Factors associated with the intellectual ability of children born to women with high risk pregnancies.

The intellectual abilities of 242 children born to women who had been hypertensive during pregnancy were assessed at the age of 7 1/2 years. Associations between 15 maternal, fetal, perinatal, postnatal and environmental factors, and test scores were investigated. After adjustment for confounding variables children in the upper social classes, born to non-smokers, who were first born, breast fed, and with birth weights above the 10th centile had significantly higher scores in some aspects of ability than the rest. Children whose mothers had developed superimposed pre-eclampsia had higher scores than those whose mothers had not suffered preeclampsia; and children delivered by elective caesarean section had lower scores than those delivered spontaneously. In a small subgroup of women with particularly high risk pregnancies perinatal mortality had been 10 times greater than in the rest of the sample. At 7 1/2 years the intellectual ability of the survivors in this subgroup did not differ from that of the rest. These findings do not support the notion that there is a quantitative continuum of "reproductive casualty" from mortality to morbidity.     

Lipoprotein metabolism of pregnant women is associated with both their genetic polymorphisms and those of their newborn children

To explore whether the placenta contributes to the lipoprotein metabolism of pregnant women, we took advantage of the fact that placental proteins are encoded from the fetal genome and examined the associations between lipids of 525 pregnant women and the presence, in their newborns, of genetic polymorphisms of LPL and apolipoprotein E (APOE), two genes expressed in placenta. After adjustment for maternal polymorphisms, newborn LPL*S447X was associated with lower triglycerides (-21 +/- 9 mg/dl), lower LDL-cholesterol (LDL-C; -12 +/- 5 mg/dl), lower apoB (-14 +/- 4 mg/dl), higher HDL-C (5 +/- 2 mg/dl), and higher apoA-I (9 +/- 4 mg/dl) in their mothers; newborn LPL*N291S was associated with higher maternal triglycerides (114 +/- 31 mg/dl); and newborn APOE*E2 (compared to E3E3) was associated with higher maternal LDL-C (14 +/- 6 mg/dl) and higher maternal apoB (14 +/- 5 mg/dl). These associations (all P < 0.05) were independent of polymorphisms carried by the mothers and of lipid concentrations in newborns and were similar in amplitude to the associations between maternal polymorphisms and maternal lipids. Such findings support the active role of placental LPL and APOE in the metabolism of maternal lipoproteins and suggest that fetal genes may modulate the risk for problems related to maternal dyslipidemia (preeclampsia, pancreatitis, and future cardiovascular disease).     

Protein kinases and their protein substrates associated with chromatin and ribosomes in SV40-transformed rat cells.

The level of endogenous protein phosphorylation in non-histone chromosomal and ribosomal wash proteins is 7--10 times greater in SV40-transformed rat cells than in untransformed parental cells. Protein kinase activity in these proteins was fractionated by either phosphocellulose or DEAE-cellulose chromatography. One major and one minor component were detected in non-histone proteins and only one component in ribosomal wash proteins when the activity in each fraction was measured with an exogenous substrate, casein. These enzymes prefer casein to whole histone as substrate and are cyclic AMP-independent. The enzyme activity in a major peak of non-histone proteins and in ribosomal wash proteins measured with casein as substrate is 3 times greater in transformed cells than in untransformed cells, whereas pH optimum, cation requirements and apparent Km values for casein and ATP are identical or very similar in the two cell types. No significant phosphatase was detected in non-histone and ribosomal wash proteins from the two types of cell. The patterns of endogenous protein phosphorylation in these protein fractions analysed by gel electrophoresis are significantly different between these cells. These results suggest that the high level of endogenous protein phosphorylation in non-histone and ribosomal wash proteins from SV40-transformed cells is caused mainly by the increased activity of protein kinase and the nature of protein substrates.     

Factors affecting nitrogenase activity associated with marsh grasses and their soils from eutrophic lakes

The acetylene reduction activity (ARA) of soil-plant cores and intact, soil-free plant-root systems was used to study the influence of soil moisture content, diurnal cycles of temperature and light, and inorganic N and P on the nitrogenase activity (AR) associated with Phalaris arundinacea L. and Phragmites australis (Cav.) Trin. from two eutrophic lakes (lochs), Balgavies and Forfar.A positive correlation (r = 0.81, n = 26) was established between AR and soil moisture content in individual soil-plant cores of Phalaris from Forfar Loch. Nitrogenase activity, soil moisture and NO₂⁻-N increased with decreasing distance from lake water in Balgavies Loch.Diurnal fluctuations in AR, probably attributable to a combined effect of soil temperature and illumination changes, were observed under field conditions for Phalaris and Phragmites. Under laboratory conditions, the shading and cutting of Phalaris shoots did not inhibit ARA, which suggested that new photosynthates did not necessarily supply substrate for activity in the short term.Partial and temporary inhibition of ARA was obtained in dissected soil-plant cores after a single application of NH₄⁺-N and NO₃⁻-N (350 μg N g⁻¹ fresh weight). At concentrations equivalent to 300 μg P g⁻¹ fresh weight of Phalaris cores, PO₄³⁻-P also caused partial and temporary inhibition of ARA of soil-free plant-root systems, but stimulated activity in intact simulated in situ systems.     

American and European recommendations for screening mammography in younger women: a cultural divide?

The American Cancer Society advocates mammography screening for all women from age 40, whereas in Europe it is not recommended for women below the age of 50. Randomised prospective studies have failed to show a significant benefit from screening women aged under 50 and five potentially harmful effects of screening should be considered: lead time, overdiagnosis, radiation exposure, false positive results, and cost. Younger women must be properly informed about the potential for harm as well as for benefit before screening.     

Factors associated with the preincubation effect of hypoxic cell sensitizers in vitro and their possible implications in chemosensitization

The enhancement of melphalan toxicity was observed by preincubation of V-79- 379A cells in spinner culture with multiple doses of misonidazole (miso) or SR-2508 under hypoxic conditions. Chemosensitization was shown to be a function of sensitizer concentration and duration of exposure to the alkylating agent. A preincubation exposure of cells with 5 mM miso reduced endogenous cell thiols to less than 5% of controls and enhanced melphalan toxicity by a factor of 4.7. Cells preincubated with miso not only had lower levels of nonprotein thiols, but also were shown to have altered levels of intracellular calcium and a lower threshold to oxidative stress as measured by toxicity to cysteamine or H2O2. Preincubated cells, hypoxic cells, and cells receiving moderate hyperthermia (42.5 degrees C for 3 hr) all showed increased sensitivity to either cysteamine or H2O2. The increased killing of preincubated cells by cysteamine was shown to be similar to that of H2O2, and the dramatic reduction of cysteamine toxicity by catalase indicated H2O2 was the major reaction associated with this effect. These results indicate that preincubated cells exhibit a variety of biological effects that may significantly influence their response to further treatment with drugs or radiation, especially where peroxidative and free radical mechanisms are involved. The depletion of endogenous thiols, calcium disturbance, and vulnerability to oxidative stress are factors to be considered when interpreting mechanisms of combined drug action and effects that may potentially be exploited in terms of therapeutic gains.     

Factors associated with neonatal lamb mortality

Three factors were associated with lamb neonatal mortality: birthweight (P<0.003), number of lambs born per ewe (P<0.001) and lamb sex (P<0.32). Lamb birthweight had the greatest predictive power for survival during the neonatal period. The neonatal mortality rate was 14.3%. The age specific mortality for lambs one day old was 7.9% (P<0.05). Seventy-nine percent of the lambs that died, did so by the end of the fourth post-natal day. Starvation was associated with 58.3% (P < 0.05) of the lamb deaths.     

Factors associated with colposcopy-histopathology confirmed cervical intraepithelial neoplasia among HIV-infected women from Rio De Janeiro, Brazil

Introduction

Despite the availability of preventive strategies (screening tests and vaccines), cervical cancer continues to impose a significant health burden in low- and medium-resourced countries. HIV-infected women are at increased risk for infection with human papillomavirus (HPV) and thus development of cervical squamous intraepithelial neoplasia (CIN).

Methods

Study participants included HIV-infected women enrolling the prospective open cohort of Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation (IPEC/FIOCRUZ). At cohort entry, women were subjected to conventional Papanicolaou test, HPV-DNA test and colposcopy; lesions suspicious for CIN were biopsied. Histopathology report was based on directed biopsy or on specimens obtained by excision of the transformation zone or cervical conization. Poisson regression modeling was used to assess factors associated with CIN2+ diagnosis.

Results

The median age of the 366 HIV-infected women included in the study was 34 years (interquartile range: 28–41 years). The prevalence of CIN1, CIN2 and CIN3 were 20.0%, 3.5%, and 2.2%, respectively. One woman was found to have cervical cancer. The prevalence of CIN2+ was 6.0%. Factors associated with CIN2+ diagnosis in the multivariate model were age < years compared to ≥35 years (aPR  =  3.22 95%CI 1.23–8.39), current tobacco use (aPR  =  3.69 95%CI 1.54–8.78), nadir CD4 T-cell count <350 cells/mm3 when compared to ≥ 350 cells/mm3 (aPR  =  6.03 95%CI 1.50–24.3) and concomitant diagnosis of vulvar and/or vaginal intraepithelial lesion (aPR  =  2.68 95%CI 0.99–7.24).

Discussion

Increased survival through wide-spread use of highly active antiretroviral therapy might allow for the development of cervical cancer. In Brazil, limited cytology screening and gynecological care adds further complexity to the HIV-HPV co-infection problem. Integrated HIV care and cervical cancer prevention programs are needed for the prevention of cervical cancer mortality in this group of women.     

Factors associated with unfavourable birth outcomes in Kenya

Studies addressing factors associated with adverse birth outcomes have almost exclusively been based on hospital statistics. This is a serious limitation in developing countries where the majority of births do not occur within health facilities. This paper examines factors associated with premature deliveries, small baby's size at birth and Caesarean section deliveries in Kenya based on the 1993 Kenya Demographic and Health Survey data. Due to the hierarchical nature of the data, the analysis uses multilevel logistic regression models to take into account the family and community effects. The results show that the odds of unfavourable birth outcomes are significantly higher for first births than for higher order births. Furthermore, antenatal care (measured by frequency of antenatal care visits and tetanus toxoid injection) is observed to have a negative association with the incidence of premature births. For the baby's size at birth, maternal nutritional status is observed to be a predominant factor. Short maternal stature is confirmed as a significant risk factor for Caesarean section deliveries. The observed higher odds of Caesarean section deliveries among women from households of high socioeconomic status are attributed to the expected association between socioeconomic status and the use of appropriate maternal health care services. The odds of unfavourable birth outcomes vary significantly between women. In addition, the odds of Caesarean section deliveries vary between districts, after taking into account the individual-level characteristics of the woman.     

Factors associated with lamb mortalities in Muzaffarnagari sheep

The Muzaffarnagari sheep, a mutton-producing breed of India, is generally known for its fast growth rate and high feed conversion efficiency. The study identified the causes of perinatal and postnatal deaths and factors contributing to the cause of mortalities in lambs. Data were recorded for 4628 lambs born to Muzaffarnagari ewes in single-sire matings from 165 rams, between 1978 and 2002. The least-squares means for overall lamb mortality from birth to 1 year of age in the flock was 12.6% (582/4628), while the overall pre- and post-weaning mortality rate averaged 6.6% and 6.0%, respectively. The mortality rate of the lambs declined as the lambs grew older. The major causes associated with lamb losses were pneumonia (31.4%), digestive disorders (14.6%), starvation (9.6%), endoparasitism (5.0%), septicaemia and toxaemia (10.1%), accidental (2.1%) and undetermined causes (27.2%), respectively. The main causes of early lamb mortality (within 15 days of birth) were pneumonia followed by starvation. The highest lamb mortalities occurred within the first 15 days of life. The year of birth of the lamb significantly affected (P < 0.01) the cumulative lamb mortality rate at all ages. The sire of the lamb also had a significant (P < 0.01) effect on lamb mortality rate at all ages. Lambs reared under an intensive feeding management system had a remarkably (P < 0.01) lower mortality rate than lambs maintained under a semi-intensive management system, at 3 months of age and later. The lamb losses were significantly (P < 0.01) higher in ram lambs than in females during the post-weaning stages. The linear regressions of lamb birth weight and dam weight at lambing were highly significant (P < 0.01) with lamb mortality rate during pre- and post-weaning stages. Logistic regression analyses revealed lambs maintained under a semi-intensive system, to be at a greater risk of dying from all ailments than lambs maintained under intensive feeding systems. Male lambs had greater risk of death from respiratory, digestive and other causes, compared to their female counterparts. The findings of this study revealed causes of pre-weaning lamb mortalities to be mainly due to a low birth weight and non-parasitic diseases (predominantly pneumonia). These factors must be considered in any lamb production system.     

Factors associated with black bear density and implications for management

Wildlife density estimates are important to accurately formulate population management objectives and understand the relationship between habitat characteristics and a species’ abundance. Despite advances in density and abundance estimation methods, management of common game species continues to be challenged by a lack of reliable population estimates. In Washington, USA, statewide American black bear (Ursus americanus) abundance estimates are predicated on density estimates derived from research in the 1970s and are hypothesized to be a function of precipitation and vegetation, with higher densities in western Washington. To evaluate current black bear density and landscape relationships in Washington, we conducted a 4-year capture-recapture study in 2 areas of the North Cascade Mountains using 2 detection methods, non-invasive DNA collection and physical capture and deployment of global positioning system (GPS) collars. We integrated GPS telemetry from collared bears with spatial capture-recapture (SCR) data and created a SCR-resource selection model to estimate density as a function of spatial covariates and test the hypothesis that density is higher in areas with greater vegetative food resources. We captured and collared 118 bears 132 times and collected 7,863 hair samples at hair traps where we identified 537 bears from 1,237 detections via DNA. The most-supported model in the western North Cascades depicted a negative relationship between black bear density and an index of human development. We estimated bear density at 20.1 bears/100 km², but density varied from 13.5/100 km² to 27.8 bears/100 km² depending on degree of human development. The model best supported by the data in the eastern North Cascades estimated an average density of 19.2 bears/100 km², which was positively correlated with primary productivity, with resulting density estimates ranging from 7.1/100 km² to 33.6 bears/100 km². The hypothesis that greater precipitation and associated vegetative production in western Washington supports greater bear density compared to eastern Washington was not supported by our data. In western Washington, empirically derived average density estimates (including cubs) were nearly 50% lower than managers expected prior to our research. In eastern Washington average black bear density was predominantly as expected, but localized areas of high primary productivity supported greater than anticipated bear densities. Our findings underscore the importance that black bear density is not likely uniform and management risk may be increased if an average density is applied at too large a scale. Disparities between expected and empirically derived bear density illustrate the need for more rigorous monitoring to understand processes that affect population numbers throughout the jurisdiction, and suggest that management plans may need to be reevaluated to determine if current harvest strategies are achieving population objectives. © 2019 The Wildlife Society.     

Unusual fractures associated with osteoporosis in premenopausal women.

Two premenopausal women (aged 40 and 34 years) and multiple undisplaced, often asymptomatic fractures of the femurs, ribs, metatarsals and other bones. The fractures, which appeared on roentgenograms as transverse radiolucent zones with variable callus formation, healed slowly or not at all despite treatment with calcium and vitamin D. They resembled pseudofractures (Looser''s transformation zones) radiologically, but the biochemical and histologic findings were those of idiopathic osteoporosis rather than osteomalacia. Since neither patient had been subjected to unusual stress it was concluded that the fractures had resulted from normal activity in abnormal bone.     

Factors associated with change in exacerbation frequency in COPD

Background

Patients with chronic obstructive pulmonary disease (COPD) can be categorized as having frequent (FE) or infrequent (IE) exacerbations depending on whether they respectively experience two or more, or one or zero exacerbations per year. Although most patients do not change category from year to year, some will, and the factors associated with this behaviour have not been examined.

Methods

1832 patients completing two year follow-up in the Evaluation of COPD Longitudinally to Identify Predictive Surrogate End-points (ECLIPSE) study were examined at baseline and then yearly. Exacerbations were defined by health care utilisation. Patient characteristics compared between those patients who did or did not change exacerbation category from year 1 to year 2.

Findings

Between years 1 and 2, 221 patients (17%) changed from IE to FE and 210 patients (39%) from FE to IE. More severe disease was associated with changing from IE to FE and less severe disease from FE to IE. Over the preceding year, small falls in FEV₁ and 6-minute walking distance were associated with changing from IE to FE, and small falls in platelet count associated with changing from FE to IE.

Conclusion

No parameter clearly predicts an imminent change in exacerbation frequency category.

Trial registration

SCO104960, clinicaltrials.gov identifier {"type":"clinical-trial","attrs":{"text":"NCT00292552","term_id":"NCT00292552"}}NCT00292552     

Skin models and their impact on mean glandular dose in mammography

PurposeTo quantify the influence of different skin models on mammographic breast dosimetry, based on dosimetric protocols and recent breast skin thickness findings.MethodsBy using an adapted PENELOPE (v. 2014) + PenEasy (v. 2015) Monte Carlo (MC) code, simulations were performed in order to obtain the mean glandular dose (MGD), the normalized MGD by incident air Kerma (DgN), and the glandular depth dose (GDD(z)). The geometry was based on a cranio-caudal mammographic examination. Monoenergetic and polyenergetic beams were implemented, for a breast thickness from 2 cm to 9 cm, with different compositions. Seven skin models were used: a 5 mm adipose layer; a skin layer ranging from 5 mm to 1.45 mm, a 1.45 mm skin thickness with a subcutaneous adipose layer of 2 mm and 3.55 mm.ResultsThe differences, for monoenergetic beams, are higher (up to 200%) for lower energies (8 keV), thicker and low glandular content breasts, decreasing to less than 5% at 40 keV. Without a skin layer, the differences reach a maximum of 1240%. The relative difference in DgN values for 1.45 mm skin and 5 mm adipose layers and polyenergetic beams varies from −14% to 12%.ConclusionsThe implemented MC code is suitable for mammography dosimetry calculations. The skin models have major impacts on MGD values, and the results complement previous literature findings. The current protocols should be updated to include a more realistic skin model, which provides a reliable breast dose estimation.