Glycemic Control in Diabetic Pregnancies: Effects on Fetal and Maternal Outcome

Background: Both maternal and fetal complications are increased in diabetic pregnancies. Although hypertensive complications are increased in pregnant women with pregestational diabetes, reports on hypertensive complications in women with gestational diabetes mellitus (GDM) have been contradictory. Congenital malformations and macrosomia are the main fetal complications in Type 1 diabetic pregnancies, whereas fetal macrosomia and birth trauma but not congenital malformations are increased in GDM pregnancies. Aims: To study the frequency of hypertensive disorders in gestational diabetes mellitus. To evaluate the risk of macrosomia and brachial plexus injury (Erb’s palsy) and the ability of the 2-hour glucose tolerance test (OGTT) combined with the 24-hour glucose profile to distinguish between low and high risks of fetal macrosomia among women with GDM. To evaluate the relationship between glycemic control and the risk of fetal malformations in pregnancies complicated by Type 1 diabetes mellitus. To assess the effect of glycemic control on the occurrence of preeclampsia and pregnancy-induced hypertension in Type 1 diabetic pregnancies. Subjects: A total of 986 women with GDM and 203 women with borderline glucose intolerance (one abnormal value in the OGTT) with a singleton pregancy, 488 pregnant women with Type 1 diabetes (691 pregnancies and 709 offspring), and 1154 pregnant non-diabetic women (1181 pregnancies and 1187 offspring) were investigated. Results: In a prospective study on 81 GDM patients the combined frequency of preeclampsia and PIH was higher than in 327 non-diabetic controls (19.8% vs 6.1%, p<0.001). On the other hand, in 203 women with only one abnormal value in the OGTT, the rate of hypertensive complications did not differ from that of the controls. Both GDM women and those with only one abnormal value in the OGTT had higher pre-pregnancy weights and BMIs than the controls. In a retrospective study involving 385 insulin-treated and 520 diet-treated GDM patients, and 805 non-diabetic control pregnant women, fetal macrosomia occurred more often in the insulin-treated GDM pregnancies (18.2%, p<0.001) than in the diet-treated GDM pregnancies (4.4%), or the control pregnancies (2.2%). The rate of Erb’s palsy in vaginally delivered infants was 2.7% in the insulin-treated group of women and 2.4% in the diet-treated women compared with 0.3% in the controls (p<0.001). The cesarean section rate was more than twice as high (42.3% vs 18.6%) in the insulin-treated GDM patients as in the controls. A major fetal malformation was observed in 30 (4.2%) of the 709 newborn infants in Type 1 diabetic pregnancies and in 10 (1.4%) of the 735 controls (RR 3.1, 95% CI 1.6–6.2). Even women whose levels of HbA1c (normal values less than 5.6%) were only slightly increased in early pregnancy (between 5.6 and 6.8%) had a relative risk of fetal malformation of 3.0 (95% CI 1.2–7.5). Only diabetic patients with a normal HbA1c level (<5.6%) in early pregnancy had the same low risk of fetal malformations as the controls. Preeclampsia was diagnosed in 12.8% and PIH in 11.4% of the 616 Type 1 diabetic women without diabetic nephropathy. The corresponding frequencies among the 854 control women were 2.7% (OR 5.2; 95% CI 3.3–8.4) for preeclampsia and 5.6% (OR 2.2, 95% CI 1.5–3.1) for PIH. Multiple logistic regression analysis indicated that glycemic control, nulliparity, diabetic retinopathy and duration of diabetes were statistically significant independent predictors of preeclampsia. The adjusted odds ratios for preeclampsia were 1.6 (95% CI 1.3–2.0) for each 1%-unit increment in the HbA1c value during the first trimester and 0.6 (95% CI 0.5–0.8) for each 1%-unit decrement during the first half of pregnancy. In contrast, changes in glycemic control during the second half of pregnancy did not alter the risk of preeclampsia. Conclusions: In type 1 diabetic pregnancies it is extremely important to achieve optimal glycemic control before pregnancy and maintain it throughout pregnancy in order to decrease the complication rates both in the mother and in her offspring. The rate of fetal macrosomia and birth trauma in GDM pregnancies, especially in the group of insulin-treated women, is still relatively high. New strategies for screening, diagnosing, and treatment of GDM must be developed in order to decrease fetal and neonatal complications.

Relationship between annual rainfall and tree mortality in a tropical dry forest: Results of a 19-year study at Mudumalai, southern India

Variability in rainfall is known to be a major influence on the dynamics of tropical forests, especially rates and patterns of tree mortality. In tropical dry forests a number of contributing factors to tree mortality, including dry season fire and herbivory by large herbivorous mammals, could be related to rainfall patterns, while loss of water potential in trees during the dry season or a wet season drought could also result in enhanced rates of death. While tree mortality as influenced by severe drought has been examined in tropical wet forests there is insufficient understanding of this process in tropical dry forests. We examined these causal factors in relation to inter-annual differences in rainfall in causing tree mortality within a 50-ha Forest Dynamics Plot located in the tropical dry deciduous forests of Mudumalai, southern India, that has been monitored annually since 1988. Over a 19-year period (1988-2007) mean annual mortality rate of all stems >1 cm dbh was 6.9 +/- 4.6% (range = 1.5-17.5%); mortality rates broadly declined from the smaller to the larger size classes with the rates in stems >30 cm dbh being among the lowest recorded in tropical forest globally. Fire was the main agent of mortality in stems 1-5 cm dbh, elephant-herbivory in stems 5-10 cm dbh, and other natural causes in stems > 10 cm dbh. Elephant-related mortality did not show any relationship to rainfall. On the other hand, fire-related mortality was significantly negatively correlated to quantity of rainfall during the preceding year. Mortality due to other causes in the larger stem sizes was significantly negatively correlated to rainfall with a 2-3-year lag, suggesting that water deficit from mild or prolonged drought enhanced the risk of death but only with a time lag that was greater than similar lags in tree mortality observed in other forest types. In this respect, tropical dry forests growing in regions of high rainfall variability may have evolved greater resistance to rainfall deficit as compared to tropical moist or temperate forests but are still vulnerable to drought-related mortality.

Consumption in Rural Bangladesh : Households, Lifestyles, and Identities

Bangladesh, often better known to the outside world as a country of natural calamities, is one of the most densely populated countries in the world. Despite rapid urbanization, more than 75% of the people still live in rural areas. The density of the rural population is also one of the highest in the world. Being a poor and low-income country, its main challenge is to eradicate poverty through increasing equitable income. Since its independence in 1971, Bangladesh has experienced many ups and downs, but over the past three decades, its gross domestic product (GDP) has grown at an impressive rate. Consequently, the country s economy is developing and the country has outperformed many low-income countries in terms of several social indicators. Bangladesh has achieved the Millennium Development Goal (MDG) of eliminating gender disparity in primary and secondary school enrollment. A sharp decline in child and infant mortality rates, increased per capita income, and improved food security have placed Bangladesh on the track to achieving in the near future the status of a middle-income country. All these developments have influenced the consumption pattern of the country. This study explores the consumption scenario of rural Bangladesh, its changing consumption patterns, the relationship between technology and consumption in rural Bangladesh, cultural consumption in rural Bangladesh, and the myriad reasons why consumers nevertheless feel compelled to consume chemically treated foods. Data were collected in two phases in the summers of 2006 and 2008. In 2006, the empirical data were collected from the following three sources: interviews with consumers, producers/sellers, and doctors and pharmacists; observations of sellers/producers; and reviews of articles published in the national English and Bengali (the national language of Bangladesh) daily newspapers. A total of 110 consumers, 25 sellers/producers, 7 doctors, and 7 pharmacists were interviewed and observed. In 2008, data were collected through semi-structured in-depth qualitative interviews, ethnography, and unstructured conversations substantiated by secondary sources and photographs; the total number of persons interviewed was 22. -- Data were also collected on the consumption of food, clothing, housing, education, medical facilities, marriage and dowry, the division of labor, household decision making, different festivals such as Eid (for Muslims), the Bengali New Year, and Durga puja (for Hindus), and leisure. Qualitative methods were applied to the data analysis and were supported by secondary quantitative data. The findings of this study suggest that the consumption patterns of rural Bangladeshis are changing over time along with economic and social development, and that technology has rendered aspects of daily life more convenient. This study identified the perceptions and experiences of rural people regarding technologies in use and explored how culture is associated with consumption. This study identified the reasons behind the use of hazardous chemicals (e.g. calcium carbide, sodium cyclamate, cyanide and formalin, etc.) in foods as well as the extent to which food producers/sellers used such chemicals. In addition, this study assessed consumer perceptions of and attitudes toward these contaminated food items and explored how adulterated foods and food stuffs affect consumer health. This study also showed that consumers were aware that various foods and food stuffs contained hazardous chemicals, and that these adulterated foods and food stuffs were harmful to their health.

Estimates of Marine Mammal, Sea Turtle, and Seabird Mortality in the California Drift Gillnet Fishery for Swordfish and Thresher Shark, 1996–2002

Estimates of incidental marine mammal, sea turtle, and seabird mortality in the California drift gillnet fishery for broadbill swordfish, Xiphias gladius, and common thresher shark, Alopias vulpinus, are summarized for the 7-year period, 1996 to 2002. Fishery observer coverage was 19% over the period (3,369 days observed/17,649 days fished). An experiment to test the effectiveness of acoustic pingers on reducing marine mammal entanglements in this fishery began in 1996 and resulted in statistically significant reductions in marine mammal bycatch. The most commonly entangled marine mammal species were the short-beaked common dolphin, Delphinus delphis; California sea lion, Zalophus californianus; and northern right whale dolphin, Lissodelphis borealis. Estimated mortality by species (CV and observed mortality in parentheses) from 1996 to 2002 is 861 (0.11, 133) short-beaked common dolphins; 553 (0.16, 103) California sea lions; 151 (0.25, 31) northern right whale dolphins; 150 (0.21, 27) northern elephant seals, Mirounga angustirostris; 54 (0.41, 10) long-beaked common dolphins, Delphinus capensis; 44 (0.53, 6) Dall’s porpoise, Phocoenoides dalli; 19 (0.60, 5) Risso’s dolphins, Grampus griseus; 11 (0.71, 2) gray whales, Eschrichtius robustus; 7 (0.83, 2) sperm whales, Physeter macrocephalus; 7 (0.96, 1) short-finned pilot whales, Globicephala macrorhychus; 12 (1.06, 1) minke whales, Balaenoptera acutorostrata; 5 (1.05, 1) fin whales, Balaenoptera physalus; 11 (0.68, 2) unidentified pinnipeds; 33 (0.52, 4) leatherback turtles, Dermochelys coriacea; 18 (0.57, 3) loggerhead turtles, Caretta caretta; 13 (0.73, 3) northern fulmars, Fulmarus glacialis; and 6 (0.86, 2) unidentified birds.

Distribution, demography, and discard mortality of crabs caught as bycatch in an experimental pot fishery for toothfish (Dissostichus eleginoides) in the South Atlantic

Between March 2000 and April 2001 two commercial fishing vessels fished for toothfish (Dissostichus eleginoides) off South Georgia using pots. A significant number of lithodid crabs (three species of Paralomis spp.) were caught as bycatch. Paralomis spinosissima occurred in shallow water, generally shallower than 700 m. Paralomis anamerae, not previously reported from this area and therefore representing a considerable southerly extension in the reported geographic range of this species, had an intermediate depth distribution from 400 to 800 m. Paralomis formosa was present in shallow waters but reached much higher catch levels (and, presumably, densities) between 800 and 1400 m. Differences were also noted in depth distribution of the sexes and size of crabs. Depth, soak time, and area were found to significantly influence crab catch rates. Few crabs (3% of P. spinosissima and 7% of P. formosa) were males above the legal size limit and could therefore be retained. All other crabs were discarded. Most crabs (>99% of P. formosa, >97% of P. spinosissima, and >90% of P. anamerae) were lively on arrival on deck and at subsequent discard. Mortality rates estimated from re-immersion experiments indicated that on the vessel where pots were emptied directly onto the factory conveyor belt 78–89% of crabs would survive discarding, whereas on the vessel where crabs were emptied down a vertical chute prior to being sorted, survivorship was 38–58%. Of the three, P. anamerae was the most vulnerable to handling onboard and sub-sequent discarding. Paralomis spinosissima seemed more vulnerable than P. formosa.

Livelihood and seed mortality related vulnerability of carp seed traders of Bangladesh

Carp seed traders in Bangladesh are considered as one of the poorest, most vulnerable and least studied sub-population. Millions of fingerlings are transported annually to various parts of the country using bus tops and/or truck-beds in open and hand agitated method by the traders and as a result they encounter mass seed mortality. They are the key players in augmenting aquaculture activities by distributing fish fry and fingerlings to the fish farmers. Assessment of the seed sources and the livelihood of the traders are important to identify their point of entry to the aquaculture sector and further improvement. Status of household asset, income profiles, and risks involved were examined using DFID's sustainable livelihood approach (SLA) framework. Tools used to collect data included group discussions (GD), semi-structured and structured household (HH) survey. Samples (n=637) were randomly drawn purposefully from 10% of the carp seed traders within 11 districts. Sampled HH were classified into six land classes.

Hydrogen-Bonding Recognition-Induced Color Change of Gold Nanoparticles for Visual Detection of Melamine in Raw Milk and Infant Formula

The color change induced by triple hydrogen-bonding recognition between melamine and a cyanuric acid derivative grafted on the surface of gold nanoparticles can be used for reliable detection of melamine. Since such a color change can be readily seen by the naked eye, the method enables on-site and real-time detection of melamine in raw milk and infant formula even at a concentration as low as 2.5 ppb without the aid of any advanced instruments.

Studies on growth rate and grazing mortality rate by microzooplankton of size-fractionated phytoplankton in spring and summer in the Jiaozhou Bay, China

Dilution experiments were performed to examine the growth rate and grazing mortality rate of size-fractionated phytoplankton at three typical stations, inside and outside the bay, in the spring and summer of 2003 in the Jiaozhou Bay, China. in spring, the phytoplankton community structure was similar among the three stations, and was mainly composed of nanophytoplankton, such as, Skeletonema costatum and Cylindrotheca closterium. The structure became significantly different for the three stations in summer, when the dominant species at Stas A, B and C were Chaetoceros curvisetus, Pseudo-nitzschia delicatissima, C. affinis, C. debilis, Coscinodiscus oculus-iridis and Paralia sulcata respectively. Tintinnopsis beroidea and T. tsingtaoensis were the dominant species in spring, whereas the microzooplankton was apparently dominated by Strombidium sp. in summer. Pico- and nanophytoplankton had a relatively greater growth rate than microzooplankton both in spring and summer. The growth rate and grazing mortality rate were 0.18 similar to 0.44 and 0.12 similar to 1.47 d(-1) for the total phytoplankton and 0.20 similar to 0.55 and 0.21 similar to 0.37 d-1 for nanophytoplankton in spring respectively. In summer, the growth rate and grazing mortality rate were 0.38 similar to 0.71 and 0.27 similar to 0.60 d-1 for the total phytoplankton and 0.11 similar to 1.18 and 0.41 similar to 0.72 d(-1) for nano- and microphytoplankton respectively. The carbon flux consumed by microzooplankton per day was 7.68 similar to 39.81 mg/m(3) in spring and 12.03 similar to 138.22 mg/m(3) in summer respectively. Microzooplankton ingested 17.56%similar to 92.19% of the phytoplankton standing stocks and 31.77%similar to 467.88% of the potential primary productivity in spring; in contrast, they ingested 34.60%similar to 83.04% of the phytoplankton standing stocks and 71.28%similar to 98.80% of the potential primary productivity in summer. Pico- and nanophytoplankton appeared to have relatively greater rates of growth and grazing mortality than microphytoplankton during the experimental period. The grazing rate of microzooplankton in summer was a little bit greater than that in spring because of the relatively higher incubation temperature and different dominant microzooplankton species. Microzooplankton preferred ingesting nanophytoplankton to microphytoplankton in spring, while they preferred ingesting picophytoplankton to nanophytoplankton and microphytoplankton in summer. Compared with the results of dilution experiments performed in various waters worldwide, the results are in the middle range.

Alternative splicing of the FMR1 gene in human tissues of fetal and adult

To study the time- and tissue-specificity of alternative splicing of the FMR1 gene, we analyzed the alternative splicing pattern of the FMR1 gene in human tissues from adult and fetus using RT-PCR coupled with capillary electrophoresis. Seven alternative splicing variants of FMR1 were found in adult liver and lung. The major three alternative splicing variants of the FMR1 gene in all analyzed fetal tissues were same, though the number of minor isoforms and the relative abundance of major isoforms were different. The major difference of the alternative splicing pat tem between adult and fetus was in exon 12 and 17. The results suggest that the alternative splicing pattern of the FMR1 gene is non-tissue-specific in the same developmental stage and a developmental switch may be present.

Participation in Self-Collection of Maternal and Infant DNA in a Case-Control Study on Clubfoot

National Institute of Child Health and Human Development (HD051804)