The aims were to (1) describe pharmacokinetics (PK), safety, and tolerability of oral elafibranor at 2 doses (80 and 120 mg) in children 8-17 years and (2) assess changes in aminotransferases.MethodsChildren with NASH were randomized to open-label elafibranor 80 mg or 120 mg daily for 12 weeks. The intent-to-treat analysis included all participants who received at least 1 dose. Standard descriptive statistics and PK analyses were performed.ResultsTen males [mean 15.1 years, standard deviation (SD) 2.2] with NASH were randomized to 80 mg (n = 5) or 120 mg (n = 5). Baseline mean alanine aminotransferase (ALT) was 82 U/L (SD 13) and 87 U/L (SD 20) for 80 mg and 120 mg groups, respectively. Elafibranor was rapidly absorbed and well tolerated. Elafibranor plasma exposure increased between the 80 mg and 120 mg dose with a 1.9- and 1.3-fold increase in median Cmax and AUC 0-24 , respectively. End of treatment mean ALT was 52 U/L (SD 20) for the 120 mg group, with a relative mean ALT change from baseline of -37.4% (SD 23.8%) at 12 weeks.ConclusionsOnce daily dosing of elafibranor was well tolerated in children with NASH. There was a 37.4% relative reduction from mean baseline ALT in the 120 mg group. Decreasing ALT may be associated with improvement in liver histology, thus could be considered a surrogate for histology in early phase trials. These results may support further exploration of elafibranor in children with NASH

Prospecting in ultracool dwarfs : Measuring the metallicities of mid- and late-m dwarfs

© 2014. The American Astronomical Society. All rights reserved.Metallicity is a fundamental parameter that contributes to the physical characteristics of a star. The low temperatures and complex molecules present in M dwarf atmospheres make it difficult to measure their metallicities using techniques that have been commonly used for Sun-like stars. Although there has been significant progress in developing empirical methods to measure M dwarf metallicities over the last few years, these techniques have been developed primarily for early- to mid-M dwarfs. We present a method to measure the metallicity of mid- to late-M dwarfs from moderate resolution (R ∼ 2000) K-band (≃ 2.2 μm) spectra. We calibrate our formula using 44 wide binaries containing an F, G, K, or early-M primary of known metallicity and a mid- to late-M dwarf companion. We show that similar features and techniques used for early-M dwarfs are still effective for late-M dwarfs. Our revised calibration is accurate to ∼0.07 dex for M4.5-M9.5 dwarfs with -0.58 <[Fe/H] <+0.56 and shows no systematic trends with spectral type, metallicity, or the method used to determine the primary star metallicity. We show that our method gives consistent metallicities for the components of M+M wide binaries. We verify that our new formula works for unresolved binaries by combining spectra of single stars. Lastly, we show that our calibration gives consistent metallicities with the Mann et al. study for overlapping (M4-M5) stars, establishing that the two calibrations can be used in combination to determine metallicities across the entire M dwarf sequence.Peer reviewe