Objective We sought to evaluate inadequate gestational weight gain and fetal growth among overweight and obese women. Study Design We conducted an analysis of prospective singleton term pregnancies ...in which 1053 overweight and obese women gained >5 kg (14.4 ± 6.2 kg) or 188 who either lost or gained ≤5 kg (1.1 ± 4.4 kg). Birthweight, fat mass, and lean mass were assessed using anthropometry. Small for gestational age (SGA) was defined as ≤10th percentile of a standard US population. Univariable and multivariable analysis evaluated the association between weight change and neonatal morphometry. Results There was no significant difference in age, race, smoking, parity, or gestational age between groups. Weight loss or gain ≤5 kg was associated with SGA, 18/188 (9.6%) vs 51/1053 (4.9%); (adjusted odds ratio, 2.6; 95% confidence interval, 1.4–4.7; P = .003). Neonates of women who lost or gained ≤5 kg had lower birthweight (3258 ± 443 vs 3467 ± 492 g, P < .0001), fat mass (403 ± 175 vs 471 ± 193 g, P < .0001), and lean mass (2855 ± 321 vs 2995 ± 347 g, P < .0001), and smaller length, percent fat mass, and head circumference. Adjusting for diabetic status, prepregnancy body mass index, smoking, parity, study site, gestational age, and sex, neonates of women who gained ≤5 kg had significantly lower birthweight, lean body mass, fat mass, percent fat mass, head circumference, and length. There were no significant differences in neonatal outcomes between those who lost weight and those who gained ≤5 kg. Conclusion In overweight and obese women weight loss or gain ≤5 kg is associated with increased risk of SGA and decreased neonatal fat mass, lean mass, and head circumference.
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Two placebo-controlled trials involving pregnant women with subclinical hypothyroidism or hypothyroxinemia showed that levothyroxine beginning between 8 and 20 weeks of gestation did not ...significantly improve cognitive outcomes in children through 5 years of age.
Observational studies spanning almost three decades suggest that subclinical thyroid disease during pregnancy is associated with adverse outcomes.
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–
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In 1999, interest in undiagnosed maternal thyroid dysfunction was heightened by studies suggesting an association between subclinical thyroid hypofunction and impaired fetal neuropsychological development.
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,
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In one report, children of women whose serum thyrotropin levels during pregnancy were greater than the 98th percentile had a lower IQ than children of matched controls who had a normal thyrotropin level.
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In another study, children whose mothers had a serum free thyroxine (T
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) level of less than the 10th percentile in early . . .
Identifying differentially abundant microbes is a common goal of microbiome studies. Multiple methods are used interchangeably for this purpose in the literature. Yet, there are few large-scale ...studies systematically exploring the appropriateness of using these tools interchangeably, and the scale and significance of the differences between them. Here, we compare the performance of 14 differential abundance testing methods on 38 16S rRNA gene datasets with two sample groups. We test for differences in amplicon sequence variants and operational taxonomic units (ASVs) between these groups. Our findings confirm that these tools identified drastically different numbers and sets of significant ASVs, and that results depend on data pre-processing. For many tools the number of features identified correlate with aspects of the data, such as sample size, sequencing depth, and effect size of community differences. ALDEx2 and ANCOM-II produce the most consistent results across studies and agree best with the intersect of results from different approaches. Nevertheless, we recommend that researchers should use a consensus approach based on multiple differential abundance methods to help ensure robust biological interpretations.
Abstract
We present the first results from the Mapping Obscuration to Reionization with ALMA (MORA) survey, the largest Atacama Large Millimeter/submillimeter Array (ALMA) blank-field contiguous ...survey to date (184 arcmin
2
) and the only at 2 mm to search for dusty star-forming galaxies (DSFGs). We use the 13 sources detected above 5
σ
to estimate the first ALMA galaxy number counts at this wavelength. These number counts are then combined with the state-of-the-art galaxy number counts at 1.2 and 3 mm and with a backward evolution model to place constraints on the evolution of the IR luminosity function and dust-obscured star formation in the past 13 billion years. Our results suggest a steep redshift evolution on the space density of DSFGs and confirm the flattening of the IR luminosity function at faint luminosities, with a slope of
. We conclude that the dust-obscured component, which peaks at
z
≈ 2–2.5, has dominated the cosmic history of star formation for the past ∼12 billion years, back to
z
∼ 4. At
z
= 5, the dust-obscured star formation is estimated to be ∼35% of the total star formation rate density and decreases to 25%–20% at
z
= 6–7, implying a minor contribution of dust-enshrouded star formation in the first billion years of the universe. With the dust-obscured star formation history constrained up to the end of the epoch of reionization, our results provide a benchmark to test galaxy formation models, to study the galaxy mass assembly history, and to understand the dust and metal enrichment of the universe at early times.
Objectives The aim of this study was to determine the efficacy of implantable cardioverter-defibrillators (ICDs) in children and adolescents with hypertrophic cardiomyopathy (HCM). Background HCM is ...the most common cause of sudden death in the young. The availability of ICDs over the past decade for HCM has demonstrated the potential for sudden death prevention, predominantly in adult patients. Methods A multicenter international registry of ICDs implanted (1987 to 2011) in 224 unrelated children and adolescents with HCM judged at high risk for sudden death was assembled. Patients received ICDs for primary (n = 188) or secondary (n = 36) prevention after undergoing evaluation at 22 referral and nonreferral institutions in the United States, Canada, Europe, and Australia. Results Defibrillators were activated appropriately to terminate ventricular tachycardia or ventricular fibrillation in 43 of 224 patients (19%) over a mean of 4.3 ± 3.3 years. ICD intervention rates were 4.5% per year overall, 14.0% per year for secondary prevention after cardiac arrest, and 3.1% per year for primary prevention on the basis of risk factors (5-year cumulative probability 17%). The mean time from implantation to first appropriate discharge was 2.9 ± 2.7 years (range to 8.6 years). The primary prevention discharge rate terminating ventricular tachycardia or ventricular fibrillation was the same in patients who underwent implantation for 1, 2, or ≥3 risk factors (12 of 88 14%, 10 of 71 14%, and 4 of 29 14%, respectively, p = 1.00). Extreme left ventricular hypertrophy was the most common risk factor present (alone or in combination with other markers) in patients experiencing primary prevention interventions (17 of 26 65%). ICD-related complications, particularly inappropriate shocks and lead malfunction, occurred in 91 patients (41%) at 17 ± 5 years of age. Conclusions In a high-risk pediatric HCM cohort, ICD interventions terminating life-threatening ventricular tachyarrhythmias were frequent. Extreme left ventricular hypertrophy was most frequently associated with appropriate interventions. The rate of device complications adds a measure of complexity to ICD decisions in this age group.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The ACCF/AHA Task Force on Practice Guidelines makes every effort to avoid actual, potential, or perceived conflicts of interest that may arise as a result of industry relationships or personal ...interests among the writing committee. If a writing committee member develops a new relationship with industry during his/her tenure, he/she is required to notify guideline staff in writing.\n Kovacs Official Reviewer--ACCF Board of Govenors None None None None None None Christine Mora Mangano Official Reviewer--Society of Cardiovascular Anesthesiologists None None None None None None Steven R. Mess|fe Official Reviewer--American Stroke Association None Boehringer Ingelheim None American Heart Association* None None Eric Roselli Official Reviewer--Society of Thoracic Surgeons Medtronic Vascutek None None Cook None None Geoff D. Rubin Official Reviewer--American College of Radiology Fovia Bracco TeraRecon Biosense-Webster* None None Frank J. Rybicki Official Reviewer--American College of Radiology Bracco Siemens Medical Toshiba Medical Systems* Vital Images Bracco Siemens Medical Toshiba Medical Systems* Vital Images Siemens Medical Bracco Toshiba Medical Systems* None None Thoralf M. Sundt Official Reviewer--American Association for Thoracic Surgery None None None Bolton Medical Atricure Bolton Medical Jarvik Heart Medtronic Sorin Group/Carbomedics St. Jude Medical Thoratec Corporation Ventracor W.L. Gore None Richard D. White Official Reviewer--AHA Peripheral Vascular Disease Council None None None None None None James P. Zidar Official Reviewer--Society for Cardiovascular Angiography and Interventions Abbott Vascular Cordis* Medtronic Vascular Abbott Vascular Cordis* Medtronic Vascular None Abbott Vascular Cordis* Medtronic Vascular None None Wyatt Decker Organizational Reviewer--American College of Emergency Physicians None None None None None None Josh M. Kosowsky Organizational Reviewer--American College of Emergency Physicians None None None None None None Emile Mohler Organizational Reviewer--American College of Physicians None None None None None None James Burke Content Reviewer--ACCF Catherization Committee None None None None None None (Continued) Edward P. Chen Content Reviewer None None None None None None Mark A. Creager Content Reviewer--ACCF/AHA Task Force on Practice Guidelines None None None None None None Jose G. Diez Content Reviewer--ACCF Catherization Committee Sanofi-aventis None None None None None John A. Elefteriades Content Reviewer Baxter None Coolspine Celera Diagnostics None 2006; Plaintiff; Aortic Dissection* D. Craig Miller Content Reviewer Medtronic St. Jude Medical None NHLBI Stanford PARTNER Trial   Rick Nishimura Content Reviewer--ACCF/AHA Task Force on Practice Guidelines None None None None None None Patrick T. O'Gara Content Reviewer None None None None None None Carlos Ruiz Content Reviewer--ACCF Interventional Council None None None None None None * ACCF indicates American College of Cardiology Foundation; AHA, American Heart Association; and NHLBI, National Heart, Lung, and Blood Institute.This table represents the relevant relationships with industry and other entities that were disclosed at the time of peer review. A person is deemed to have a significant interest in a business if the interest represents ownership of 5% or more of the voting stock or share of the business entity, or ownership of $10 000 or more of the fair market value of the business entity; or if funds received by the person from the business entity exceed 5% of the person's gross income for the previous year.
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Table of Contents Preamble2647 Introduction2649 Methodology and Evidence Review2649 Organization of the GWC2649 Document Review and Approval2649 Scope of the CPG2650 Overview of ACS2650 Initial ...Evaluation and Management: Recommendations2650 Clinical Assessment and Initial Evaluation2650 Emergency Department or Outpatient Facility Presentation2650 Prognosis--Early Risk Stratification2650 Cardiac Biomarkers and the Universal Definition of Myocardial Infarction2654 Biomarkers: Diagnosis2654 Biomarkers: Prognosis2654 Discharge From the ED or Chest Pain Unit2655 Early Hospital Care: Recommendations2655 Standard Medical Therapies2655 Oxygen2655 Nitrates2655 Analgesic Therapy2655 Beta-Adrenergic Blockers2656 Calcium Channel Blockers2657 Cholesterol Management2657 Inhibitors of the Renin-Angiotensin-Aldosterone System2657 Initial Antiplatelet/Anticoagulant Therapy in Patients With Definite or Likely NSTE-ACS2657 Initial Oral and Intravenous Antiplatelet Therapy in Patients With Definite or Likely NSTE-ACS Treated With an Initial Invasive or Ischemia-Guided Strategy2657 Initial Parenteral Anticoagulant Therapy in Patients With Definite NSTE-ACS2659 Ischemia-Guided Strategy Versus Early Invasive Strategies2659 Early Invasive and Ischemia-Guided Strategies2659 Risk Stratification Before Discharge for Patients With an Ischemia-Guided Strategy of NSTE-ACS2661 Myocardial Revascularization: Recommendations2661 PCI--General Considerations2661 PCI--Oral and Intravenous Antiplatelet Agents2661 PCI--GP IIb/IIIa Inhibitors2662 Anticoagulant Therapy in Patients Undergoing PCI2663 Timing of Urgent Coronary Artery Bypass Graft in Patients With NSTE-ACS in Relation to Use of Antiplatelet Agents2663 Late Hospital Care, Hospital Discharge, and Posthospital Discharge Care: Recommendations2663 Medical Regimen and Use of Medications at Discharge2663 Late Hospital and Posthospital Oral Antiplatelet Therapy2664 Combined Oral Anticoagulant Therapy and Antiplatelet Therapy in Patients With NSTE-ACS2664 Risk Reduction Strategies for Secondary Prevention2664 Plan of Care for Patients With NSTE-ACS2665 Special Patient Groups: Recommendations2665 NSTE-ACS in Older Patients2665 Heart Failure and Cardiogenic Shock2665 Diabetes Mellitus2667 Post-CABG2668 Perioperative NSTE-ACS Related to Noncardiac Surgery2668 Chronic Kidney Disease2668 Women2668 Anemia, Bleeding, and Transfusion2668 Cocaine and Methamphetamine Users2668 Vasospastic (Prinzmetal) Angina2668 ACS With Angiographically Normal Coronary Arteries2669 Stress (Takotsubo) Cardiomyopathy2669 Quality of Care and Outcomes for ACS--Use of Performance Measures and Registries: Recommendation2669 Summary and Evidence Gaps2669 References2670 Appendix 1 Author Relationships With Industry and Other Entities (Relevant)2680 Appendix 2 Reviewer Relationships With Industry and Other Entities (Relevant)2683 Preamble The American College of Cardiology (ACC) and the American Heart Association (AHA) are committed to the prevention and management of cardiovascular diseases through professional education and research for clinicians, providers, and patients. Since 1980, the ACC and AHA have shared a responsibility to translate scientific evidence into clinical practice guidelines (CPGs) with recommendations to standardize and improve cardiovascular health.
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The ABCD study is recruiting and following the brain development and health of over 10,000 9–10 year olds through adolescence. The imaging component of the study was developed by the ABCD Data ...Analysis and Informatics Center (DAIC) and the ABCD Imaging Acquisition Workgroup. Imaging methods and assessments were selected, optimized and harmonized across all 21 sites to measure brain structure and function relevant to adolescent development and addiction. This article provides an overview of the imaging procedures of the ABCD study, the basis for their selection and preliminary quality assurance and results that provide evidence for the feasibility and age-appropriateness of procedures and generalizability of findings to the existent literature.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Background There are established guidelines for recommended dietary intake for hypertension treatment and cardiovascular disease prevention. Evidence is lacking for effective dietary patterns for ...kidney disease prevention. Study Design Prospective cohort study. Setting & Participants Atherosclerosis Risk in Communities (ARIC) Study participants with baseline estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m2 (N = 14,882). Predictor The Dietary Approaches to Stop Hypertension (DASH) diet score was calculated based on self-reported dietary intake of red and processed meat, sweetened beverages, sodium, fruits, vegetables, whole grains, nuts and legumes, and low-fat dairy products, averaged over 2 visits. Outcomes Cases were ascertained based on the development of eGFRs < 60 mL/min/1.73 m2 accompanied by ≥25% eGFR decline from baseline, an International Classification of Diseases, Ninth/Tenth Revision code for a kidney disease−related hospitalization or death, or end-stage renal disease from baseline through 2012. Results 3,720 participants developed kidney disease during a median follow-up of 23 years. Participants with a DASH diet score in the lowest tertile were 16% more likely to develop kidney disease than those with the highest score tertile (HR, 1.16; 95% CI, 1.07-1.26; P for trend < 0.001), after adjusting for sociodemographics, smoking status, physical activity, total caloric intake, baseline eGFR, overweight/obese status, diabetes status, hypertension status, systolic blood pressure, and antihypertensive medication use. Of the individual components of the DASH diet score, high red and processed meat intake was adversely associated with kidney disease and high nuts, legumes, and low-fat dairy products intake was associated with reduced risk for kidney disease. Limitations Potential measurement error due to self-reported dietary intake and lack of data for albuminuria. Conclusions Consuming a DASH-style diet was associated with lower risk for kidney disease independent of demographic characteristics, established kidney risk factors, and baseline kidney function. Healthful dietary patterns such as the DASH diet may be beneficial for kidney disease prevention.
The steep rise in music downloading over CD sales has created a major shift in the music industry away from physical media formats and towards online products and services. Music is one of the most ...popular types of online information and there are now hundreds of music streaming and download services operating on the World-Wide Web. Some of the music collections available are approaching the scale of ten million tracks and this has posed a major challenge for searching, retrieving, and organizing music content. Research efforts in music information retrieval have involved experts from music perception, cognition, musicology, engineering, and computer science engaged in truly interdisciplinary activity that has resulted in many proposed algorithmic and methodological solutions to music search using content-based methods. This paper outlines the problems of content-based music information retrieval and explores the state-of-the-art methods using audio cues (e.g., query by humming, audio fingerprinting, content-based music retrieval) and other cues (e.g., music notation and symbolic representation), and identifies some of the major challenges for the coming years.
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