We study the stellar halo colour properties of six nearby massive highly inclined disc galaxies using Hubble space telescope Advanced Camera for Surveys and Wide Field Camera 3 observations in both ...F606W and F814W filters from the GHOSTS (Galaxy Halos, Outer disks, Substructure, Thick disks, and Star clusters) survey. The observed fields probe the stellar outskirts out to projected distances of ∼50–70 kpc from their galactic centre along the minor axis. The 50 per cent completeness levels of the colour–magnitude diagrams are typically at 2 mag below the tip of the red giant branch (RGB). We find that all galaxies have extended stellar haloes out to ∼50 kpc and two out to ∼70 kpc. We determined the halo colour distribution and colour profile for each galaxy using the median colours of stars in the RGB. Within each galaxy, we find variations in the median colours as a function of radius which likely indicates population variations, reflecting that their outskirts were built from several small accreted objects. We find that half of the galaxies (NGC 0891, NGC 4565, and NGC 7814) present a clear negative colour gradient in their haloes, reflecting a declining metallicity; the other have no significant colour or population gradient. In addition, notwithstanding the modest sample size of galaxies, there is no strong correlation between their halo colour/metallicity or gradient with galaxy's properties such as rotational velocity or stellar mass. The diversity in halo colour profiles observed in the GHOSTS galaxies qualitatively supports the predicted galaxy-to-galaxy scatter in halo stellar properties, a consequence of the stochasticity inherent in the assembling history of galaxies.
We study the stellar halo color properties of six nearby massive highly inclined disk galaxies using Hubble Space Telescope Advanced Camera for Surveys and Wide Field Camera 3 observations in both ...F606W and F814W filters from the GHOSTS survey. The observed fields, placed both along the minor and major axis of each galaxy, probe the stellar outskirts out to projected distances of ~ 50-70 kpc from their galactic centre along the minor axis. The 50% completeness levels of the color magnitude diagrams are typically at two mag below the tip of the red giant branch. We find that all galaxies have extended stellar halos out to ~ 50 kpc and two out to ~ 70 kpc. We determined the halo color distribution and color profile for each galaxy using the median colors of stars in the RGB. Within each galaxy we find variations in the median colors as a function of radius which likely indicates population variations, reflecting that their outskirts were built from several small accreted objects. We find that half of the galaxies (NGC 0891, NGC 4565, and NGC 7814) present a clear negative color gradient, reflecting a declining metallicity in their halos; the other have no significant color or population gradient. In addition, notwithstanding the modest sample size of galaxies, there is no strong correlation between their halo color/metallicity or gradient with galaxy's properties such as rotational velocity or stellar mass. The diversity in halo color profiles observed in the GHOSTS galaxies qualitatively supports the predicted galaxy-to-galaxy scatter in halo stellar properties; a consequence of the stochasticity inherent in the assembling history of galaxies.
Purpose: To evaluate the feasibility and acceptability of a protocol determining the relationship between emergency team response (ETR) during childbirth and acute stress disorder (ASD) and ...post-traumatic stress disorder (PTSD) symptoms.
Methods: In a prospective, observational, cohort design, women experiencing ETR during childbirth were approached and recruited on postpartum day-1 and followed for six weeks. Demographics, obstetric and birth characteristics, ASD scores and PTSD scores (by Impact of Events Scale, IES and PCL-civilian) were recorded. Recruitment and retention rates were recorded, and scores were compared to women who did not experience ETR.
Results: Three hundred sixty-nine were approached and 249 were enrolled (67.5% recruitment rate). One hundred twenty-five completed all procedures (50.2% retention). Twenty experienced ETR (3.5% event rate), 12 enrolled (60.0% recruitment rate) and 8 completed the study (66.7% retention). The ETR group had higher PCL and IES scores (PCL: ETR median 12, non-ETR median 2, p = .08; IES: ETR median 22.5, non-ETR median 20, p = .08). ASD scores were similar between groups.
Conclusions: Methodology investigating the link between ETR and postpartum psychological distress is feasible and acceptable. A relationship between ETR and PTSD symptoms appears to exist, with ETR being associated with higher PTSD scores compared to non-ETR childbirths. Methods that incorporate awareness of the unique concerns of vulnerable populations are needed.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Introduction
Vestibulodynia (VBD) is the most common cause of sexual pain in the United States, affecting up to 15% of reproductive-aged women during their lifetime with limited treatment options. ...The purpose of this study was to describe ideal physical characteristics of a vulvar film designed for insertional sexual pain in sexually active women with VBD.
Methods
Twenty women were recruited to participant in one of six, semi-structured 60-minute focus group discussions regarding treatment options for VBD. Heterosexual women, aged 18–51 years old with a diagnosis of vulvodynia, vestibulodynia or insertional dyspareunia fit the inclusion criteria. Those who reported no episodes of vaginal intercourse in the prior 18 months were excluded. A new vulvar film technology loaded with 50 mg of 5% lidocaine was introduced to the group. Participants took part in focus groups on a rolling basis depending on availability. Focus group discussions were audio-recorded and transcribed verbatim. Two study investigators coded the transcripts using inductive coding and merged their respective projects to resolve disagreements. We analyzed data related to each code to develop code clusters and higher-level primary topics regarding device preferences. Data related to each of these primary topics was analyzed to assess the range of participant attitudes and preferences and to identify patterns within each primary topic.
Results
One hundred and sixteen women were recruited, and twenty women were enrolled. The mean age for the participants was 33.3 years. Most women were educated with at least some college (93%), White (78.6%), married (75%), and had income greater than $100,000 (50%). Analysis of the focus group discussions identified five common topics addressed by participants: desired loaded medication, film size, film shape, film flexibility, and ease and accuracy of use. Concerns across topics included comfort, sexual spontaneity, and efficacy. Interest in loading the device with other acceptable medications or combination with lidocaine was independently noted in 2/6 (33%) of the focus groups.
Discussion
Mucoadhesive vulvar thin films may be an acceptable drug delivery system for insertional sexual pain for women with VBD.
Abstract
Background
Recurrent Clostridioides difficile infection (CDI) in patients with inflammatory bowel disease (IBD) is a clinical challenge. Fecal microbiota transplantation (FMT) has emerged as ...a recurrent CDI therapy. Anecdotal concerns exist regarding worsening of IBD activity; however, prospective data among IBD patients are limited.
Methods
Secondary analysis from an open-label, prospective, multicenter cohort study among IBD patients with 2 or more CDI episodes was performed. Participants underwent a single FMT by colonoscopy (250 mL, healthy universal donor). Secondary IBD-related outcomes included rate of de novo IBD flares, worsening IBD, and IBD improvement—all based on Mayo or Harvey-Bradshaw index (HBI) scores. Stool samples were collected for microbiome and targeted metabolomic profiling.
Results
Fifty patients enrolled in the study, among which 15 had Crohn’s disease (mean HBI, 5.8 ± 3.4) and 35 had ulcerative colitis (mean partial Mayo score, 4.2 ± 2.1). Overall, 49 patients received treatment. Among the Crohn’s disease cohort, 73.3% (11 of 15) had IBD improvement, and 4 (26.6%) had no disease activity change. Among the ulcerative colitis cohort, 62% (22 of 34) had IBD improvement, 29.4% (11 of 34) had no change, and 4% (1 of 34) experienced a de novo flare. Alpha diversity significantly increased post-FMT, and ulcerative colitis patients became more similar to the donor than Crohn’s disease patients (P = 0.04).
Conclusion
This prospective trial assessing FMT in IBD-CDI patients suggests IBD outcomes are better than reported in retrospective studies.
IMPORTANCE: Because of the substantial increase in the occurrence of type 2 diabetes in the pediatric population and the medical complications of this condition, therapies are urgently needed that ...will achieve better glycemic control than standard medical management. OBJECTIVE: To compare glycemic control in cohorts of severely obese adolescents with type 2 diabetes undergoing medical and surgical interventions. DESIGN, SETTING, AND PARTICIPANTS: A secondary analysis of data collected by the Teen–Longitudinal Assessment of Bariatric Surgery (Teen-LABS) and Treatment Options of Type 2 Diabetes in Adolescents and Youth (TODAY) consortia was performed. Teen-LABS enrolled 242 adolescents (≤19 years of age) from March 1, 2007, through December 31, 2011. TODAY randomized 699 participants (aged 10-17 years) from July 24, 2004, through February 25, 2009. Data analysis was performed from July 6, 2015, to June 24, 2017. Anthropometric, clinical, and laboratory data from adolescents with severe obesity and type 2 diabetes who underwent treatment with metabolic or bariatric surgery in the Teen-LABS study or medical therapy in the TODAY study were compared. INTERVENTIONS: Teen-LABS participants underwent a primary bariatric surgical procedure; TODAY participants were randomized to receive metformin therapy alone or in combination with rosiglitazone or an intensive lifestyle intervention; insulin therapy was given in cases of progression of disease. MAIN OUTCOMES AND MEASURES: Glycemic control, body mass index, prevalence of elevated blood pressure, dyslipidemia, abnormal kidney function, and clinical adverse events were measured. RESULTS: Data from 30 participants from Teen-LABS (mean SD age at baseline, 16.9 1.3 years; 21 70% female; 18 66% white) and 63 from TODAY (mean SD age at baseline, 15.3 1.3 years; 28 44% female; 45 71% white) were analyzed. During 2 years, mean hemoglobin A1c concentration decreased from 6.8% (95% CI, 6.4%-7.3%) to 5.5% (95% CI, 4.7% -6.3%) in Teen-LABS and increased from 6.4% (95% CI, 6.1%-6.7%) to 7.8% (95% CI, 7.2%-8.3%) in TODAY. Compared with baseline, the body mass index decreased by 29% (95% CI, 24%-34%) in Teen-LABS and increased by 3.7% (95% CI, 0.8%-6.7%) in TODAY. Twenty-three percent of Teen-LABS participants required a subsequent operation during the 2-year follow-up. CONCLUSIONS AND RELEVANCE: Compared with medical therapy, surgical treatment of severely obese adolescents with type 2 diabetes was associated with better glycemic control, reduced weight, and improvement of other comorbidities. These data support the need for a well-designed, prospective controlled study to define the role of surgery for adolescents with type 2 diabetes, including health and surgical outcomes.
To compare general ophthalmologists, retina specialists, and the EyeArt Artificial Intelligence (AI) system to the clinical reference standard for detecting more than mild diabetic retinopathy ...(mtmDR).
Prospective, pivotal, multicenter trial conducted from April 2017 to May 2018.
Participants were aged ≥ 18 years who had diabetes mellitus and underwent dilated ophthalmoscopy. A total of 521 of 893 participants met these criteria and completed the study protocol.
Participants underwent 2-field fundus photography (macula centered, disc centered) for the EyeArt system, dilated ophthalmoscopy, and 4-widefield stereoscopic dilated fundus photography for reference standard grading.
For mtmDR detection, sensitivity and specificity of EyeArt gradings of 2-field, fundus photographs and ophthalmoscopy grading versus a rigorous clinical reference standard comprising Reading Center grading of 4-widefield stereoscopic dilated fundus photographs using the ETDRS severity scale. The AI system provided automatic eye-level results regarding mtmDR.
Overall, 521 participants (999 eyes) at 10 centers underwent dilated ophthalmoscopy: 406 by nonretina and 115 by retina specialists. Reading Center graded 207 positive and 792 eyes negative for mtmDR. Of these 999 eyes, 26 eyes were ungradable by the EyeArt system, leaving 973 eyes with both EyeArt and Reading Center gradings. Retina specialists correctly identified 22 of 37 eyes as positive (sensitivity 59.5%) and 182 of 184 eyes as negative (specificity 98.9%) for mtmDR versus the EyeArt AI system that identified 36 of 37 as positive (sensitivity 97%) and 162 of 184 eyes as negative (specificity of 88%) for mtmDR. General ophthalmologists correctly identified 35 of 170 eyes as positive (sensitivity 20.6%) and 607 of 608 eyes as negative (specificity 99.8%) for mtmDR compared with the EyeArt AI system that identified 164 of 170 as positive (sensitivity 96.5%) and 525 of 608 eyes as negative (specificity 86%) for mtmDR.
The AI system had a higher sensitivity for detecting mtmDR than either general ophthalmologists or retina specialists compared with the clinical reference standard. It can potentially serve as a low-cost point-of-care diabetic retinopathy detection tool and help address the diabetic eye screening burden.
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