Simulation and analysis of XCO 2 in North China based on high accuracy surface modeling

Abstract

As an important cause of global warming, CO₂ concentrations and their changes have aroused worldwide concern. Establishing explicit understanding of the spatial and temporal distributions of CO₂ concentrations at regional scale is a crucial technical problem for climate change research. High accuracy surface modeling (HASM) is employed in this paper using the output of the CO₂ concentrations from weather research and forecasting-chemistry (WRF-CHEM) as the driving fields, and the greenhouse gases observing satellite (GOSAT) retrieval XCO₂ data as the accuracy control conditions to obtain high accuracy XCO₂ fields. WRF-CHEM is an atmospheric chemical transport model designed for regional studies of CO₂ concentrations. Verified by ground- and space-based observations, WRF-CHEM has a limited ability to simulate the conditions of CO₂ concentrations. After conducting HASM, we obtain a higher accuracy distribution of the CO₂ in North China than those calculated using the classical Kriging and inverse distance weighted (IDW) interpolation methods, which were often used in past studies. The cross-validation also shows that the averaging mean absolute error (MAE) of the results from HASM is 1.12 ppmv, and the averaging root mean square error (RMSE) is 1.41 ppmv, both of which are lower than those of the Kriging and IDW methods. This study also analyses the space-time distributions and variations of the XCO₂ from the HASM results. This analysis shows that in February and March, there was the high value zone in the southern region of study area relating to heating in the winter and the dense population. The XCO₂ concentration decreased by the end of the heating period and during the growing period of April and May, and only some relatively high value zones continued to exist.

Pax-5 Inhibits NF-κB Activity in Breast Cancer Cells Through IKKε and miRNA-155 Effectors

Abstract

Pax-5, an essential transcription factor in B cell development, is aberrantly expressed in various B cell cancer lesions and solid tumors such as breast carcinoma. We have recently shown that Pax-5 regulates NF-κB activity which lead to the modulation of breast cancer phenotypic features (EMT-MET). NF-κB is known as a central mediator in inflammation, stress response as well as being a gatekeeper of pro-tumorigenic activity. However, little is known as to how Pax-5 affects this modulation. We thus turned our attention to microRNAs as potential regulatory effectors. In this study, we set out to elucidate the regulatory network between differential Pax-5 expression and NF-κB activity which dictate breast cancer malignancy. Through next-generation sequencing (NGS) of breast cancer cells conditionally expressing Pax-5, we profile significantly upregulated microRNAs; including microRNA-155, a known regulator of pathological processes and suppressor of malignant growth. Through the conditional expression of microRNA-155 in breast cancer models, we identify and validate IKKε (IKBKE) as a downstream target and an essential effector of Pax-5-mediated suppression of NF-κB signaling. Using rescue experiments, we also confirm that Pax-5 modulates NF-κB activity via IKKε downregulation. Interestingly, we also show that microRNA-155, in turn, supresses Pax-5 expression, indicative of an auto-regulatory feedback loop. Altogether, we demonstrate that Pax-5 inhibits NF-κB signalling through the regulation of microRNA-155 and its downstream target IKKε. The elucidation of this signaling network is relevant as Pax-5 and NF-κB are potent transcriptional regulators of breast cancer aggressivity. In addition, IKKε is relevant oncogene aberrantly expressed in 30% of breast carcinomas. Further insight into the regulatory pathways of breast cancer progression will eventually identify strategic therapeutic and prognostic targets to improve cancer patient outcome.

Prediction of long-term heavy metal leaching from dredged marine sediment applied inland as a construction material

Abstract

Column leaching studies have been suggested as a reference for site-specific prediction of the long-term leaching characteristics of trace constituents in granular materials used as construction materials. In this study, the concept of the long-term leaching prediction using column studies is applied for dredged marine sediment impacted by heavy metals. The column studies show tailing of the liquid to solid ratio-dependent heavy metal leaching for sediment after heavy metal treatment by acid washing. A dual-mode first-order decay model, applied for the first time in this study for column leaching studies, is able to reproduce the leaching characteristics observed. A procedure for long-term leaching prediction using the dual-mode model is developed and applied to a virtual field scenario for which the sediment is beneficially used as a construction material. The prediction results show that by more accurately reproducing the column study results, the dual-mode model generally predicts greater long-term heavy metal loading to the underlying soil layer and longer duration of leaching than the single-mode model. The heavy metal leaching observed in the columns does not show any correlation with the sequential extraction procedure and toxicity characteristic leaching procedure (TCLP) results, suggesting that the column leaching test should be considered to be independent of such batch test procedures.

Modeling nitrous oxide emissions from rough fescue grassland soils subjected to long-term grazing of different intensities using the Soil and Water Assessment Tool (SWAT)

Abstract

Given the rising nitrous oxide (N₂O) concentration in the atmosphere, it has become increasingly important to identify hot spots and hot moments of N₂O emissions. With field measurements often failing to capture the spatiotemporal dynamics of N₂O emissions, estimating them with modeling tools has become an attractive alternative. Therefore, we incorporated several semi-empirical equations to estimate N₂O emissions with the Soil and Water Assessment Tool from nitrification and denitrification processes in soil. We then used the model to simulate soil moisture and the N₂O flux from grassland soils subjected to long-term grazing (> 60 years) at different intensities in Alberta, Canada. Sensitivity analysis showed that parameters controlling the N₂O flux from nitrification were most sensitive. On average, the accuracy of N₂O emission simulations were found to be satisfactory, as indicated by the selected goodness-of-fit statistics and predictive uncertainty band, while the model simulated the soil moisture with slightly higher accuracy. As expected, emissions were higher from the plots with greater grazing intensity. Scenario analysis showed that the N₂O emissions with the recommended fertilizer rate would dominate the emissions from the projected wetter and warmer future. The combined effects of fertilization and wetter and warmer climate scenarios would increase the current N₂O emission levels by more than sixfold, which would be comparable to current emission levels from agricultural soils in similar regions.

Theoretical analysis of pollutant mixing zone considering lateral distribution of flow velocity and diffusion coefficient

Abstract

Theoretical formulae have shown significant advantages in describing the characteristic geometric scales of the pollutant mixing zone (PMZ) formed by offshore pollutant discharged by a single general form. They, however, fail to predict the influence of the lateral inhomogeneity of the river flow because constant flow velocity and the lateral diffusion coefficient are assumed during the derivation. The realistic flow velocity in a river is fitted by an exponential law in this study and the lateral diffusion coefficient is proposed to have the same form. Similar idea has been used in previous studies on the vertical dispersion of scalar in the lower atmosphere. Pollutant discharged from a steady onshore point source into a wide straight open channel is examined to characterize the concentration taking into consideration of these lateral variations. Theoretical formulae describing the maximum length, maximum width and its corresponding longitudinal position, as well as the area of the PMZ are derived. A non-dimensional standard curve equation for the isoconcentration boundary of PMZ is also obtained. The results show that the shape of the dimensionless standard curve of PMZ depends only on the exponential constants in the exponential laws. The exponential profiles that fit the near-shore velocity give good prediction, while the ones that match the entire lateral range up to the center of the river underpredict the PMZ significantly. These findings are of great importance for practitioners to characterize the geometry of the PMZ in rivers and for water quality modeling.

Pax-5 Inhibits NF-κB Activity in Breast Cancer Cells Through IKKε and miRNA-155 Effectors

Abstract

Pax-5, an essential transcription factor in B cell development, is aberrantly expressed in various B cell cancer lesions and solid tumors such as breast carcinoma. We have recently shown that Pax-5 regulates NF-κB activity which lead to the modulation of breast cancer phenotypic features (EMT-MET). NF-κB is known as a central mediator in inflammation, stress response as well as being a gatekeeper of pro-tumorigenic activity. However, little is known as to how Pax-5 affects this modulation. We thus turned our attention to microRNAs as potential regulatory effectors. In this study, we set out to elucidate the regulatory network between differential Pax-5 expression and NF-κB activity which dictate breast cancer malignancy. Through next-generation sequencing (NGS) of breast cancer cells conditionally expressing Pax-5, we profile significantly upregulated microRNAs; including microRNA-155, a known regulator of pathological processes and suppressor of malignant growth. Through the conditional expression of microRNA-155 in breast cancer models, we identify and validate IKKε (IKBKE) as a downstream target and an essential effector of Pax-5-mediated suppression of NF-κB signaling. Using rescue experiments, we also confirm that Pax-5 modulates NF-κB activity via IKKε downregulation. Interestingly, we also show that microRNA-155, in turn, supresses Pax-5 expression, indicative of an auto-regulatory feedback loop. Altogether, we demonstrate that Pax-5 inhibits NF-κB signalling through the regulation of microRNA-155 and its downstream target IKKε. The elucidation of this signaling network is relevant as Pax-5 and NF-κB are potent transcriptional regulators of breast cancer aggressivity. In addition, IKKε is relevant oncogene aberrantly expressed in 30% of breast carcinomas. Further insight into the regulatory pathways of breast cancer progression will eventually identify strategic therapeutic and prognostic targets to improve cancer patient outcome.

Association between gentamicin resistance and stress tolerance in water isolates of Ralstonia pickettii and R . mannitolilytica

Abstract

Members of the species Ralstonia pickettii and R. mannitolilytica, although ubiquitous and lacking major virulence factors, have been associated with nosocomial outbreaks. Tolerance to metals, antibiotics, and disinfectants may represent an advantage for their ubiquity and opportunistic pathogenic potential. In this study, we compared five strains that differed on the origin (hospital effluent, tap water, mineral water) and in the susceptibility to aminoglycosides, regarding their tolerance to metals and disinfection. The growth kinetics and biofilm formation capacity were tested in four R. pickettii strains and one R. mannitolilytica at sub-inhibitory concentrations of aminoglycosides or arsenite. The survival to UV radiation, chlorine, or hydrogen peroxide was also compared in aminoglycoside resistant and susceptible strains. Aminoglycoside-resistant strains presented a higher tolerance to arsenite than the susceptible ones and either aminoglycosides or arsenite was observed to stimulate the biofilm formation. Sub-inhibitory concentrations of the aminoglycoside gentamicin or arsenite significantly decreased the growth rate and yield, but only arsenite caused a significant increase of the lag phase. Hydrogen peroxide presented higher disinfection effectiveness against aminoglycoside susceptible than against resistant strains, an effect that was not observed for UV or chlorine. Although this conclusion needs validation based on a larger number of isolates, including clinical, the results suggest that aminoglycoside resistance may be associated with traits that influence Ralstonia spp. fitness in the environment.

The Design and Implementation of the 2016 National Survey of Children’s Health

Abstract

Introduction Since 2001, the Health Resources and Services Administration's Maternal and Child Health Bureau (HRSA MCHB) has funded and directed the National Survey of Children's Health (NSCH) and the National Survey of Children with Special Health Care Needs (NS-CSHCN), unique sources of national and state-level data on child health and health care. Between 2012 and 2015, HRSA MCHB redesigned the surveys, combining content into a single survey, and shifting from a periodic interviewer-assisted telephone survey to an annual self-administered web/paper-based survey utilizing an address-based sampling frame. Methods The U.S. Census Bureau fielded the redesigned NSCH using a random sample of addresses drawn from the Census Master Address File, supplemented with a unique administrative flag to identify households most likely to include children. Data were collected June 2016–February 2017 using a multi-mode design, encouraging web-based responses while allowing for paper mail-in responses. A parent/caregiver knowledgeable about the child's health completed an age-appropriate questionnaire. Experiments on incentives, branding, and contact strategies were conducted. Results Data were released in September 2017. The final sample size was 50,212 children; the overall weighted response rate was 40.7%. Comparison of 2016 estimates to those from previous survey iterations are not appropriate due to sampling and mode changes. Discussion The NSCH remains an invaluable data source for key measures of child health and attendant health care system, family, and community factors. The redesigned survey extended the utility of this resource while seeking a balance between previous strengths and innovations now possible.

Impact of Maternal Infant Weight Perception on Infant Feeding and Dietary Intake

Abstract

Introduction Obesity is a global problem that is challenging to prevent and expensive to treat. Early childhood interventions show promise in establishing lifelong healthy eating patterns, however a better understanding of how parental feeding practices develop is needed. The study aimed to investigate maternal perception of infant weight and its relationship to feeding practices and infant dietary intake. Methods A questionnaire was completed by 263 Queensland mothers of infants aged between 5 and 13 months. Logistic regression was used to describe the association between maternal feeding practices (restriction, pressure-to-eat, monitoring), parenting style (warmth, hostility), infant weight concern and infant dietary intake. Correlation and linear regression were used to identify relationships between maternal feeding practices, parenting style, infant weight concern and infant weight. Results Mothers were found to be more concerned about underweight than overweight, misjudge infants as being underweight and failed to recognise overweight infants. Underweight concern was associated with infant weight (r = −0.27, p < 0.01), early introduction of solids (OR 0.24, CI 0.11–0.51) and pressure-to-eat (r = 0.19, p < 0.01). Pressure-to-eat was associated to maternal perception of infant weight (r = − 0.21, p < 0.01), infant weight (r = − 0.17, p < 0.05) and lower fruit and vegetable intake (OR 0.50, CI 0.27–0.92). Restrictive feeding practices were correlated to overweight concern (r = 0.08, p < 0.05). Discussion Maternal infant weight perception and concerns are related to control feeding practices which can be detrimental to infant dietary intake. Inability to recognise healthy weight may ignite these concerns or fail to address infant feeding risk factors. Discussing healthy growth should be a fundamental component of strategies to support healthy infant feeding and eating.

Association Between Obstetric Provider’s Advice and Gestational Weight Gain

Abstract

Objective This study examined associations between pregnant women's report of obstetric provider GWG advice, self-reported adherence to such advice, and GWG. Methods Healthy pregnant women (N = 91) who started obstetric care prior to 17 weeks of gestation completed assessments between 30 and 34 weeks of gestation. These included survey (questions on receipt of and adherence to provider GWG advice, and demographics) and anthropometric measures. GWG data were abstracted from electronic health records. Analyses included Chi square and Mann–Whitney tests, and binary and multivariate logistic regressions. Results The cohort's median age was 28 years, 68% of women were White, 78% had a college education, 50.5% were overweight or obese before the pregnancy, and 62.6% had GWGs above the Institute of Medicine-recommended ranges. Sixty-seven percent of women reported having received GWG advice from their obstetric providers and, of those, 54.1% reported that they followed their provider's advice. Controlling for race, education and pre-pregnancy BMI, receipt of GWG advice was marginally associated with increased odds of excessive weight gain (OR 2.52, CI 0.89–7.16). However, women that reported following the advice had lower odds of excessive GWG (OR 0.18, CI 0.03–0.91) and, on average, gained 11.3 pounds less than those who reported following the advice somewhat or not at all. Conclusions Frequency of GWG advice from obstetric providers is less than optimal. When given and followed, provider advice may reduce the risk of excessive GWG. Research to understand factors that facilitate providers GWG advice giving and women's adherence to providers' advice, and to develop interventions to optimize both, is needed.

Racial/Ethnic Inequities in Low Birth Weight and Preterm Birth: The Role of Multiple Forms of Stress

Abstract

Introduction Racial/ethnic inequities in low birth weight (LBW) and preterm birth (PTB) persist in the United States. Research has identified numerous risk factors for adverse birth outcomes; however, they do not fully explain the occurrence of, or inequalities in PTB/LBW. Stress has been proposed as one explanation for differences in LBW and PTB by race/ethnicity. Methods Using the Pregnancy Risk Assessment Monitoring System (PRAMS) data from 2012 to 2013 for 21 states and one city (n = 15,915) we used Poisson regression to estimate the association between acute, financial and relationship stressors and LBW and PTB, and to examine the contribution of these stressors individually and simultaneously to racial/ethnic differences in LBW and PTB. Results Adjusting for age and race/ethnicity, acute (p < 0.001), financial (p < 0.001) and relationship (p < 0.05) stressors were associated with increased risk of LBW, but only acute (p < 0.05) and financial (p < 0.01) stress increased risk of PTB. Across all models, non-Hispanic blacks had higher risk of LBW and PTB relative to non-Hispanic whites (IRR 1.87, 95% CI 1.55, 2.27 and IRR 1.46, 95% CI 1.18, 1.79). Accounting for the effects of stressors attenuated the risk of LBW and PTB by 17 and 22% respectively, but did not fully explain the increased likelihood of LBW and PTB among non-Hispanic blacks. Discussion Results of this study demonstrate that stress may increase the risk of LBW and PTB. While stressors may contribute to racial/ethnic differences in LBW and PTB, they do not fully explain them. Mitigating stress during pregnancy may help promote healthier birth outcomes and reduce racial/ethnic inequities in LBW and PTB.

Exploring Lactation Consultant Views on Infant Safe Sleep

Abstract

Objectives The purpose of this qualitative study was to explore the infant safe sleep beliefs and occupational practices of lactation consultants and to determine if lactation consultants give advice to clients that is consistent with the American Academy of Pediatrics' recommendations on this topic. Methods Focus groups were conducted with certified lactation consultants in two cities in Ohio. Participants discussed the role of lactation consultants, the infant sleep advice they provide to women, their views on the American Academy of Pediatrics' infant safe sleep recommendations and related policies, and perceived benefits and barriers associated with providing infant safe sleep education as part of their work. A member-checking session was held to ensure the credibility of the findings. Results Four focus groups were conducted with 22 certified lactation consultants between September and November 2015. Major themes that emerged included: lactation consultants' beliefs regarding the importance of bedsharing for supporting breastfeeding success; their disagreement with the infant safe sleep recommendations of the American Academy of Pediatrics; their frustration with policies that restrict consultants' ability to discuss bedsharing; and the impact of infant safe sleep policies on their work and the advice they provide. Conclusions for Practice Lactation consultants interact with mothers of newborns at a critical time for infant safe sleep decision-making and may influence a woman's choices related to this topic. Women may not be receiving messages from lactation consultants that are consistent with the infant safe sleep recommendations of the American Academy of Pediatrics.

Hispanic Immigrant Father Involvement with Young Children in the United States: A Comparison with US-Born Hispanic and White non-Hispanic Fathers

Abstract

Objectives Fathering is known to foster child development and health, yet evidence on Hispanic immigrant fathers' involvement with their young children is sparse. This study assessed disparities in pregnancy intendedness and father involvement with children ages 0–4 among Hispanic immigrant co-resident fathers versus two reference groups: US-born Hispanic and US-born White fathers. We hypothesized that differentials in involvement were associated with socioeconomic and cultural factors. Methods Using 2011–2013 data from the National Survey of Family Growth (N = 598), we performed bivariate, logistic and linear regression analyses to assess disparities in pregnancy intendedness and five father involvement outcomes (physical care, warmth, outings, reading and discipline). The models controlled for socio-economic, structural, health and cultural covariates. Results Pregnancy intendedness did not differ significantly between Hispanic immigrant fathers and the two reference groups. Compared with US-born Hispanics, unadjusted models showed that immigrant fathers were less likely to engage in physical care, warmth and reading, (p ≤ 0.05) though the differences were attenuated when controlling for covariates. Hispanic immigrant fathers were less likely than US-born White fathers to engage in each of the father involvement outcomes (p ≤ 0.05), with the disparity in reading to their child persisting even after controlling for all covariates. Conclusions for Practice We found marked socio-economic and cultural differences between Hispanic immigrant and US-born Hispanic and White fathers which contribute to disparities in father involvement with their young children. Hispanic immigrant status is an important determinant of involved fathering and should be taken into account when planning public health policies and programs.

African-American women’s Upward Economic Mobility and Small for Gestational Age Births: A Population-Based Study

Abstract

Background The relationship between African-American women's upward economic mobility and small for gestational age (weight for gestational < 10th percentile, SGA) rates is incompletely understood. Objective To ascertain the extent to which African-American women's upward economic mobility from early-life impoverishment is coupled with reduced SGA rates. Methods Stratified and multilevel logistic regression analyses were completed on the Illinois transgenerational dataset of African-American infants (1989–1991) and their Chicago-born mothers (1956–1976) with linked U.S. census income information. Results Impoverished-born (defined as lowest quartile of neighborhood income distribution) African-American women (n = 4891) who remained impoverished by the time of delivery had a SGA rate of 19.7%. Individuals who achieved low (n = 5827), modest (n = 2254), or high (n = 732) upward economic mobility by adulthood had lower SGA rates of 17.2, 14.8, and 13.7%, respectively; RR = 0.9 (0.8–0.9), 0.8 (0.7–0.8), and 0.7 (0.6–0.8), respectively. In adjusted (controlling for traditional individual-level risk factors) multilevel regression models, there was a decreasing linear trend in SGA rates with increasing levels of upward economic mobility; the adjusted RR of SGA birth for impoverished-born African-American women who experienced low, modest, of high (compared to no) upward mobility equaled 0.95 (0.91, 0.99), 0.90 (0.83, 0.98), and 0.86 (0.75, 0.98), respectively, p < 0.05. Conclusions African-American women's upward economic mobility from early-life residence in poor urban communities is associated with lower SGA rates independent of adulthood risk status.

Exploring Preconception Care: Insurance Status, Race/Ethnicity, and Health in the Pre-pregnancy Period

Abstract

Objective To measure the association of preconception health insurance status with preconception health among women in New York City, and examine whether this association is modified by race/ethnicity. Methods Using data from the New York City Pregnancy Risk Assessment Monitoring System 2009–2011 (n = 3929), we created a "Preconception Health Score" (PHS) capturing modifiable behaviors, healthcare services utilization, pregnancy intention, and timely entry into prenatal care. We then built multivariable logistic regression models to measure the association of PHS with health insurance status and race/ethnicity. Results We found PHS to be higher among women with private insurance (7.3 ± 0.07) or public insurance (6.3 ± 0.08) before pregnancy than no insurance (5.9 ± 0.09) (p < .001). However, when stratified by race/ethnicity, the positive association of PHS with insurance was absent in the non-white population. Conclusions for Practice Having health insurance during the pre-pregnancy period is associated with greater health among white women, but not among black or Hispanic women in NYC.

Factors Associated with Quality of Life Among Mothers Rearing 4- and 18-Month Old Infants in Japan

Abstract

Objective The purpose of the present study was to investigate factors associated with quality of life (QOL) among mothers raising 4 and 18-month-old infants. Methods A cross-sectional study was conducted using self-report questionnaires. Participants included 400 women who took their infants for health checkups at a city in Aichi Prefecture, Japan (4-month-olds: n = 197, 18-month-olds: n = 203). Study variables included the World Health Organization Quality of Life-BREF (WHOQOL-BREF) scale, mother's lifestyle, support from family, and other factors potentially related to QOL. Results For mothers of 4-month-old infants, total QOL was associated with emotional support from families (OR 6.09, 95% CI 2.13–17.43) and having enough sleep (7 h or more; OR 4.18, 95% CI 1.86–9.36). These mothers had shorter sleeping hours than mothers of 18-month-old infants. QOL of mothers of 18-month-old infants was associated with emotional support from families (OR 3.06, 95% CI 1.14–8.22) and using childrearing support facilities (OR 2.02, 95% CI 1.01–4.01). Conclusion Different factors contributed to mothers' QOL as a function of infant age. Emotional support from families was associated with better QOL in both mother groups. Differences were that for mothers of 4-month-old infants, enough sleep was relevant to QOL, while in mothers of 18-month-old infants, childcare services helped improving their QOL.

Continuing Professional Development in Maternal Health Care: Barriers to Applying New Knowledge and Skills in the Hospitals of Rwanda

Abstract

Objectives Training healthcare professionals in emergency maternal healthcare is a critical component of improving overall maternal health in developing countries like Rwanda. This paper explored the challenges that healthcare professionals who participated in a Continuing Professional Development (CPD) program on Advanced Life Support in Obstetrics® (ALSO) face in putting the learned knowledge and skills into practice in hospitals of Rwanda. Methods This study used a mixed methods approach to understand the challenges/barriers to applying new knowledge and skills in the hospitals of Rwanda. We conducted thirteen purposive in-depth interviews with ALSO® trainees (nurses, midwives and physicians) complemented with a cross-sectional survey on staff turnover in eight of the nine hospitals in the Eastern province of Rwanda. Results Our study found that trainees do not get enough opportunity to apply the new knowledge and skills in their hospitals and expand to health centers. In part because they are frequently rotating to different departments of the hospital and are not getting the opportunity to train their colleagues to share the learned knowledge and skills. The lack of refresher trainings/mentorship and the high personnel turnover were also reported as a barrier to applying new knowledge and skills. Reasons for staff turnover included pursuing further studies, a better opportunity (job/remuneration), low morale, and family related motives including joining a spouse or better schools for children. Conclusions for Practice Expanding and formalizing CPD training to all the healthcare professionals involved in providing maternal care services would improve the provision of emergency maternal healthcare in Rwanda.

The Impact of Food Insecurity on the Home Emotional Environment Among Low-Income Mothers of Young Children

Abstract

Objectives Household stressors, such as food insecurity, contribute to the home emotional environment and negatively affect child development. Little research on this topic has been conducted among very young children. This study aimed to examine the relationship between food insecurity and the home emotional environment, as well the extent to which the relationship may be mediated by maternal symptoms of depression. Frequency of praise, affection, and discipline of young children by mothers were examined as markers of the home emotional environment. Methods Data were collected in a cross-sectional study of mothers of children under the age of five (N = 4231). Logistic regression was used to assess the relationship between level of food security and frequency of praise and discipline of children. Mediation analysis using the KHB method was conducted to test whether maternal mental health mediated the relationship between food insecurity and each outcome. Results Low and very low food security were significantly associated with higher odds of disciplining children with high frequency. Controlling for all covariates, frequency of praise was not significantly associated with level of household food insecurity. Differences in praise and discipline frequency were found by language of interview, maternal education, and employment. Conclusions for Practice Parent–child interactions, specifically related to discipline, are related to food insecurity. Further research should consider cultural patterns and mechanisms behind the relationship between food insecurity and the home environment. Household stressors begin affecting children at young ages, and early intervention is essential to prevent further negative sequelae as children grow older.

The Influence of Objectively Measured Physical Activity During Pregnancy on Maternal and Birth Outcomes in Urban Black South African Women

Abstract

Objectives Research indicates the beneficial effects of physical activity during pregnancy on maternal health, although controversy still exists regarding its influence on birth outcomes. Little research has been done to objectively measure physical activity during pregnancy in black African women from low-to-middle income countries. The purpose of this study was to examine the association between physical activity and maternal and birth outcomes in this unique population. Methods This observational, longitudinal study assessed total physical activity using a hip-mounted triaxial accelerometer at 14–18 weeks (second trimester, n = 120) and 29–33 weeks (third trimester, n = 90) gestation. Physical activity is expressed as gravity-based acceleration units (mg). Maternal outcomes included both weight and weight gain at 29–33 weeks gestation. Birth outcomes included gestational age, birth weight, ponderal index and Apgar score, measured within 48 h of delivery. Results There was a significant decline in physical activity from the second to the third trimester (12.8 ± 4.1 mg vs. 9.7 ± 3.6 mg, p ≤ 0.01). Physical activity at 29–33 weeks as well as a change in PA was inversely associated with weight change at 29–33 weeks (β = − 0.24; 95% CI − 0.49; − 0.00; p = 0.05 and β = − 0.36; 95% CI − 0.62; − 0.10; p = 0.01, respectively). No significant associations were found between physical activity and birth outcomes. Conclusions for Practice Physical activity during pregnancy may be an effective method to control gestational weight gain, whilst presenting no adverse risk for fetal development, in women from a low-income urban setting.

Methodological Considerations in Couples’ Fertility Intentions: Missing Men and the Viability of Women’s Proxy Reports

Abstract

Introduction Recent efforts show potential to advance research on unintended childbearing by taking a couple-level approach. However, this work has neither adequately addressed methodological concerns stemming from the challenges associated with male fertility data nor considered the viability of women's proxy reports of fathers intentions. Methods Data from the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B) were used to assess the implications of low response rates among men on couples' unintended childbearing. Then, the accuracy of women's proxy reports of fathers intentions was assessed. Weighted logistic regression analyses were conducted to determine how women's characteristics were associated with men's survey participation whereas weighted multinomial logistic regression analyses were applied to determine how women's characteristics were linked with the accuracy of her proxy report. Results Almost half (46%) of women cannot be matched with data from the child's father, and this discrepancy is most problematic for women who are black, foreign-born, less educated, and unmarried at birth. Women's proxy reports appear viable as 75% of women's reports are consistent with men's responses. Yet, proxy reports underestimate disagreement in couples' intentions as mothers who intended the birth are at an increased risk of "inaccurately" reporting that fathers share their intentions. Discussion Direct approaches to couples' intentions yield privileged samples and systematically omit women at the greatest risk of an unintended birth. However, proxies underestimate disagreement in couples' intentions—a key contribution to the couple approach. Accordingly each approach has its own merits which must be considered in light of specified research questions.

Longitudinal Impact of a Randomized Clinical Trial to Improve Family Function, Reduce Maternal Stress and Improve Child Outcomes in Families of Children with ADHD

Abstract

Objective Evaluate the efficacy of a 12 month nursing case-management intervention over a period of 18 months, 6 months after the end of intervention, for families of children attention deficit hyperactivity disorder (ADHD). Methods Mother and child dyads were enrolled to participate in a randomized controlled clinical trial. Children were 4–18 years old. Data were collected at baseline, 6, 12, and 18 months or 6 months after the termination of direct intervention. Longitudinal analyses, using generalized estimating equations, were conducted to assess change in study outcomes relating to family function, maternal stress, and child behavior over the 18 month period. Results Compared to control families, some family function outcomes were moderately improved in the intervention group. In particular, intervention families demonstrated substantial improvement in implementing family behavior controls (p value = 0.038) and improvement in family satisfaction (not statistically significant p = 0.062). Although there was improvement in the overall family function measure there was not a statistically significant difference between groups. Maternal stress and child behavior outcomes were not significantly different between control and intervention groups by the end of the intervention. Conclusions for Practice Addressing ADHD is complex and requires the assessment of comorbidities that might exacerbate negative behavior. Our findings support the latest American Academy of Pediatrics guidelines to use behavioral therapy as the first line of treatment in young children. Nursing case-management interventions that provide direct family education and improve family function, especially with respect to providing structure and behavior control, may complement and facilitate behavioral therapy for treatment of ADHD and improving child behavior.

Hepatitis C Virus Knowledge Among Pregnant Women with Opioid Use Disorder

Abstract

Objectives To evaluate Hepatitis C virus (HCV) knowledge and awareness among pregnant women with opioid use disorder (OUD). Methods From May through November 2015, a one-time survey was distributed to a convenience sample of pregnant women with OUD to assess their knowledge and awareness of (a) risk factors for HCV infection, (b) HCV transmission prevention strategies, (c) hepatotoxic risk reduction and (d) perinatal transmission and neonatal implications of HCV infection. Chi square and Fisher's exact tests were used to compare demographic characteristics and HCV knowledge between participants who were HCV positive and negative. Results Of 179 pregnant women with OUD approached, 169 (94%) completed the survey. Of these, 153 (90.5%) reported at least one risk factor for HCV infection, 85 (50.3%) were HCV positive and 38 (44.7%) of HCV positive women were diagnosed with HCV for the first time during pregnancy. When HCV knowledge was evaluated, 114 (66.7%) responded that sharing eating utensils could transmit HCV, 69 (55.0%) responded that there is a vaccine to prevent HCV and 56 (32.7%) did not identify intranasal drug use as a risk factor for HCV transmission. Among HCV positive women, 61 (71.8%) associated breastfeeding with an increased risk for HCV transmission, 33 (38.1%) failed to identify the importance of pediatric follow-up for HCV-exposed children and 16 (18.8%) perceived the risk of HCV vertical transmission as "likely" or "very likely." Conclusions for Practice Gaps in HCV knowledge exist among a rapidly growing population of pregnant women with OUD. Healthcare providers have a unique opportunity to provide HCV education and counseling during pregnancy.

Similarities in Maternal Weight and Birth Weight Across Pregnancies and Across Sisters

Abstract

Objectives The current study examined how prepregnancy body mass index (BMI), gestational weight gain, and birth weight cluster between births within women and between women who are sisters. Methods Using data from the National Longitudinal Survey of Youth 1979 cohort, we utilized nested, multivariable hierarchical linear models to examine the correlation of these three outcomes between births (n = 6006) to women (n = 3605) and sisters (n = 3170) so that we can quantify the clustering by sibship and by woman for these three pregnancy-related outcomes. Results After controlling for confounding covariates, prepregnancy BMI (intraclass correlation (ICC) 0.24, 95% CI 0.16, 0.32), gestational weight gain (ICC 0.23, 95% CI 0.16, 0.31), and infant's birthweight (ICC 0.07, 95% CI 0.003, 0.13) were correlated between sisters. Additionally, all three outcomes were significantly correlated between births for each sister, suggesting that prepregnancy BMI (ICC 0.82, 95% CI 0.81, 0.83), gestational weight gain (ICC 0.45, 95% CI 0.42, 0.49), and birth weight (ICC 0.31, 95% CI 0.28, 0.35) track between pregnancies in the same woman. Conclusions for Practice The observed clustering both within women and between sisters suggests that shared genetic and environmental factors among sisters play a role in pregnancy outcomes above and beyond that of women's own genetic and environmental factors. Findings suggest that asking a woman about her sisters' pregnancy outcomes could provide insight into the possible outcomes for her current pregnancy. Future research should test if collecting such a family history and providing tailored clinical recommendations accordingly would be useful.

Impact of Medicaid Policy on the Oral Health of Publicly Insured Children

Abstract

Objective Fluoride varnish (FV) applications among non-dentist primary care providers has increased due to state Medicaid policies. In this study we examine the impact of FV policies on the oral health of publicly insured children aged 2–6 years old. Methods Using three waves of the National Survey of Children's Health (2003, 2007, 2011/12), we used a logistic regression model with state and year fixed effects, adjusting for relevant child characteristics, to examine the association between years since a state implemented a FV policy and the odds of a publicly insured child having very good or excellent teeth. We compared children with public insurance in states with FV policies to children with public insurance in states without FV policies, controlling for the same difference among children with private insurance who were unlikely to be affected by Medicaid FV policies. Results Among 68,890 children aged 2–6 years, 38% had public insurance. Compared to privately insured children, publicly insured children had significantly lower odds of having very good or excellent teeth [odds ratio (OR) 0.70, 95% CI 0.62–0.81]. Publicly insured children in states with FV policies implemented for four or more years had significantly greater odds of having very good or excellent teeth (OR 1.28, 95% CI 1.03–1.60) compared to publicly insured children in states without FV policies. Conclusions for Practice State policies supporting non-dental primary care providers application of FV were associated with improvements in oral health for young children with public insurance.

Functional Information: a Graded Taxonomy of Difference Makers

Abstract

There are many different notions of information in logic, epistemology, psychology, biology and cognitive science, which are employed differently in each discipline, often with little overlap. Since our interest here is in biological processes and organisms, we develop a taxonomy of functional information that extends the standard cue/signal distinction (in animal communication theory). Three general, main claims are advanced here. (1) This new taxonomy can be useful in describing learning and communication. (2) It avoids some problems that the natural/non-natural information distinction faces. (3) Functional information is​ ​produced through exploration and stabilisation processes.

Iatrogenic Dermatoses in Hospitalized Patients

Abstract

Purpose of Review

Hospitalized patients are at risk of skin injury from drugs and procedures. These complications carry a high risk of morbidity, mortality, and internal organ involvement. This review examines updates in the treatment of drug eruptions and diagnosis of newly reported iatrogenic skin injuries that accompany novel procedures.

Recent Findings

Drug eruptions are a common cause of iatrogenic injury and they vary in presentation and severity. Recent research suggests that medications such as cyclosporine and etanercept may improve mortality in patients with epidermal necrosis although a randomized controlled trial is still needed. Innovative non-invasive procedures can have cutaneous complications such as radiation injury and microemboli. In immunocompromised patients, seemingly banal clinical manipulation such as application of medical tape can lead to cutaneous infection.

Summary

Physicians should maintain a high index of suspicion for iatrogenic injury when caring for the hospitalized patient. It is crucial to obtain a thorough medication and procedural history when evaluating these patients.

The effects of three types of environmental regulation on energy consumption—evidence from China

Abstract

Based on panel data from 1997 to 2015 in China, in this paper, the direct and indirect effects of three types of environmental regulation on energy consumption are explored with the 2SLS and system GMM method. The main conclusions of this study are as follows: (1) the effects of three types of environmental regulation on energy consumption are quite varied. The cost effect of the economical environmental regulation is significant in the direct path. However, the phenomenon of "Green Paradox" emerges in legal and supervised types of environmental regulation. The "rebound effect" of energy, which led to a new energy demand, is greater than the energy conservation generated by technological innovation in the indirect path, which is embodied as a suppression effect. (2) The legal and supervised types of environmental regulation in the eastern, central, and western regions have a Green Paradox and rebound effect on energy consumption. By contrast, the economical environmental regulation shows an opposite performance. (3) The counterfactual simulation results indicate that the net effects of three types of environmental regulation on energy consumption are different. Based on the findings, some corresponding policy implications are provided.

Reconstruction mammaire par prothèse d’expansion temporaire

Publication date: Available online 21 July 2018

Source: Annales de Chirurgie Plastique Esthétique

Author(s): C. Huttin-Marquelet, C. Huttin

Résumé

La reconstruction mammaire par expansion cutanée préalable est une technique simple dans son principe mais sujette à de nombreux pièges. Il faut savoir sélectionner les patientes, préparer la loge de l'expandeur, ne pas précipiter le temps de l'expansion, et ne pas négliger le travail de la loge lors de la pose de l'implant définitif. Cet exposé a pour objectif de détailler point par point les différents temps opératoires, leur mise en pratique, les écueils et les pièges à éviter pour mener à bien la reconstruction par expansion.

Summary

Tissue expansion in breast reconstruction is a technique based on a simple principle but subjected to numerous traps. Its success relies on the patient selection, a good preparation of the skin pocket, no rush during the inflating time, and a specific care during the definitive implant placement inside the skin pocket. This article aims to list and detail point-by-point the different surgical timings, their practical application, the pitfalls and the possible traps to avoid, in order to succeed in breast reconstruction using tissue expander.

Angiokératome circonscrit naeviforme

Publication date: Available online 21 July 2018

Source: Annales de Dermatologie et de Vénéréologie

Author(s): H. Kasssem Youssef, E. Backobi, C. Michel

Correlation of 18 F-FDG and 11 C-methionine uptake on PET/CT with Ki-67 immunohistochemistry in newly diagnosed intracranial meningiomas

Abstract

Objective

We evaluated the uptake of 2-deoxy-2-¹⁸F-fluoro-d-glucose (FDG) and l-[methyl-¹¹C]-methionine (MET) in patients with newly diagnosed intracranial meningiomas and correlated the results with tumor proliferation.

Methods

Data from 22 patients with newly diagnosed intracranial meningioma (12 grade I and 10 grade II) who underwent both FDG and MET brain PET/CT studies were retrospectively analyzed. The PET images were evaluated by a qualitative method and semiquantitative analysis using standardized uptake value (SUV) (SUV_max and SUV_peak) and tumor-to-reference tissue ratio (T_max/N ratio and T_peak/N ratio). Proliferative activity as indicated by the Ki-67 index was estimated in tissue specimens.

Results

MET PET/CT showed a higher detection rate of meningioma than did FDG PET/CT (100 vs. 46%, respectively). The T_max/N ratio and T_peak/N ratio on MET PET/CT were significantly higher than those on FDG PET/CT (p < 0.001 and p < 0.001, respectively). There was a significant difference between grades I and II with respect to FDG SUVmax (p = 0.003), FDG SUV_peak (p = 0.003), FDG T_max/N ratio (p = 0.02), FDG T_peak/N ratio (p = 0.006), MET SUV_max (p = 0.002), MET SUV_peak (p = 0.002), MET T_max/N ratio (p = 0.002), and MET T_peak/N ratio (p = 0.002). There was a significant correlation between Ki-67 index and FDG PET/CT for SUV_max (p = 0.02), SUV_peak (p = 0.005), and T_peak/N ratio (p = 0.05) and between Ki-67 index and MET PET/CT for SUV_max (p = 0.004), SUV_peak (p = 0.007), T_max/N ratio (p = 0.002), and T_peak/N ratio (p = 0.004).

Conclusion

MET PET/CT showed a high sensitivity compared with FDG PET/CT for detection of newly diagnosed WHO grades I and II intracranial meningiomas. Both FDG and MET uptake were found to be useful for evaluating tumor proliferation in meningiomas.

Investigating vulnerability of ecological industrial symbiosis network based on automatic control theory

Abstract

System fluctuations of eco-industrial symbiosis network (EISN) organization due to disturbance are very similar to the controller adjustment in the automatic control theory. Thus, a methodology is proposed in this study to assess the vulnerability of EISN based on the automatic control theory. The results show that the regulator plays a key role to enhance the resilience of the network system to vulnerability. Therefore, it is imperative to strengthen the real-time regulation and control of EISN so that the system stability is improved. In order to further explore the impact of various regulations on the system vulnerability, the influence of system stability is simulated by means of proportional, differential, and integral control. A case study with Guigang eco-industrial park (EIP) was undertaken to test this model. The results showed that when the system was disturbed at different positions, the key nodes which had great influence on system vulnerability could be selected according to the magnitude of simulation curve. By changing the ratio coefficient of proportional, differential, and integral units to adjust the ecological chain network, the system's resilience to vulnerability can be enhanced. Firstly, if basic conditions of EISN organization remain unchanged, the integral control of the policy support and infrastructure sharing should be strengthened. Secondly, the differential regulation should be improved continuously for the technological innovation capability of key node enterprises. Finally, the key chain filling projects should be introduced for proportional control so that the chain network design can be optimized from the source.

Photocatalytic degradation of imidacloprid by Ag-ZnO composite

Abstract

The present study focused on exploring the potential of Ag-ZnO composites for complete mineralization of imidacloprid with the aim to sustain the pollutant free safe water supply. The composites were prepared by hydrothermal method and characterized by Scanning electron microscope (SEM), Energy dispersive X-ray crystallography (EDX), X-ray diffraction (XRD) and band gap measurements. These composites were used to study the UV irradiated degradation of imidacloprid while optimizing the process parameters such as time of UV irradiation, pH of medium, pesticide concentration and composite loading. The results of the study revealed an increase in photodegradation of imidacloprid by Ag-ZnO composites than pure ZnO. Temperature and catalyst loading had a positive effect on degradation efficiency, while an inverse relation was observed between pesticide concentration and degradation. Moreover, no harmful degradation products of imidacloprid were observed in GC-MS analyses that confirmed its complete mineralization.

Vitiligo and social acceptance