The current study investigated the extent to which interparental support reduced pregnancy stress and subsequent postpartum bonding impairments with infant. We hypothesized that receiving higher ...quality partner support would be associated with decreased maternal pregnancy-related concerns, and less maternal and paternal pregnancy stress which, in turn, would predict fewer parent-infant bonding impairments. One hundred fifty-seven cohabiting couples completed semi-structured interviews and questionnaires once during pregnancy and twice postpartum. Path analyses with tests of mediation were employed to test our hypotheses. Higher quality support received by mothers was associated with lower maternal pregnancy stress which, in turn, predicted fewer mother-infant bonding impairments. An indirect pathway of equal magnitude was observed for fathers. Dyadic pathways also emerged such that higher quality support received by fathers was associated with lower
maternal
pregnancy stress which reduced mother-infant bonding impairments. Similarly, higher quality support received by mothers reduced
paternal
pregnancy stress and subsequent father-infant bonding impairments. Hypothesized effects reaching statistical significance (
p
< .05) were small to moderate in magnitude. These findings have important theoretical and clinical implications in demonstrating the critical role of both receiving and providing high-quality interparental support to reduce pregnancy stress and subsequent postpartum bonding impairments for mothers and fathers. Results also highlight the utility of investigating maternal mental health in the couple context.
Effect of Intravenous Infusion of Exenatide (Synthetic Exendin-4) on Glucose-Dependent Insulin Secretion and Counterregulation
During Hypoglycemia
Kristine B. Degn 1 2 ,
Birgitte Brock 1 2 ,
Claus B. ...Juhl 1 2 ,
Christian B. Djurhuus 1 ,
Jaime Grubert 3 ,
Dennis Kim 3 ,
Jenny Han 3 ,
Kristin Taylor 3 ,
Mark Fineman 3 and
Ole Schmitz 1 2
1 Department of Endocrinology and Diabetes, Aarhus University Hospital, Aarhus, Denmark
2 Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark
3 Amylin Pharmaceuticals, San Diego, California
Address correspondence and reprint requests to Ole Schmitz, MD, Department of Endocrinology and Diabetes, Aarhus University
Hospital, DK-8000 Aarhus C, Denmark. E-mail: ole.schmitz{at}iekf.au.dk
Abstract
This study assessed whether glucose-dependent insulin secretion and overall counterregulatory response are preserved during
hypoglycemia in the presence of exenatide. Twelve healthy fasted volunteers were randomized in a triple-blind crossover study
to receive either intravenous exenatide (0.066 pmol · kg −1 · min −1 ) or placebo during a 270-min stepwise hyperinsulinemic-hypoglycemic clamp (insulin infusion 0.8 mU · kg −1 · min −1 ). Plasma glucose was clamped sequentially at 5.0 (0–120 min), 4.0 (120–180 min), 3.2 (180–240 min), and 2.7 mmol/l (240–270
min). At 270 min, insulin infusion was terminated and plasma glucose increased to ∼3.2 mmol/l. The time to achieve plasma
glucose ≥4 mmol/l thereafter was recorded. Insulin secretory rates (ISRs) and counterregulatory hormones were measured throughout.
Glucose profiles were superimposable between the exenatide and placebo arms. In the presence of euglycemic hyperinsulinemia,
ISRs in the exenatide arm were ∼3.5-fold higher than in the placebo arm (353 ± 29 vs. 100 ± 29 pmol/min least-square means
± SE). However, ISRs declined similarly and rapidly at all hypoglycemic steps (≤4 mmol/l) in both groups. Glucagon was suppressed
in the exenatide arm during euglycemia and higher than placebo during hypoglycemia. Plasma glucose recovery time was equivalent
for both treatments. The areas under the concentration-time curve from 270 to 360 min for cortisol, epinephrine, norepinephrine,
and growth hormone were similar between treatment arms. There were no differences in adverse events. In the presence of exenatide,
there was a preserved, glucose-dependent insulin secretory response and counterregulatory response during hypoglycemia.
FFA, free fatty acid
GLP, glucagon-like peptide
ISR, insulin secretory rate
Footnotes
O.S. holds stock in Amylin.
Accepted June 14, 2004.
Received February 16, 2004.
DIABETES
Cancer patients have worse outcomes from the COVID-19 infection and greater need for ventilator support and elevated mortality rates than the general population. However, previous artificial ...intelligence (AI) studies focused on patients without cancer to develop diagnosis and severity prediction models. Little is known about how the AI models perform in cancer patients. In this study, we aim to develop a computational framework for COVID-19 diagnosis and severity prediction particularly in a cancer population and further compare it head-to-head to a general population.
We have enrolled multi-center international cohorts with 531 CT scans from 502 general patients and 420 CT scans from 414 cancer patients. In particular, the habitat imaging pipeline was developed to quantify the complex infection patterns by partitioning the whole lung regions into phenotypically different subregions. Subsequently, various machine learning models nested with feature selection were built for COVID-19 detection and severity prediction.
These models showed almost perfect performance in COVID-19 infection diagnosis and predicting its severity during cross validation. Our analysis revealed that models built separately on the cancer population performed significantly better than those built on the general population and locked to test on the cancer population. This may be because of the significant difference among the habitat features across the two different cohorts.
Taken together, our habitat imaging analysis as a proof-of-concept study has highlighted the unique radiologic features of cancer patients and demonstrated effectiveness of CT-based machine learning model in informing COVID-19 management in the cancer population.
A multi-objective genetic algorithm (MOGA) was used to automate a search for optimized pseudopotential parameters. Pseudopotentials were generated using the atomPAW program and density functional ...theory (DFT) simulations were conducted using the pwPAW program. The optimized parameters were the cutoff radius and projector energies for the s and p orbitals. The two objectives were low pseudopotential error and low computational work requirements. The error was determined from (1) the root mean square difference between the all-electron and pseudized-electron log derivative, (2) the calculated lattice constant versus reference data of Holzwarth et al., and (3) the calculated bulk modulus versus reference potentials. The computational work was defined as the number of flops required to perform the DFT simulation. Pseudopotential transferability was encouraged by optimizing each element in different lattices: (1) nitrogen in GaN, AlN, and YN, (2) oxygen in NO, ZnO, and SiO4, and (3) fluorine in LiF, NaF, and KF. The optimal solutions were equivalent in error and required significantly less computational work than the reference data. This proof-of-concept study demonstrates that the combination of MOGA and ab-initio simulations is a powerful tool that can generate a set of transferable potentials with a trade-off between accuracy (error) and computational efficiency (work).
To investigate whether software optimisation can improve an observers’ perception of image quality in low dose paediatric pelvic examinations.
Twenty-five consecutive patients (3–7 years old) were ...referred for a pelvic digital radiography (DR) examination. They were prospectively enrolled in the study over a 3-month period. Images were taken at 80 kV and 2–4 mAs depending on pelvic thickness (9–15 cm). A small focal spot, 130 cm SID: 10 cm air gap and 1 mm Al and 0.2 mm Cu additional filtration were also utilised. Images were acquired on a Canon DR detector and optimised using five different combinations of the multi-frequency processing software (Canon DR system version NE, Version 7.1 with SPECTRA) to comply with the ALARA principle. Image quality was blindly evaluated using the subjective Visual Grading Analysis (VGA) by five experienced musculoskeletal radiologists, including the evaluation of six anatomical image quality criteria (scored from 1 to 5).
Consistently, the VGA results indicated that by using software optimised parameters, image quality was suitable for diagnosis in 48–71% of all images. Based on a VGC analysis all software optimised images did have significant better image quality then the one with just the clinical settings. Noise reduction was the software setting which influenced the image quality the most, area under the curve (AUC) of 0.8172 95%CI 0.7953–0.8375.
Software optimisation improve the radiologists' perception of image quality and should thus be thoroughly considered within clinical practise. Noise reduction is the software parameter which has the greatest influence.
•Multi-frequency image processing can influence an observer's perception of image quality.•Noise reduction was found to be the only processing parameter that could improve image quality.•Low dose femur DR examinations can be used diagnostically when software optimization is applied.
Because of the ubiquity of phthalates and their potential role in increasing risk for cancer and reproductive dysfunction, the need for human exposure assessment studies is urgent. In response to ...this need, we developed a high-throughput, robust, sensitive, accurate, and precise assay for simultaneous measurement of trace levels of eight phthalate metabolites in human urine by HPLC−MS/MS. Human urine samples were processed using enzymatic deconjugation of the glucuronides followed by solid-phase extraction. The eluate was concentrated, and the phthalate metabolites were chromatographically resolved by reversed-phase HPLC, detected by APCI-tandem mass spectrometry, and quantified by isotope dilution. This selective analytical method permits rapid detection (7.7 min total run time) of eight urinary metabolites of the most commonly used phthalates with detection limits in the low nanagram per milliliter range. Assay precision was improved by incorporating 13C4-labeled internal standards for each of the eight analytes, as well as a conjugated internal standard to monitor deconjugation efficiency. This selective, sensitive, and rapid method will help elucidate potential associations (if any) between human exposure to phthalates and adverse health effects.
A PowerPC system-on-a-chip processor which makes use of dynamic voltage scaling and on-the-fly frequency scaling to adapt to the dynamically changing performance demands and power consumption ...constraints of high-content, battery powered applications is described. The PowerPC core and caches achieve frequencies as high as 380 MHz at a supply of 1.8 V and active power consumption as low as 53 mW at a supply of 1.0 V. The system executes up to 500 MIPS and can achieve standby power as low as 54 /spl mu/W. Logic supply changes as fast as 10 mV//spl mu/s are supported. A low-voltage PLL supplied by an on-chip regulator, which isolates the clock generator from the variable logic supply, allows the SOC to operate continuously while the logic supply voltage is modified. Hardware accelerators for speech recognition, instruction-stream decompression and cryptography are included in the SOC. The SOC occupies 36 mm/sup 2/ in a 0.18 /spl mu/m, 1.8 V nominal supply, bulk CMOS process.
Polychlorinated biphenyls (PCBs) are persistent pollutants that are ubiquitous in the food chain, and detectable amounts are in the blood of almost every person in most populations that have been ...examined. Extensive evidence from animal studies shows that PCBs are neurotoxins, even at low doses. Interpretation of human data regarding low-level, early-life PCB exposure and subsequent neurodevelopment is problematic because levels of exposure were not similarly quantified across studies. We expressed the exposure levels from 10 studies of PCB and neurodevelopment in a uniform manner using a combination of data from original investigators, laboratory reanalyses, calculations based on published data, and expert opinion. The mainstay of our comparison was the median level of PCB 153 in maternal pregnancy serum. The median concentration of PCB 153 in the 10 studies ranged from 30 to 450 ng/g serum lipid, and the median of the 10 medians was 110 ng/g. We found that a) the distribution of PCB 153 exposure in most studies overlapped substantially, b) exposure levels in the Faroe Islands study were about 3-4-fold higher than in most other studies, and c) the exposure levels in the two recent U.S. studies were about one-third of those in the four earlier U.S. studies or recent Dutch, German, and northern Québec studies. Our results will facilitate a direct comparison of the findings on PCBs and neurodevelopment when they are published for all 10 studies.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NMLJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The morphological disparity of lophotrochozoan phyla makes it difficult to predict the morphology of the last common ancestor. Only fossils of stem groups can help discover the morphological ...transitions that occurred along the roots of these phyla. Here, we describe a tubular fossil Yuganotheca elegans gen. et sp. nov. from the Cambrian (Stage 3) Chengjiang Lagerstätte (Yunnan, China) that exhibits an unusual combination of phoronid, brachiopod and tommotiid (Cambrian problematica) characters, notably a pair of agglutinated valves, enclosing a horseshoe-shaped lophophore, supported by a lower bipartite tubular attachment structure with a long pedicle with coelomic space. The terminal bulb of the pedicle provided anchorage in soft sediment. The discovery has important implications for the early evolution of lophotrochozoans, suggesting rooting of brachiopods into the sessile lophotrochozoans and the origination of their bivalved bauplan preceding the biomineralization of shell valves in crown brachiopods.
Summary Introduction Idiopathic testicular/groin pain can be a difficult entity for children, their families, and caregivers. The role of interdisciplinary pain management has previously been ...demonstrated in treating chronic orchialgia at the present pediatric pain clinic. Objective To evaluate the role of interdisciplinary pain management in managing refractory orchialgia. It was hypothesized that children with refractory orchialgia might respond well. Interdisciplinary care was defined as that which crosses two medical disciplines such as a surgical specialty and specialist in analgesia. Subjects and methods Pediatric patients were identified who were: ≥10 years old; evaluated in the pediatric urology clinic between 2002 and 2012; were diagnosed wtih ICD code 608.9 or had the diagnosis of male genital disorder NOS. Children were included if they presented with orchialgia without an identifiable cause and failed conservative management (rest, scrotal support, Sitz bath, timed voiding, constipation avoidance) including conventional anti-nociceptive analgesics (acetaminophen, non-steroidal anti-inflammatory drugs, opioids). Patient electronic medical records were reviewed retrospectively. Results Twenty-two children met inclusion criteria. Mean age was 13.7 years (range 10–17). Nearly half (45%) of the children had chronic medical conditions such as asthma, allergies, and obesity. Twenty-one of the 22 children were referred to the pediatric pain clinic; 15 were evaluated, and one refused treatment. All children evaluated in the pediatric pain clinic were initially offered an empiric anti-neuropathic anti-convulsant (i.e. gabapentin) and/or an anti-depressant (i.e. amitriptyline) before being offered a nerve block. Of the 14 children accepting treatment in the pediatric pain clinic, six were treated solely with an empiric anti-neuropathic anti-convulsant and/or anti-depressant; eight received medications followed by nerve block (seven ilioinguinal–iliohypogastric blocks, one spinal and ilioinguinal–iliohypogastric block) (see Fig. 1). A total of eight of the 14 children (57%) treated by the pain clinic had resolution of pain, with 50% of those treated with medications alone (three out of six children) responding (two responding to gabapentin and a tricyclic antidepressant, one to gabapentin alone); and five out of eight (63%) treated with medications and then nerve block (ilioinguinal–iliohypogastric block) responding. Of the eight children undergoing nerve block, five required more than one block. The time between each block ranged from 4 to 22.6 weeks. Response to nerve block required an average of 1.4 procedures (range 1–2); mean follow-up after nerve block was 2.4 months (range 0.1–4.8). Discussion Children with refractory orchialgia often have comorbidities that suggest a multidisciplinary approach would be useful for treating them. The present study found that the majority of children with refractory orchialgia treated in the pediatric pain clinic responded to management. Major limitations, however, included small cohort size and short follow-up, particularly in those children undergoing nerve block. There was also no objective assessment of pain improvement or improvement in quality of life, which could be rectified with a prospective study. Conclusion Collaboration and early referral for interdisciplinary pain management as one of these multidisciplinary approaches may help to coordinate care and ease patient suffering. Figure 1 Treatments and outcomes.
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