Abstract only
Deer mice are native to high altitude (HA) at White Mountains in the Eastern Sierra Nevada. A colony has been maintained at a low altitude (LA) at the University of California Riverside ...(UCR, 252 m) and the
Peromyscus
Genetic Stock Center (Columbia, SC, 98 m), for 18 generations and shown to remain genetically similar to the wild strain. To examine how these mice re‐acclimatize to HA, one group (5 weeks old) was brought to the Barcroft Laboratory of the University of California White Mountain Research Center (HA, 3,800 m, n=13, body mass (BM) = 18.8±3.3 g) where they resided for 10 weeks before being studied at HA (15 weeks old). An age‐matched group was maintained and studied at UCR (LA, n=13, 22.5±4.1 g). Both groups were compared to outbred laboratory mice (Swiss Webster, SW) of similar age studied at UT Southwestern (80 m, n=8, 36.6±2.1 g).
Following measuring maximal O
2
uptake (V
O2max
), mice were anesthetized and mechanically ventilated. Lung function was measured by a rebreathing technique via a tracheal cannula. A test gas mixture (0.3% CO, 0.5% Ne, 0.8% C
2
H
2
, in either 40% or 90% O
2
and balance of N
2
) was delivered to the lung using a calibrated syringe and the mixture rebreathed for a pre‐determined period. Initial and final gas samples were diluted by a known factor and the concentrations measured by a gas chromatograph. Airway pressure‐volume curve was measured at incremental inflation volumes, and capillary blood hematocrit (Hct) was measured. Following euthanasia the lungs were fixed by tracheal instillation of 2.5% glutaraldehyde at 25 cmH
2
O of airway pressure. Lung volume was calculated from Ne dilution. Lung diffusing capaicty (DL
CO
) and pulmonary blood flow (Q) were calculated from the exponential disappearance of CO and C
2
H
2
, respectively. Duplicate measurements were obtained at each condition. From measurements made at two alvoelar O
2
tensions (PAO
2
) and the Hct, DL
CO
was expressed at a standard PAO
2
(120 mmHg) and Hct (0.45). Results normalized to BM (mean±SD) were compared across groups by ANOVA. P<0.05: * vs. SW, † vs. LA.
Compared to SW mice, BM was lower in deer mice (LA 22.5±4.1*, HA 18.8±3.3*† vs. SW 36.6±2.1 g); Hct was also lower (LA 0.42±0.02*, HA 0.44±0.04* vs. SW 0.45±0.04) but BM‐specific lung function results were similar between LA deer mice and SW mice. Compared to LA deer mice, HA deer mice had a lower BM; however, BM‐specific V
O2max
, Hct, and standardized DL
CO
were similar. Resting lung volume (HA 66.2±16.9 † vs. LA 47.2±10.0 ml.kg
−1
), and Q (HA 242±150 † vs. LA 142±47 ml.min.kg
−1
) were significantly higher. Postmortem volume of the fixed lung was also higher (HA 41.3±3.7 † vs. LA 33.2±5.6 ml.kg
−1
). Thus, deer mice bred at LA do not develop the expected increase in Hct or the decrement in V
O2max
upon re‐acclimatization to HA, indicating retention of phenotypic plasticity, which may be attributed to both structural (larger lung volume) and non‐structural (higher Q) mechanisms. It remains to be determined whether the larger lung volume in HA‐reacclimatized deer mice is accompanied by accelerated structural lung growth.
Support or Funding Information
Support: National Science Foundation Grant 145700
The 31P NMR spectra of CpRu(PR3)2Cl and Cp*Ru(PR3)2Cl complexes with PR3 = PMe3, PPhMe2, PPh2Me, PPh3, PEt3, P n Bu3 have been measured; these data correlate with and can be used to predict Ru–P ...bond distances and enthalpies. Their 31P NMR coordination chemical shifts (Δ(ppm) = δcomplex – δfree) show significant linear correlations with literature values of both the enthalpies of the ligand exchange reactions to form the Ru–P bonds and the average Ru–P bond distances from crystal structures. The strong correlation between Δ(ppm) and Ru–P distance can be extended to include the first-generation Grubbs metathesis catalyst (PCy3)2Cl2RuC(H)Ph and four of its derivatives, (PCy3)2Cl2RuC(H)(p-C6H4X) (X = OCH3, CH3, Cl, Br), the four related Fischer carbenes (PCy3)2Cl2RuC(H)ER (ER = OEt, SPh, N(carbazole), N(pyrrolidinone)), the second-generation Grubbs catalyst (PCy3)(IMes)Cl2RuC(H)Ph, and its derivative (PCy3)(IMes)Cl2RuC(H)OEt. Other significant correlations in the Cp′Ru(PR3)2Cl complexes are found between the enthalpies of reaction and Ru–P bond distances and between the cone angle and the Ru–P enthalpy, Ru–P bond distance, and Δ(ppm) values. The 31P NMR shifts for six phosphines correlate nearly linearly with their crystallographic cone angles, allowing prediction of cone angles from 31P NMR data.
Exclusive breastmilk feeding during the delivery hospitalization, a Joint Commission indicator of perinatal care quality, is associated with longer-term breastfeeding success. Marked racial and ...ethnic disparities in breastfeeding exclusivity and duration existed prior to COVID-19. The pandemic, accompanied by uncertainty regarding intrapartum and postpartum safety practices, may have influenced disparities in infant feeding practices. Our objective was to examine whether the first wave of the COVID-19 pandemic in New York City was associated with a change in racial and ethnic disparities in exclusive breastmilk feeding during the delivery stay.
We conducted a cross-sectional study of electronic medical records from 14,964 births in two New York City hospitals. We conducted a difference-in-differences (DID) analysis to compare Black-white, Latina-white, and Asian-white disparities in exclusive breastmilk feeding in a pandemic cohort (April 1-July 31, 2020, n=3122 deliveries) to disparities in a pre-pandemic cohort (January 1, 2019-February 28, 2020, n=11,842). We defined exclusive breastmilk feeding as receipt of only breastmilk during delivery hospitalization, regardless of route of administration. We ascertained severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection status from reverse transcription-polymerase chain reaction tests from nasopharyngeal swab at admission. For each DID model (e.g. Black-white disparity), we used covariate-adjusted log binomial regression models to estimate racial and ethnic risk differences, pandemic versus pre-pandemic cohort risk differences, and an interaction term representing the DID estimator.
Exclusive breastmilk feeding increased from pre-pandemic to pandemic among white (40.8% to 46.6%, p<0.001) and Asian (27.9% to 35.8%, p=0.004) women, but not Black (22.6% to 25.3%, p=0.275) or Latina (20.1% to 21.4%, p=0.515) women overall. There was an increase in the Latina-white exclusive breastmilk feeding disparity associated with the pandemic (DID estimator=6.3 fewer cases per 100 births (95% CI=-10.8, -1.9)). We found decreased breastmilk feeding specifically among SARS-CoV-2 positive Latina women (20.1% pre-pandemic vs. 9.1% pandemic p=0.013), and no change in Black-white or Asian-white disparities.
We observed a pandemic-related increase in the Latina-white disparity in exclusive breastmilk feeding, urging hospital policies and programs to increase equity in breastmilk feeding and perinatal care quality during and beyond this health emergency.
Background
Small intestinal bacterial overgrowth (SIBO) is defined by an increased number of bacteria measured via exhaled hydrogen and/or methane gas following the ingestion of glucose. This ...condition is prevalent following abdominal surgery, including Roux-en-Y gastric bypass (RYGB), and associated with a variety of non-specific abdominal symptoms, often requiring an extensive diagnostic work-up.
Aim
To assess the frequency that individuals with RYGB anatomy are diagnosed with SIBO and if they are more likely to report specific gastrointestinal (GI) symptoms compared to individuals with native anatomy.
Methods
This large matched cohort study evaluated patients with GI symptoms who underwent a glucose breath test (GBT) for SIBO evaluation, utilizing 1:2 matching between RYGB and native anatomy. Patients with positive GBT were included in univariate and multivariate analyses to distinguish the presence of ten specific GI symptoms between RYGB and native anatomy.
Results
A total of 17,973 patients were included, where 271 patients with RYGB were matched to 573 patients with native anatomy that underwent GBT. Patients with RYGB anatomy and a positive GBT (199; 73.4%) as compared to those with native anatomy and a positive GBT (209; 36%) more often reported nausea, vomiting, bloating, and diarrhea. There were no differences between the two groups in the report of heartburn, regurgitation, chest pain, gas, or constipation.
Conclusions
SIBO is common in patients with RYGB and more commonly report nausea, vomiting, bloating, and diarrhea. The results of this study suggest that the report of these symptoms in RYGB should prompt early evaluation for SIBO.
Type 2 diabetes mellitus is associated with obesity, dyslipidemia, and hypertension, all well-known risk factors for cardiovascular disease. Surgical weight loss has resulted in a marked reduction of ...these risk factors in adults. We hypothesized that gastric bypass would improve parameters of metabolic dysfunction and cardiovascular risk in adolescents with type 2 diabetes mellitus.
Eleven adolescents who underwent Roux-en-Y gastric bypass at 5 centers were included. Anthropometric, hemodynamic, and biochemical measures and surgical complications were analyzed. Similar measures from 67 adolescents with type 2 diabetes mellitus who were treated medically for 1 year were also analyzed.
Adolescents who underwent Roux-en-Y gastric bypass were extremely obese (mean BMI of 50 +/- 5.9 kg/m(2)) with numerous cardiovascular risk factors. After surgery there was evidence of remission of type 2 diabetes mellitus in all but 1 patient. Significant improvements in BMI (-34%), fasting blood glucose (-41%), fasting insulin concentrations (-81%), hemoglobin A1c levels (7.3%-5.6%), and insulin sensitivity were also seen. There were significant improvements in serum lipid levels and blood pressure. In comparison, adolescents with type 2 diabetes mellitus who were followed during 1 year of medical treatment demonstrated stable body weight (baseline BMI: 35 +/- 7.3 kg/m(2); 1-year BMI: 34.9 +/- 7.2 kg/m(2)) and no significant change in blood pressure or in diabetic medication use. Medically managed patients had significantly improved hemoglobin A1c levels over 1 year (baseline: 7.85% +/- 2.3%; 1 year: 7.1% +/- 2%).
Extremely obese diabetic adolescents experience significant weight loss and remission of type 2 diabetes mellitus after Roux-en-Y gastric bypass. Improvements in insulin resistance, beta-cell function, and cardiovascular risk factors support Roux-en-Y gastric bypass as an intervention that improves the health of these adolescents. Although the long-term efficacy of Roux-en-Y gastric bypass is not known, these findings suggest that Roux-en-Y gastric bypass is an effective option for the treatment of extremely obese adolescents with type 2 diabetes mellitus.
Avon's apparent success in using entrepreneurship to help women escape poverty, as well as its staying power in circumstances where similar efforts have failed, has captured the attention of the ...international development community. This study, the first independent empirical investigation, reports that in South Africa, Avon helps some impoverished women earn a better income and inspires empowerment among them. The authors introduce a new theory, pragmatist feminism, to integrate past work on women's entrepreneurship and argue that feminist scholars should reexamine the histories of the market democracies for replicable innovations that may have empowered women.
To determine contemporary incidence rates and risk factors for major adverse events in youth-onset T1D and T2D.
Participant interviews were conducted once during in-person visits from 2018 to 2019 in ...SEARCH (T1D: N = 564; T2D: N = 149) and semi-annually from 2014 to 2020 in TODAY (T2D: N = 495). Outcomes were adjudicated using harmonized, predetermined, standardized criteria.
Incidence rates (events per 10,000 person-years) among T1D participants were: 10.9 ophthalmologic; 0 kidney; 11.1 nerve, 3.1 cardiac; 3.1 peripheral vascular; 1.6 cerebrovascular; and 15.6 gastrointestinal events. Among T2D participants, rates were: 40.0 ophthalmologic; 6.2 kidney; 21.2 nerve; 21.2 cardiac; 10.0 peripheral vascular; 5.0 cerebrovascular and 42.8 gastrointestinal events. Despite similar mean diabetes duration, complications were higher in youth with T2D than T1D: 2.5-fold higher for microvascular, 4.0-fold higher for macrovascular, and 2.7-fold higher for gastrointestinal disease. Univariate logistic regression analyses in T1D associated age at diagnosis, female sex, HbA1c and mean arterial pressure (MAP) with microvascular events. In youth-onset T2D, composite microvascular events associated positively with MAP and negatively with BMI, however composite macrovascular events associated solely with MAP.
In youth-onset diabetes, end-organ events were infrequent but did occur before 15 years diabetes duration. Rates were higher and had different risk factors in T2D versus T1D.
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