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Children with congenital heart disease are at high risk for malnutrition. Standardisation of feeding protocols has shown promise in decreasing some of this risk. With little standardisation between institutions’ feeding protocols and no understanding of protocol adherence, it is important to analyse the efficacy of individual aspects of the protocols.
Adherence to and deviation from a feeding protocol in high-risk congenital heart disease patients between December 2015 and March 2017 were analysed. Associations between adherence to and deviation from the protocol and clinical outcomes were also assessed. The primary outcome was change in weight-for-age z score between time intervals.
Increased adherence to and decreased deviation from individual instructions of a feeding protocol improves patients change in weight-for-age z score between birth and hospital discharge (p = 0.031). Secondary outcomes such as markers of clinical severity and nutritional delivery were not statistically different between groups with high or low adherence or deviation rates.
High-risk feeding protocol adherence and fewer deviations are associated with weight gain independent of their influence on nutritional delivery and caloric intake. Future studies assessing the efficacy of feeding protocols should include the measures of adherence and deviations that are not merely limited to caloric delivery and illness severity.
OBJECTIVES/SPECIFIC AIMS: Intensive lifestyle change (e.g., the Diabetes Prevention Program) and metformin reduce type 2 diabetes risk among patients with prediabetes. However, real-world uptake remains low. Shared decision-making (SDM) may increase awareness and help patients select and follow through with informed options for diabetes prevention that are aligned with their preferences.The objective was to test the effectiveness of a prediabetes SDM intervention. METHODS/STUDY POPULATION: This was a cluster-randomized controlled trial in 20 primary care clinics within a large regional health system. Participants were overweight/obese adults with prediabetes (BMI>24 kg/m2 and HbA1c 5.7-6.4%) were enrolled from 10 SDM intervention clinics. Propensity score matching was used to identify control patients from 10 usual care clinics.Intervention clinic patients were invited to participate in a face-to-face SDM visit with a pharmacist who used a decision aid (DA) to describe prediabetes and four possible options for diabetes prevention; DPP, DPP +/− metformin, metformin only, or usual care. RESULTS/ANTICIPATED RESULTS: Uptake of DPP and/or metformin was higher among SDM participants (n=351) than controls receiving usual care (n = 1,028; 38% vs. 2%, p<.001). At 12-months follow-up, adjusted weight loss (lbs.) was greater among SDM participants than controls (−5.3 vs. −0.2, p < .001). DISCUSSION/SIGNIFICANCE OF IMPACT: A prediabetes SDM intervention led by pharmacists increased patient engagement in evidence-based options for diabetes prevention and was associated with significantly greater uptake of DPP and/or metformin at 4-months and weight loss at 12-months. Prediabetes SDM may be a promising approach to enhance prevention efforts among patients at increased risk.
The Queen Elizabeth Islands of the Canadian Arctic Archipelago exhibit one of the most complex sea-ice regimes in the Northern Hemisphere. Time series of minimum monthly passive-microwave sea-ice area (1979−98), minimum sea-ice extent, melting degree-days (1961−98) and minimum sea ice from the new Canadian Ice Service digital database (1968−98) are examined. The extreme nature of the amount of sea-ice melt in the summers of 1998 and 1962 is evident in these time series. The 38 year record of minimum ice, to date, shows no significant trend. Details of the sea-ice behavior during summer 1998 were then examined within 13 individual sea-ice regimes. The multi-year fast-ice plugs in both Sverdrup Channel and Nansen Sound broke up and became truly mobile in 1998. Discussion focuses on the areas surrounding the multi-year plugs, relating sea-ice conditions to weather. Results emphasize the importance of the timing of synoptic events in combination with strong thermal preconditioning in determining the sea-ice conditions in this area during summer 1998.
We have developed several detector systems for use in observational astronomy. These include a rapid scanning spectrometer (Jeffers and Weller, 1973), a rapid chopping spectrophotometer (Stiff and Jeffers, 1978) and an intensified, silicon vidicon detector for use either for spectrophotometry (Jeffers, Stiff and Weller, 1983) or direct imaging (Jeffers, 1982). These detector systems have been used for rapid variability studies of emission line strengths and profiles in Wolf-Rayet and Of stars (Weller and Jeffers, 1979; Jeffers, Stiff and Weller, 1985) and for low dispersion spectrophotometry of these stars (Jeffers and Weller, 1985). Here we report on the spectrophotometric performance of the intensified, silicon vidicon detector (RCA 4804H) when used with a low dispersion spectrograph.
Among the solar proxies, κ1 Cet, stands out as potentially having a mass very close to solar and a young age. We report magnetic field measurements and planetary habitability consequences around this star, a proxy of the young Sun when life arose on Earth. Magnetic strength was determined from spectropolarimetric observations and we reconstruct the large-scale surface magnetic field to derive the magnetic environment, stellar winds, and particle flux permeating the interplanetary medium around κ1 Cet. Our results show a closer magnetosphere and mass-loss rate 50 times larger than the current solar wind mass-loss rate when Life arose on Earth, resulting in a larger interaction via space weather disturbances between the stellar wind and a hypothetical young-Earth analogue, potentially affecting the habitability. Interaction of the wind from the young Sun with the planetary ancient magnetic field may have affected the young Earth and its life conditions.
Trois résolutions ont été adoptées par la 4e Assemblée générale de l’Union astronomique internationale, à Cambridge (Mass.) en 1932.
Elles se rapportaient à l’opération internationale des longitudes (réalisée en 1933) et avaient pour objet:
(1)L’émission d’un trait d’une durée de 10 secondes après tout envoi de signaux horaires.
(2)La mission confiée au Bureau international de l’Heure (B.I.H.) de centraliser, discuter et publier les résultats de l’opération.
(3)L’approbation du programme des opérations, exposé dans le Rapport présenté à Cambridge par le Président et le Secrétaire de la Commission.
Le Président est heureux de constater que les propositions de ce Rapport ont pu être réalisées dans une très large part. Il remercie tous les Observatoires et organismes participants de leur collaboration et les félicite vivement de l’activité qu’ils ont déployée pendant la campagne scientifique de 1933.
Since the last meeting of the International Astronomical Union, much attention has been given both in Germany and America to the systematic errors of the fundamental catalogues of Boss and Auwers. This is of special importance if the proper motions of any of the stars are to be used in the verification of the rotation in the plane of the Milky Way. The periodic errors in the proper motions, both in right ascension and declination, are of significance in this connection, while the motion of the equinox is required for the determination of precession, and the systematic correction to the proper motions of declination affects the position of the Solar Apex and the Vertices of the Star Streams.
A circular letter was sent out to all members of the Commission in December 1937, to which the majority have replied. While work is going on steadily in the Observatories where meridian observations are carried out, comparatively few catalogues have been published since 1935. In view of the very full report made three years ago it is only necessary to draw attention to the progress which has been made in the interval.
Since the last meeting of the Union, Sir Frank Dyson, who for forty years had devoted himself to the advancement of meridian astronomy, has resigned the position of president of the Commission. The Executive Committee have done me the honour of inviting me to fill the vacancy.
I have sent a circular letter to all members of the Commission asking for a report on the meridian astronomy being carried on in the institutions with which they are connected, and for suggestions of subjects which might be discussed in Paris. In some countries, particularly Germany and U.S.S.R., there are a number of observatories carrying on meridian astronomy but not represented on the Commission, and I have asked the representatives of these countries to send me details of the work of the various institutions in their countries. The following report is largely based on the replies I have received.
La centralisation au Bureau international de l’Heure des résultats d’observations de l’Opération internationale de 1933 a été très lente, puisque les dernières données attendues ont été reçues vers la fin de 1937.
Le nombre des stations ayant coopéré à l’Opération internationale et ayant transmis leurs observations à l’organisme centralisateur s’élève à soixante et onze. Ainsi qu’il a été expliqué à notre Commission mixte, lors du Congrès de l’Union géodésique et géophysique internationale tenu à Édimbourg en 1936, ces stations ont été réparties en trois groupes:
Le Ier comprenant vingt Observatoires, disposant chacun de plusieurs horloges de première classe (soit à poids sous pression et à température constantes, soit à quartz piézoélectrique);
In recent years many observations of short time scale variability in a variety of spectral classes have been published. Some of these observations relate to phenomena which are reasonably well understood, as for example the Beta Canis Majoris stars, which are short period pulsators. In other cases, such as the Of and WR stars, the mechanism responsible for the variation is not fully understood. Models proposed to explain this variability include:- the binary hypothesis which ascribes the variations to fluctuations in gas streams in and around the members of a close binary system, and:- the pulsation hypothesis, which ascribes the variation in line strength to the presence of pulsational instability of massive carbon burning cores of evolved objects. The choice of the correct model is made difficult by the lack of an extended set of homogeneous observations. We must fulfil two conditions before making this choice. It is necessary to observe individual objects over extended periods of time at high dispersion to establish whether or not all WR's are binary systems. It is also required firmly to establish the temporal nature of the variations, since short term periodicities would tend to favor the core pulsation model.