Infant growth outcomes from birth to 12 months of age: findings from the Delta Healthy Sprouts randomized comparative impact trial

OBJECTIVE

Multicomponent lifestyle modification interventions designed for gestational and early postnatal periods may be key to preventing obesity in children. The primary objective of the study was to determine if infant growth outcomes differed between treatment arms of an 18-month, maternal, infant and early childhood home visiting project.

METHODS

Pregnant women at least 18 years of age, less than 19 weeks pregnant and residing in a lower Mississippi Delta county were recruited between March 2013 and December 2014. Postnatal data were collected from 24 experimental and 30 control participants between September 2013 and May 2016. Infant growth outcomes were modelled as time-to-event data using Kaplan-Meier survival curves with log-rank tests to determine if survival curves differed between treatment arms.

RESULTS

Retention rates for the experimental and control arms were 88% (21/24) and 83% (25/30), respectively. Approximately three-fourths of infants in both treatment arms were classified as overweight and experienced rapid weight gain during the first 12 months of life. No differences between median times neither to classification as overweight (3-4 months) nor to experiencing rapid weight gain (6-7 months) were observed between treatment arms.

CONCLUSIONS

As compared with a standard educational (control) curriculum, an educational curriculum enhanced with diet and physical activity components was not effective at improving infant growth outcomes.

House Flies in the Confined Cattle Environment Carry Non-O157 Shiga Toxin-Producing Escherichia coli

Cattle manure is one of the primary larval developmental habitats of house flies, Musca domestica (L.). Cattle serve as asymptomatic reservoirs of Shiga toxin-producing Escherichia coli (STEC), and bacteria are released into the environment in cattle feces. The USDA-FSIS declared seven STEC serogroups (O157, O26, O45, O103, O145, O121, and O111) as adulterants in beef products. In addition, the serogroup O104 was a culprit of a large outbreak in Germany in 2011. Our study aimed to assess the prevalence of seven non-O157 STEC (O26, O45, O145, O103, O121, O111, and O104) serogroups in adult house flies. Flies (n = 463) were collected from nine feedlots and three dairy farms in six states in the United States and individually processed. This involved a culturing approach with immunomagnetic separation followed by multiplex polymerase chain reactions for detection of individual serogroups and virulence traits. The concentration of bacteria on modified Possé agar ranged between 1.0 × 101 and 7.0 × 107 (mean: 1.5 ± 0.3 × 106) CFU/fly. Out of 463 house flies, 159 (34.3%) carried one or more of six E. coli serogroups of interest. However, STEC was found in 1.5% of house flies from feedlots only. These were E. coli O103 and O104 harboring stx1 and ehxA and E. coli O45 with stx1, eae, and ehxA. This is the first study reporting the isolation of non-O157 STEC in house flies from the confined cattle environment and indicating a potential role of this insect as a vector and reservoir of non-O157 STEC in confined beef cattle.

Moderators of intervention dose effects on diet quality and physical activity changes in a church-based, multicomponent, lifestyle study: Delta Body and Soul III

Many community-based lifestyle interventions targeting African Americans have reported positive effects on participants' dietary choices and physical activity habits. However, these effects vary and not all participants will have outcome changes. Moderation analysis can help explain differential effects observed, but are not often reported. Hence, the objective of this secondary analysis was to explore potential moderators of intervention dose effects on diet quality and physical activity outcomes in an effective lifestyle intervention. Delta Body and Soul III, conducted from 2011 to 2012, was a 6-month, church-based, multicomponent, educational intervention designed to improve diet quality and increase physical activity in rural Southern African American adults. Generalized linear mixed models were used to determine associations among indicators of intervention dose received by participants, potential moderators and health outcome changes. Results indicated only three baseline characteristics-employment status, food shopping frequency and individual with primary responsibility for meal preparation-moderated the effects of education session attendance on diet quality changes. No evidence for moderation of exercise class attendance effects on physical activity changes was found. Thus, this culturally targeted, multicomponent lifestyle intervention did induce positive health changes in participants with a range of sociodemographic characteristics and food shopping and eating behaviors.

Modeling disease progression of Camellia twig blight using a recurrent event model

To improve control of camellia twig blight (CTB) using sanitation methods, a more complete epidemiologic understanding of this disease is necessary. Three CTB disease stages were modeled using recurrent event analysis. Wound inoculated stems were observed at regular intervals for appearance of disease symptoms. Survival times (time from inoculation until symptom appearance) for the three disease stages (mild, moderate, and severe) were regressed against stem diameter, monthly mean hours/day within a specified temperature range (15 to 30 degrees C), and season (spring, summer, fall, and winter). For all three CTB disease stages, stem diameter had a protective effect on survival times, while monthly mean hours/day in the specified temperature range and warmer seasons were risk factors. Based upon median ratios, the mild disease stage developed 2 to 3 times faster in spring, summer, and fall than in winter. Similarly, moderate and severe disease stages developed 2 to 2.5 times faster. For all three disease stages, seasonal differences in stage development were smaller among fall, spring, and summer, varying from 1 to 1.6 times faster. Recurrent event modeling of CTB progression provides knowledge concerning developmental expression of this disease, information necessary for creating a comprehensive, integrated disease management program.

Survival Analysis to Determine the Length of the Incubation Period of Camellia Twig Blight Caused by Colletotrichum gloeosporioides

Camellia twig blight, caused by Colletotrichum gloeosporioides, is a disease common to several Camellia species in the southern United States. To determine the potential seasonal differences in incubation periods, stems of Camellia sasanqua 'Rosea' plants grown in pine bark under ambient conditions were wounded and inoculated monthly with C. gloeosporioides mycelium. The time until appearance of the first symptom of disease (incubation period length) was recorded for all stems. Stems that did not display a disease symptom by the last day of the observation period were recorded as censored observations. Survival analysis using Kaplan-Meier estimates, Cox proportional hazards, and extended Cox models was used to analyze the data. Incubation period length was regressed against stem diameter, monthly mean hours per day in a specified temperature range (15 to 30°C), and a categorical season variable approximating the four host growth stages (winter dormancy, spring leaf and stem growth, summer stem hardening and bud set, fall cessation of leaf and stem growth and opening of flowers) at the time stems were inoculated. Stems of thicker diameter tended to have greater incubation period length, while higher monthly mean hours per day in the specified temperature range decreased incubation period length. In comparison to winter months, spring, summer, and fall months were all associated with significantly higher risks for disease symptom appearance. The median incubation period lengths for the spring, summer, fall, and winter months were 18, 23, 28, and 57 days, respectively.

Colchicine and 2-methoxyestradiol Inhibit Human Angiogenesis

BACKGROUND

Angiogenesis is a critical determinant of tumor growth and the development of metastases. Tubulin inhibitors have been shown to be effective inhibitors of angiogenesis. We hypothesized that colchicine, a well-know tubulin inhibitor and 2-methoxyestradiol (2 MeOH), a novel tubulin inhibitor, would limit the initiation of a human angiogenic response and would limit subsequent neovessel growth in a dose-dependent manner.

METHODS

To test this hypothesis, we cultured full-thickness human placental vein discs from three placentas in a fibrin-thrombin clot model. Both colchicine and 2 MeOH were tested over a wide range of concentrations (10(-6) to 10(-12) M) to determine their effect on the percent of wells that initiated an angiogenic response (%I) and the subsequent growth (Angiogenic Index, 0-16 range) of vein-derived neovessels.

RESULTS

Colchicine at doses of 10(-6) and 10(-8) M completely inhibited the angiogenic response (CI: 95%, P < 0.0001) but lower (10(-10) to 10(-12) M) doses did not significantly inhibit angiogenesis (P = NS). Effective in vitro colchicine levels far exceed achievable non-toxic human plasma levels. In contrast, 2-methoxyestradiol decreased initiation and angiogenic growth significantly at 10(-6) M (CI: 95%, P < 0.0001), but did not significantly decrease angiogenesis at doses of 10(-8), 10(-10), or 10(-12) M. In contrast to colchicine, human plasma levels of 10(-6) M 2 MeOH are achievable clinically with little or no associated toxicity.

CONCLUSIONS

Effective in vitro drug levels of 2 MeOH can be achieved in vivo, suggesting that 2 MeOH may have a role in the clinical treatment of angiogenesis-dependent diseases.

Expression of cyclooxygenase 1 and 2 by human gastric endothelial cells

BACKGROUND

Non-steroidal anti-inflammatory drugs (NSAIDs) inhibit cyclooxygenase (COX) and cause gastric ulceration. NSAIDs also impair granulation tissue angiogenesis and healing of established gastric ulcers in humans. The mechanism whereby NSAIDs inhibit granulation tissue angiogenesis is unknown but may involve inhibition of either or both COX isoforms (COX-1 and COX-2).

AIMS

To investigate COX expression by human gastric endothelial (HuGE) cells during angiogenesis in vitro.

METHODS

COX-1 and COX-2 expression by HuGE cells was investigated by western blot analysis, indirect immunofluorescence, reverse transcriptase polymerase chain reaction, and measurement of prostaglandin E(2) synthesis. Plating onto basement membrane matrix and stimulation by phorbol ester were used as in vitro models of angiogenesis.

RESULTS

Under normal culture conditions (30% serum), HuGE cells expressed COX-1 and low levels of COX-2. COX-2 expression was induced in HuGE cells in both angiogenesis models. Prostaglandin E(2) production and tubular structure formation by HuGE cells on basement membrane matrix was significantly inhibited by a selective COX-2 inhibitor (NS-398).

CONCLUSION

Angiogenesis by HuGE cells in vitro was associated with induction of functional COX-2 expression. A selective COX-2 inhibitor significantly decreased HuGE cell angiogenesis on basement membrane matrix. Extrapolation of these data to human gastric ulcer angiogenesis in vivo suggests that selective COX-2 inhibitors could delay gastric ulcer healing to the same extent as traditional NSAIDs which are non-selective COX inhibitors.

Photoreceptor rim protein: partial sequences of cDNA show a high degree of similarity to ABC transporters

PURPOSE

To isolate and sequence cDNA for bovine rim protein, a large membrane-bound glycoprotein found in photoreceptor outer segments.

METHODS

Bovine rim protein was N-terminally sequenced (22 residues) and fragments were prepared by partial proteolysis. Two internal sequences of 21 and 18 amino acid residues were obtained from 35 kDa and 32 kDa fragments, respectively. Sense and anti-sense oligonucleotide primers were constructed, based on the peptide sequences derived from the 35 kDa and 32 kDa fragments, respectively, and the polymerase chain reaction (PCR) was used to amplify a 150 bp sequence from bovine retinal cDNA.

RESULTS

The amplified sequence coded for the remainder of the peptide sequence determined from the 35 kDa fragment, which was not present in the primer, confirming that it was derived from the rim protein. The 150 bp sequence was translated to give a 50 amino acid peptide. Part of this peptide was compared with Dna sequence databases using the TFastA program, which found 94.6% identity with an EST derived from human retina and 86.1% identity to the mouse abc1 transporter.

CONCLUSIONS

It is proposed that rim protein is a member of the ATP transporter family of proteins. It may be involved in transport of molecules involved in visual transduction across the photoreceptor disk membrane.

Vasodilator responses of rat isolated tail artery enhanced by oxygen- dependent, photochemical release of nitric oxide from iron-sulphur-nitrosyls

1. The vasodilator properties and photochemical decomposition of two synthetic iron-sulphur-nitrosyl clusters (cluster A: [Fe4S4(NO)4], tetranitrosyl-tetra-mu 3-sulphido-tetrahedro-tetrairon; and B:[Fe4S3 (NO)7]-1, heptanitrosyl-tri-mu 3-thioxotetraferrate(-1)) have been investigated. Experiments were carried out on isolated, internally-perfused segments of rat tail artery. 2. Bolus injections (10 microliters) of A or B ( > 0.25 mM) delivered into the internal perfusate generated sustained (or S-type) vasodilator responses, characterized by a persistent plateau of reduced tone due to NO released from clusters which enter and become trapped within endothelial cells. Clusters were therefore irradiated with visible laser light (lambda = 457.9 or 514.5 nm) either (a) in solution, while passing through a glass tube en route to the artery; or (b) when retained within the endothelium, by illuminating the artery directly during the plateau of an S-type response. Irradiation produced an additional vasodilator response, the magnitude of which depended upon wavelength and laser beam energy. 3. The nitric oxide synthase inhibitor, NG-monomethyl-L-arginine (100 microM), had no effect on light-induced vasodilator responses. However, they were (a) blocked entirely by adding oxyhaemoglobin (5 microM) to the internal perfusate; and (b) greatly enhanced by the enzyme superoxide dismutase (150 u ml-1). 4. Photolysis of cluster B was measured by absorption spectroscopy and by detecting NO released with an electrochemical sensor. The photochemical reaction was found to be oxygen-dependent. The half-time for inactivation of cluster-derived NO was measured by interposing different lengths of tubing (i.e. time delays) between the photolysis tube and NO sensor. The steady-state probe current decayed exponentially with increasing delay time, with a t 1/2 of 21 s. The amplitudes of vasodilator responses of the tail artery also decreased exponentially by increasing the time delay (t 1/2 = 58 s). Superoxide dismutase (150 u ml-1) prevented this from happening, showing that "inactivation' of cluster-derived NO was caused by reaction with superoxide anions formed during photolysis. 5. We conclude that potentiation of vasodilator responses to iron-sulphur-nitrosyl clusters by visible light is due to an oxygen-dependent photochemical reaction which accelerates the release of ligated nitrosyl groups as free NO. Based on our measurements, we estimate that ca 100 pM NO is sufficient to produce a just-detectable additional vasodilatation and that the ED50 dose is ca 3.7 nM.

Further experience at the Bristol Centre, following the installation of a second MRI unit

A second magnetic resonance imaging (MRI) machine has been installed at the Bristol Centre, which therefore now has two systems (both 0.5T), working alongside, one being 5 years older than the other. This has allowed a virtual doubling of patient throughput. The financial cost of adding the necessary building extension and the comparative capital costs of the two machines, together with the differences in the cryogen requirements are itemized; as are the extra number of staff engaged. It is estimated that the new machine cost approximately half that of the original, bought in 1987, after allowing for inflation; and that the revenue costs have increased by only 25% in the first year, with a likely increase of about 45% in year two. One result has been that in Bristol, where there are now three MRI machines, myelography and knee arthrography as diagnostic procedures have almost disappeared.

Cranial magnetic resonance imaging in patients with tuberous sclerosis and normal intellect

The pattern of cerebral hamartomas among a population of patients with tuberous sclerosis and normal intellect was determined. All patients with tuberous sclerosis over 5 years old with normal intellect who were resident in the Bath health district were offered cranial scanning by magnetic resonance imaging. Cerebral axial and coronal images were obtained in 10 mm contiguous sections with a Picker 0.5 tesla magnetic resonance imaging unit. The number, size, and distribution of lesions found was recorded. Eleven of 13 eligible patients underwent scanning. Two patients had normal scans. Seven patients had between one and five subependymal nodules. Nine patients had between two and nine cerebral tubers best seen on T2 weighted images. Our findings suggest that the wrong conclusions may be drawn if the number of lesions alone is used to predict neurological outcome in tuberous sclerosis.

Experiences at the new magnetic resonance imaging centre at Bristol

The magnetic resonance imaging unit in Bristol has been housed in a new purpose-built centre, shared between three District Health Authorities, but operated entirely separate from the National Health Service. Inasmuch as this is thought to be a unique arrangement, the publication of its finances and statistics have been readily tabulated at the end of its first year's operation, and may be of interest to others planning a similar organization.

Assessment of the Meditech Euroscanner for clinical use

In April 1983, Prototype I of the Meditech Whole Body CT Scanner (Euroscanner) was installed at Frenchay Hospital as part of a Department of Health and Social Security (DHSS) trial to assess its function and reliability. After a few months usage, several modifications were made to the machine. The official trial therefore commenced on Prototype II in the middle of January 1984 and lasted until the end of July 1984. During that time a planned changeover took place in the Neuroradiological Department, with the replacement of a ten-year-old EMI 1010 head scanner by an IGE 8800. This meant that from the beginning of May until the end of July, the Meditech Scanner was the only available CT scanner in a busy Regional Department with District Hospital commitments as well. This paper provides a summary of the clinical experiences resulting from the use of the machine, and is a rider to that in which Greensmith et al (1985) describe the physical properties of the machine.

Isodense colloid cysts of the third ventricle: a diagnostic and therapeutic problem resolved by ventriculoscopy

Eighteen patients with a colloid cyst of the 3rd ventricle presented to the Frenchay Hospital Neurosurgery Unit. The investigations included computed tomography (CT). Of these patients, 9 had radiographically isodense cysts that caused considerable diagnostic difficulties, being described only as an anterior 3rd ventricular space-occupying lesion and lateral ventricular dilatation in all but 2 cases. The clinical findings are described and the CT appearance is discussed. The new use of ventriculoscopy may resolve the problem rapidly; ventriculoscopy made the diagnosis in 5 cases and confirmed a CT diagnosis in 3 others. (It has also confirmed the diagnosis in 2 cases of hyperdense cysts.) Lately, it has been possible to aspirate the cyst contents endoscopically or, if the colloid is too viscous, to remove it with endoscopic rongeurs. After either of these procedures, the cyst wall can be coagulated with diathermy endoscopically. The method is described, and the advantages over other investigations and treatment are discussed.

Surface treatment studies aimed at streamlining fissure sealant application

Three laboratory studies were carried out with the aim of improving or streamlining enamel surface treatment procedures in fissure sealing. In Study 1, the effect of reducing acid etch time from 60 s to 10 s was assessed by SEM and tensile bond strength measurements. Reduction in etch time produced a finer etch pattern, gave a reduced but still high, bond-strength, albeit with slightly poorer long-term adhesion. Study 2 showed that a conventional acid etch treatment could completely remove acquired pellicle, without prior prophylaxis. SEM studies and bond-strength measurements corroborated this view. In Study 3, compressed air and chemical drying agents were compared for drying speed and efficiency. Compressed air gave more rapid, thorough drying, and greater resultant bond strengths.

Computed tomography in the investigation of dementia

To assess the value of computed tomography in investigating patients with dementia, 500 consecutive patients presenting with a provisional clinical diagnosis of dementia of recent onset were reviewed and the results analysed in a computer. Most patients had either cerebral atrophy or infarction, but 82 patients had a normal scan and 42 others had tumours. More than 10% of all patients, including 5% with no other symptoms or signs, had a treatable lesion. Various associated symptoms and signs were useful pointers to such a treatable lesion and clearly indicated computed tomography. Accurate diagnosis is the cornerstone of proper management, and if a few patients with treatable lesions can be identified then the benefits to all concerned may be incalculable.

Computed tomographic appearances in microgliomatosis

The computed tomography (CT) appearances of 11 patients with microgliomatosis have been reviewed, and as a result it is possible to suggest that there may be typical features for the recognition of such tumours. In this series three fairly distinctive patterns were encountered. In view of their reputed response to radiotherapy, there is a strong case for making the diagnosis of such lesions, and CT has given the opportunity of alerting the surgeon and the pathologist to the likelihood of their presence at an early stage.

The effect of salivary contamination on fissure sealant--enamel bond strength

The effect of accidental salivary contamination on the retention of fissure sealants is investigated via in vitro bond tests and scanning electron microscopy. The strength of the bond between sealant and saliva contaminated and washed enamel (168 +/- 14 kg cm-2) is not found to be significantly different from the bond strength to uncontaminated enamel (174 +/- kg cm-2). Unwashed contaminated enamel gives significantly reduced bond strength (68 +/- 11 kg cm-2).

CAT brain scans after central nervous system prophylaxis for acute lymphoblastic leukaemia

Images

Computerised axial tomography in posterior fossa lesions

The author found that 191 patients out of the first 6000 examined by the EMI brain scanner had lesions in the posterior fossa. Appearances in acoustic tumours, meningiomas, astrocytomas, haemangioblastomas, medulloblastomas, gliomas of the brain stem and metastases are described.

Computerised axial tomography and acute neurological problems of childhood

The results of computerised axial tomography (CAT) in 80 children with neurological symptoms and/or signs of less than 3 months' duration are discussed in relation firstly to intracranial pathology and secondly to clinical presentation. 26 children had intracranial space-occupying lesions (tumour, abscess, haemorrhage, infarct). CAT was abnormal in 25 of these and diagnostic in 18. A further 20 children had meningitis or encephalitis, and CAT was abnormal in 12. In contrast with this high rate of scans showing pathology, CAT was abnormal in only 4 of the remaining 34 children who had less definite or no intracranial disease. Analysis of clinical presentation showed that 42 of 69 children presented with persisting neurological signs and of these, 25 had an intracranial space-occupying lesion and 29 had abnormal CAT. Only 5 of 27 children who had symptoms alone or signs lasting less than 24 hours had abnormal CAT, and no intracranial lesion requiring specific treatment was missed. CAT is useful for demonstrating the site, size, and nature of many lesions. The scan may not initially be abnormal in brain stem gliomas and in small subdural collections of fluid.

Computerised axial tomography and the diagnosis of glioma: a study of 100 consecutive histologically proven cases

The reliability of computerised axial tomography (CAT) in the recognition of intracranial lesions is now accepted. Apart from ventricular displacement, compression or distension, abnormal patterns in the area of a lesion may be shown on the oscilloscope display and the corresponding polaroid film, and these may show additional enhancement patterns after the intravenous injection of a contrast medium. In an attempt to assess the changes shown with gliomas, both before and after contrast enhancement, and the possible relationship to the type of glioma present, and analysis has been made of 100 consecutive histologically proven cases. Other lesions occurring during the same period as the study, and giving a similar display, are illustrated and the differential diagnosis discussed.

Cerebral atrophy in young cannabis smokers

Evidence of cerebral atrophy was demonstrated by air encephalography in ten patients with histories of consistent cannabis smoking over a period of 3-11 years. The average age of the patients was 22 years; all were males. Amphetamines and lysergide (L.S.D.) had also been taken, but in much smaller amounts. Measurements of the lateral and third ventricles were significantly different from those in thirteen controls of a similar age-group.

THE POLAROGRAPHIC REDUCTION OF AMARANTH

Amaranth, a food color, has been studied polarographically over a pH range of 2.0 to 10.0 in aqueous solution and was found to give a well-defined wave, diffusion controlled and suitable for quantitative work. Irreversibility was indicated by the behavior of the half-wave potential to changes in pH and concentration. With pH, a direct relationship of −0.080 v. per pH unit held between pH 2.0 and 7.0, while with concentration, the half-wave potential was found to apparently vary directly with the logarithm of concentration. Using a coefficient of diffusion value obtained by conductance measurements the value of n for the reaction was calculated to be 4, which corresponds to a rupture of the azo group to yield the corresponding amines.