Analysis of spontaneous, user-generated data about gestational diabetes on online forums: implications for diabetes prevention.

AIMS: To explore the experiences and perceptions of gestational diabetes mellitus reported by women within online parental-support forums and, specifically, to analyse what women say about a diagnosis of gestational diabetes, their future risk of type 2 diabetes, and lifestyle behaviour for management of gestational diabetes and prevention of type 2 diabetes. METHODS: The discussion boards of two parenting websites (Mumsnet and Netmums) were searched using the search term 'gestational diabetes or GD' in February 2019. Relevant posts made by users with gestational diabetes on or after 1 January 2017 were retained for analysis. Framework analysis using pre-existing framework from a previous study was used to organize and analyse the data. RESULTS: A total of 646 posts generated by 282 unique users were included in the analysis. Analysis of the online content identified three important implicit messages that may be being conveyed to readers. The first is that gestational diabetes is not a serious diagnosis that warrants undue concern. Secondly, few users recognized the importance of their own behaviours or lifestyle, with others minimizing personal responsibility or attributing gestational diabetes to non-modifiable factors. Finally, there was a lack of acknowledgment of heightened risk of type 2 diabetes. These three messages will all directly mitigate against the efforts of clinicians (and others) to encourage women with gestational diabetes to improve their lifestyle behaviours in the longer term. CONCLUSIONS: These findings highlight messages that are being widely disseminated and that are unlikely to support prevention of type 2 diabetes.

Confirmation of in vitro and clinical safety assessment of behentrimonium chloride-containing leave-on body lotions using post-marketing adverse event data.

Behentrimonium chloride (BTC) is a straight-chain alkyltrimonium chloride compound commonly used as an antistatic, hair conditioning, emulsifier, or preservative agent in personal care products. Although the European Union recently restricted the use of alkyltrimonium chlorides and bromides as preservatives to ≤0.1%, these compounds have been safely used for many years at ≤5% in hundreds of cosmetic products for other uses than as a preservative. In vitro, clinical, and controlled consumer usage tests in barrier-impaired individuals were conducted to determine if whole body, leave-on skin care products containing 1-5% BTC cause dermal irritation or any other skin reaction with use. BTC-containing formulations were predicted to be non-irritants by the EpiDerm® skin irritation test and the bovine corneal opacity and permeability (BCOP)/chorioallantoic membrane vascular assay (CAMVA) ocular irritation test battery. No evidence of allergic contact dermatitis or cumulative dermal irritation was noted under the exaggerated conditions of human occlusive patch tests. No clinically assessed or self-reported adverse reactions were noted in adults or children with atopic, eczematous, and/or xerotic skin during two-week and four-week monitored home usage studies. These results were confirmed by post-marketing data for five body lotions, which showed only 0.69 undesirable effects (mostly skin irritation) reported per million shipped consumer units during 2006-2011; a value consistent with a non-irritating body lotion. No serious undesirable effects were reported during in-market use of the products. Therefore, if formulated in appropriate conditions at 1-5%, BTC will not cause dermal irritation or delayed contact sensitization when used in a whole-body, leave-on product.

Physical impairments related to kinetic energy during sit-to-stand and curb-climbing following stroke.

OBJECTIVE: Compare kinetic energy and duration of task during sit-to-stand and curb-climbing of two groups: hemiparetic stroke patients and matched controls. For patients, describe relationships between selected physical impairments and sit-to-stand and curb-climbing performance. DESIGN: Descriptive and correlational.Background. Measures and treatments are best selected after specific limitations in functional activities (e.g., sit-to-stand) and related impairments are identified. METHOD. Fifteen patients, 29-77 (mean=53.7) years with recent stroke and 15 demographically matched healthy controls participated. Physical performance variables measured were standing balance, maximum paretic extremity weight-bearing, and knee extension strength. Sit-to-stand and curb-climbing performance were characterized using kinetic energy and task duration. Differences in physical and functional performance between groups were determined. Spearman correlations were calculated between patients' physical impairments and sit-to-stand and curb-climbing performance. RESULTS: Compared to controls, patients demonstrated reduced kinetic energy (P< or =0.003) and prolonged duration (P< or = 0.001) for sit-to-stand and curb-climbing. Significant relationships (r(s)=0.49-0.50) were demonstrated between sit-to-stand kinetic energy and knee extension strength, standing balance, and maximum weight-bearing. For curb climbing, significant relationships (r(s)=0.45) were found between kinetic energy and standing balance and maximum weight-bearing. CONCLUSION: Impaired balance and maximum weight-bearing are relevant to sit-to-stand and curb-climbing limitations after stroke. RELEVANCE: Clinicians treating sit-to-stand or curb-climbing limitations have reason to measure and treat impairments in maximum weight-bearing, knee extension strength, and standing balance.

Complete characterization of a self-mode-locked ti:sapphire laser in the vicinity of zero group-delay dispersion by frequency-resolved optical gating.

The intensity and the phase of ultrashort pulses from a self-mode-locked Ti:sapphire laser operating in the vicinity of zero group-delay dispersion (GDD) have been completely characterized by the technique of frequency-resolved optical gating (FROG). For small values of negative GDD, the appearance of a dispersive wave in the pulse spectrum is manifested in the measured FROG trace, and pulse retrieval directly shows its association with a broad leading-edge pedestal. For positive GDD, we confirm previous experimental observations of picosecond pulses with large positive chirp and report a new operating regime in which the output pulses are of picosecond duration but are intensity modulated at 20 THz. The physical origin of this modulation is discussed by analogy with similar effects observed during pulse propagation in optical fibers, and the experimental results are compared with a model of intracavity four-wave mixing about the cavity zero GDD wavelength.

Influence of hip position on measurements of the straight leg raise test.

Variations of the straight leg raise (SLR) test are described clinically; however, no studies have examined how these variations may affect the outcome of this test. This study examined whether measurements of SLR are influenced by position of contralateral hip (flexed vs. extended), nature of the trial (active vs. passive), or trial repetitions (1 vs. 2). Twenty-two healthy, young subjects participated in this study. A 35-mm camera recorded the position of the pelvis and lower limb during the performance of a right SLR. Passive SLR (opposite hip extended vs. opposite hip flexed) and active SLR (opposite hip extended vs. opposite hip flexed) were performed twice, in random order. Three different measures of SLR were obtained while subjects performed SLR under the aforementioned conditions--SLR relative to horizontal, SLR relative to pelvis, and pelvis relative to horizontal. Differences in SLR between opposite hip flexed vs. extended, passive vs. active, and trials were analyzed using a multifactorial analysis of variance for repeated measures. Hip position affected SLR relative to horizontal (p < .000) and pelvis relative to horizontal (p < .000), with an increase in measurement occurring with the opposite hip flexed. Nature of the trial (active vs. passive) affected SLR to pelvis (p < .003) and pelvis to horizontal (p < .000) with an increase in measurement for passive SLR. A difference in measurements existed between trials 1 and 2 for SLR to horizontal (p < .005) and for SLR to pelvis (p < .005). Although conducted on healthy subjects, the study points out the necessity of consistency of method when performing and interpreting the SLR test.

Relationship between active knee extension and active straight leg raise test measurements.

This study was conducted to determine the relationship between two alternative tests for indicating hamstring musculotendinous length, active knee extension (AKE) and active straight leg raise (ASLR). Before alternatives to a commonly practiced clinical test such as AKE can be recommended for application, their convergent validity should be established. Twenty-three healthy subjects (mean age = 29.4 years) were tested. A 35-mm camera was used to record the position of the right side of the pelvis and lower limb during the performance of the ASLR test on the right. The camera set-up was also used to record the position of the right knee and pelvis during the performance of AKE with the right hip flexed to 90 degrees. For ASLR, the angle of the straight leg to the horizontal was measured. For AKE, the angle of knee extension was measured. The intraclass correlation coefficients for the AKE (.861) and ASLR (.953) tests were good and high, respectively. There was a significant relationship (r = -.718; r2 = .515; p < .001) between AKE and ASLR. The significant correlation between the measurements obtained using these two tests suggests that both are providing an indication of the same basic phenomenon, presumably hamstring musculotendinous length. For this reason, the AKE test may be a useful alternative to the straight leg raise test for providing an indication of hamstring muscle length.

Evaluation of the efficacy of Broilact in preventing infection of broiler chicks with Salmonella enteritidis PT4.

A study was conducted to evaluate treatment of day-old broiler chicks with Broilact, a live-culture preparation, for preventing intestinal colonization by a non-host-specific Salmonella (S. enteritidis PT4, with high resistance to nalidixic acid). Newly hatched broiler chicks were sprayed with Broilact at a commercial hatchery and delivered on the same day to Huntingdon Research Centre. Control chicks from the same source (i.e. chicks not treated with Broilact) were sent separately. Chicks were maintained in floor pens in groups of 40. The challenge was introduced by means of seeder birds infected with S. enteritidis PT4 (nalr) at a nominal dose level of 10(4) CFU per bird (3 seeder birds per pen of 40 contact birds). Groups of birds were killed 7, 28 and 40 days after challenge, and in each case caecal contents were examined culturally for the test organism. A total of 18 deaths occurred including 13 untreated contact birds, 3 Broilact-treated contact birds and 2 seeder birds. These were attributed to the experimental infection. Results of the examination of caecal contents from untreated control birds indicated that the challenge organism was successfully established in contact chicks via the seeder birds. The overall results for birds treated with Broilact showed a clear protective effect, with little indication of any significant infection by the challenge organism. It was concluded therefore that under the conditions of this study, Broilact was largely effective in preventing intestinal colonization by the non-host-specific s. enteritidis PT4.

A high flow turbine CPAP system.

A continuous high flow CPAP system incorporating a turbine blower is described. The system achieves inspiratory flow rates of 150 l/min or more by means of reticulated gas flow and inspired oxygen fractions of 0.21-0.95. Positive airway pressure is provided by weighted disc valves and a modified aviation-type CPAP face mask provides electronic communication with the patient. The mobility of the system also enables its use as an intermittent physiotherapy aid. Work of breathing of the system, as assessed by total pressure fluctuations is at a minimum.

Real-time analysis of breath using an atmospheric pressure ionization mass spectrometer.

A new technique is reported resulting in the direct, instantaneous analyses of trace compounds in breath. The analyses were performed using a commercial atmospheric pressure chemical ionization mass spectrometer (TAGA TM2000 APCI mass spectrometer). A known flow of breath sample is introduced into the ionization region of the mass spectrometer. The study includes the measurement and monitoring in real-time, of breath ammonia during a 24 hour and a 48 hour period. The ammonia profiles indicate a personalized daily pattern associated with each subject. This method appears to be of potential value in routine detection and treatment of hyperammonemia patients. Results also show that it is possible to obtain instantaneous analyses of several naturally occurring metabolites and other substances on breath in the ppm to ppt range, suggesting a number of diagnostic research applications.