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02 for interaction effect). Among infants randomized to skin-to-skin care with a polyethylene bag in phase 1, the risk of moderate-severe hypothermia was decreased in infants randomized to continue this intervention until discharge compared with infants randomized to skin-to-skin care alone. The rates of severe hypothermia, hyperthermia, and other adverse events did not differ significantly between groups.

Low-cost polyethylene bags started after birth in combination with skin-to-skin care reduced moderate or severe hypothermia at 1hour and at discharge among infants born at term in a resource-limited setting compared with skin-to-skin care alone.

ClinicalTrials.gov NCT03141723.

ClinicalTrials.gov NCT03141723.

To evaluate the fat but fit conceptual model, testing whether this paradigm for body mass index (BMI) and maximum rate of oxygen consumption (VO

) exists in schoolchildren and whether executive functions mediate the relationship between fat but fit categories and academic achievement.

Cluster cross-sectional analyses of data from 554 children aged 9-11 from Cuenca, Spain. BMI, VO

, core executive functions (inhibition, working memory, and cognitive flexibility) and academic achievement (language and mathematics).

Cluster analysis of BMI and VO

z-scores resulted in a 4-cluster solution that could be interpreted according to fat unfit, unfat unfit, fat fit, and unfat fit categories. ANCOVA models confirmed an increasing trend by cluster category in terms of VO

levels and, conversely, a decreasing trend in terms of adiposity variables. These models also confirmed that children in the fat fit and unfat fit categories scored higher than their peers in the fat unfit and unfat unfit categories. Mediation analyses using fat but fit clusters as multicategory independent variable, executive functions as mediators, and academic achievement as outcome variable showed that the positive association between the BMI-VO

clusters and academic achievement was mediated by inhibition levels in fat fit and unfat fit individuals, by working memory levels only in those classified as fat fit, and by cognitive flexibility only in unfat fit individuals.

This study confirms the validity of the 4-cluster conceptual model regarding BMI and VO

and reinforces the predictive validity, proving that fitness levels are able to counteract the detrimental effect of obesity on academic achievement.

This study confirms the validity of the 4-cluster conceptual model regarding BMI and VO2max and reinforces the predictive validity, proving that fitness levels are able to counteract the detrimental effect of obesity on academic achievement.

To determine plasma lactate and beta-hydroxybutyrate (BHB) concentrations of healthy infants in the first 5days and their relationships with glucose concentrations.

Prospective masked observational study in Hamilton, New Zealand. Term, appropriately grown singletons had heel-prick blood samples, 4 in the first 24hours then twice daily.

In 67 infants, plasma lactate concentrations were higher in the first 12hours (median, 20; range, 10-55 mg/dL [median, 2.2mmol/L; range, 1.1-6.2mmol/L]), decreasing to 12mg/dL (range, 7-29mg/dL [median, 1.4mmol/L; range, 0.8-3.3mmol/L]) after 48hours. Plasma BHB concentrations were low in the first 12hours (median,0.9mg/dL; range, 0.5-5.2mg/dL [median, 0.1mmol/L; range, 0.05-0.5mmol/L]), peaked at 48-72hours (median, 7.3mg/dL; range, 1.0-25.0mg/dL [median, 0.7mmol/L; range, 0.05-2.4mmol/L]), and decreased by 96hours (median, 0.9mg/dL; range, 0.5-16.7mg/dL [median, 0.1mmol/L; range, 0.05-1.6mmol/L]). Compared with infants with plasma glucose concentrations above the median (median, 67mg/dL [median, 3.7mmol/L]), those with lower glucose had lower lactate concentrations in the first 12hours and higher BHB concentrations between 24 and 96hours. Lower interstitial glucose concentrations were also associated with higher plasma BHB concentrations, but only if the lower glucose lasted greater than 12hours. Glucose contributed 72%-84% of the estimated potential adenosine triphosphate throughout the 5days, with lactate contributing 25% on day 1 and BHB 7% on days 2-3.

Lactate on day 1 and BHB on days 2-4 may contribute to cerebral fuels in healthy infants, but are unlikely to provide neuroprotection during early or acute hypoglycemia.

The Australian and New Zealand Clinical Trials Registry ACTRN12615000986572.

The Australian and New Zealand Clinical Trials Registry ACTRN12615000986572.Autophagy is a very versatile process through which the cell degrades damaged long-lived proteins, entire organelles, or pathogens, by engulfing them in characteristic double-membrane vesicles and conveying the cargo to lysosomes. It is a dynamic pathway tunable at multiple levels and responsive to nutrient and stress stimuli, also coming from the extracellular microenvironment and its remodeling. In the extracellular matrix, collagen type VI forms a distinctive set of beaded microfilaments that assemble into an intricate and multimodular meshwork of tightly linked proteins and surface receptors. When missing or defective, collagen VI triggers a series of pathological events in skeletal muscle and other tissues, with a remarkable impact on key cell processes, such as apoptosis and autophagy. In this review, we discuss the current knowledge about collagen VI regulation of autophagy in the different experimental models and human pathologies where it was studied, and provide some hints for future directions aimed at the fine dissection of this intriguing relationship, as well as its prospective translational impact for disease and therapy.Identifying patients with high genetic risk for cancer has important clinical ramifications, but hereditary cancer risk is often not identified because of testing barriers at both the provider and patient level. It is unknown how to best implement appropriate genetic testing and follow-up care into an operating primary care clinic. Implementation studies to date have been conducted in high resourced facilities under optimal conditions, often not at the clinic level. This study aims to compare and evaluate two population-wide engagement strategies for identifying members of a primary care clinic's population with a family or personal history of cancer and offering high-risk individuals genetic testing for cancer susceptibility mutations. The two engagement strategies are 1) point of care screening (POC), conducted when a patient is scheduled for an appointment and 2) direct patient engagement (DPE), where outreach provides the patient an opportunity to complete screening online on their own time. The study will identify changes, problems, and inefficiencies in clinical flow during and after the implementation of risk assessment and genomic testing for cancer risk across primary care clinics. It will also evaluate the effects of the two engagement strategies on patient, provider, and clinic leader outcomes, including perceptions of benefits, harms, and satisfaction with the engagement strategy and process of cancer risk assessment and genetic testing, across gender, racial/ethnic, socioeconomic, and genetic literacy divides. Finally, the study will evaluate the cost-effectiveness and budget impact of each engagement strategy.

Although serum fibroblast growth factor 21 (FGF21) levels are associated with liver fat content in non-alcoholic liver fat disease (NAFLD), the precise nature of the association remains undetermined. Therefore, this study aimed to explore the potential dose-response relationship between FGF21 and liver fat content in NAFLD.

For this exploratory randomized clinical trial, 220 NAFLD patients with central obesity were recruited via community-based screening and randomly assigned to either control, moderate or vigorous-moderate exercise groups for 12 months. After this exercise intervention, patients were followed-up for a further 12 months. Serum FGF21 levels were measured by ELISA. Intrahepatic triglyceride (IHTG) content was determined by proton magnetic resonance spectroscopy.

Of the 220 patients, 149 (67.7%) were female; mean age was 53.9 ± 7.1 years and mean BMI was 28.0 ± 2.9 kg/m2 for all patients. Baseline IHGT increased gradually (P = 0.029 for trend) according to baseline serum FGF21 quartiles 1,iver fat content in NAFLD.

Serum FGF21 is strongly associated with liver fat content in a dose-response manner in centrally obese NAFLD patients. These findings support the use of serum FGF21 as a biomarker of liver fat content in NAFLD.Intracerebral implantation of neural stem cells (NSCs) to treat stroke remains an inefficient process with less then 5% of injected cells being retained. To improve the retention and distribution of NSCs after a stroke, we investigated the utility of NSCs' encapsulation in polyethylene glycol (PEG) microspheres. We first characterized the impact of the physical properties of different syringes and needles, as well as ejection speed, upon delivery of microspheres to the stroke injured rat brain. A 20 G needle size at a 10 μL/min flow rate achieved the most efficient microsphere ejection. Secondly, we optimized the delivery vehicles for in vivo implantation of PEG microspheres. The suspension of microspheres in extracellular matrix (ECM) hydrogel showed superior retention and distribution in a cortical stroke caused by photothrombosis, as well as in a striatal and cortical cavity ensuing middle cerebral artery occlusion (MCAo). Thirdly, NSCs or NSCs + endothelial cells (ECs) encapsulated into biodegradable microspheres were implanted into a large stroke cavity. Cells in microspheres exhibited a high viability, survived freezing and transport. Implantation of 110 cells/microsphere suspended in ECM hydrogel produced a highly efficient delivery that resulted in the widespread distribution of NSCs in the tissue cavity and damaged peri-infarct tissues. Co-delivery of ECs enhanced the in vivo survival and distribution of ∼1.1 million NSCs. The delivery of NSCs and ECs can be dramatically improved using microsphere encapsulation combined with suspension in ECM hydrogel. These biomaterial innovations are essential to advance clinical efforts to improve the treatment of stroke using intracerebral cell therapy.Social spatial cognition refers to the interaction between self, place, and partners, with emphasis on the impact of the social environment on spatial behavior and on how individual spatial representations converge to form collective spatial behavior - i.e., common places and routes. Recent studies suggest that in addition to their mental representation (cognitive map) of the physical environment, humans and other animals also have a social cognitive map. We suggest that while social spatial cognition relies on knowledge of both the physical and the social environments, it is the latter hat predominates. This dominance is illustrated here in the modulation of spatial behavior according to dynamic social interactions, ranging from group formation to an attenuation of drug-induced stereotypy through the mere presence of a normal subject. Consequently we suggest that the numerous studies on the biobehavioral controlling mechanisms of spatial behavior (i.e. Epacadostat solubility dmso - the hippocampal formation, animal models for mental disorders) should also consider the social environment rather than solely focusing on the spatial behavior of lone animals.