Adherence to the Dietary Approaches to Stop Hypertension (DASH) diet is inversely associated with type 2 diabetes mellitus (T2DM) risk. Metabolic changes due to DASH adherence and their potential relationship with incident T2DM have not been described. The objective is to determine metabolite clusters associated with adherence to a DASH-like diet in the Insulin Resistance Atherosclerosis Study cohort and explore if the clusters predicted 5-year incidence of T2DM. The current study included 570 non-diabetic multi-ethnic participants aged 40–69 years. Adherence to a DASH-like diet was determined a priori through an eighty-point scale for absolute intakes of the eight DASH food groups. Quantitative measurements of eighty-seven metabolites (acylcarnitines, amino acids, bile acids, sterols and fatty acids) were obtained at baseline. Metabolite clusters related to DASH adherence were determined through partial least squares (PLS) analysis using R. Multivariable-adjusted logistic regression was used to explore the associations between metabolite clusters and incident T2DM. A group of acylcarnitines and fatty acids loaded strongly on the two components retained under PLS. Among strongly loading metabolites, a select group of acylcarnitines had over 50 % of their individual variance explained by the PLS model. Component 2 was inversely associated with incident T2DM (OR: 0·89; (95 % CI 0·80, 0·99), P-value = 0·043) after adjustment for demographic and metabolic covariates. Component 1 was not associated with T2DM risk (OR: 1·02; (95 % CI 0·88, 1·19), P-value = 0·74). Adherence to a DASH-type diet may contribute to reduced T2DM risk in part through modulations in acylcarnitine and fatty acid physiology.

A national need is to prepare for and respond to accidental or intentional disasters categorized as chemical, biological, radiological, nuclear, or explosive (CBRNE). These incidents require specific subject-matter expertise, yet have commonalities. We identify 7 core elements comprising CBRNE science that require integration for effective preparedness planning and public health and medical response and recovery. These core elements are (1) basic and clinical sciences, (2) modeling and systems management, (3) planning, (4) response and incident management, (5) recovery and resilience, (6) lessons learned, and (7) continuous improvement. A key feature is the ability of relevant subject matter experts to integrate information into response operations. We propose the CBRNE medical operations science support expert as a professional who (1) understands that CBRNE incidents require an integrated systems approach, (2) understands the key functions and contributions of CBRNE science practitioners, (3) helps direct strategic and tactical CBRNE planning and responses through first-hand experience, and (4) provides advice to senior decision-makers managing response activities. Recognition of both CBRNE science as a distinct competency and the establishment of the CBRNE medical operations science support expert informs the public of the enormous progress made, broadcasts opportunities for new talent, and enhances the sophistication and analytic expertise of senior managers planning for and responding to CBRNE incidents.

To this date ψ Per is the only classical Be star that was angularly resolved in radio (by the VLA at λ = 2 cm). Gaussian fit to the azimuthally averaged visibility data indicates a disk size (FWHM) of ~500 stellar radii (Dougherty & Taylor 1992). Recently, we obtained new multi-band cm flux density measurements of ψ Per from the enhanced VLA. We modeled the observed spectral energy distribution (SED) covering the interval from ultraviolet to radio using the Monte Carlo radiative transfer code HDUST (Carciofi & Bjorkman 2006). An SED turndown, that occurs between far-IR and radio wavelengths, is explained by a truncated viscous decretion disk (VDD), although the shallow slope of the radio SED suggests that the disk is not simply cut off, as is assumed in our model. The best-fit size of a truncated disk derived from the modeling of the radio SED is 100+5−15 stellar radii, which is in striking contrast with the result of Dougherty & Taylor (1992). The reasons for this discrepancy are under investigation.

We examined the cross-language relations among Spanish-speaking preschoolers’ (N = 125; M age = 53 months, SD = 4.58) English and Spanish vocabulary, letter–word, and math skills; the changes they exhibited in those skills during 1 year of preschool; and the extent to which Spanish skills were associated with English skill gains. The results revealed that children's Spanish and English vocabulary skills were unassociated across languages, whereas their letter–word and math skills were positively associated. Children exhibited gains in vocabulary, letter–word, and math skills in English, with letter–word and math skills in Spanish at the start of preschool being positively associated with the development of those skills in English. Children also gained math skills in Spanish. However, their Spanish vocabulary and letter–word skills did not appear to change. Vocabulary skills showed positive within-language relations with children's letter–word and math skills. The findings highlight cross-language linkages between Spanish-speaking preschoolers’ academic skills in English and Spanish and how Spanish skills associate with their English academic readiness.

This study examined the combined and unique contributions of home, teacher, and peer English exposure levels on Spanish-speaking preschoolers’ (N = 107) English receptive and expressive vocabulary skills. The combined levels of English exposure during the fall of preschool were positively associated with children's English receptive and expressive vocabulary skills in the spring. Furthermore, English exposure levels at home were uniquely and positively associated with children's English receptive and expressive vocabularies, whereas peer English exposure levels were uniquely and positively associated with children's English expressive vocabulary. Teachers’ English exposure levels were not uniquely associated with children's English vocabulary. The findings highlight the importance of the home environment and peer experiences in the classroom for maximizing Spanish-speaking children's early English vocabulary skills.

Physical activity is influenced by genetic factors whose expression may change with age. We employed an extension to the classical twin model that allows a modifier variable, age, to interact with the effects of the latent genetic and environmental factors. The model was applied to self-reported data from twins aged 19 to 50 from seven countries that collaborated in the GenomEUtwin project: Australia, Denmark, Finland, Norway, Netherlands, Sweden and United Kingdom. Results confirmed the importance of genetic influences on physical activity in all countries and showed an age-related decrease in heritability for 4 countries. In the other three countries age did not interact with heritability but those samples were smaller or had a more restricted age range. Effects of shared environment were absent, except in older Swedish participants. The study confirms the importance of taking age effects into account when exploring the genetic and environmental contribution to physical activity. It also suggests that the power of genome-wide association studies to identify the genetic variants contributing to physical activity may be larger in young adult cohorts.

The provision of surgery within humanitarian crises is complex, requiring coordination and cooperation among all stakeholders. During the 2011 Humanitarian Action Summit best practice guidelines were proposed to provide greater accountability and standardization in surgical humanitarian relief efforts. Surgical humanitarian relief planning should occur early and include team selection and preparation, appropriate disaster-specific anticipatory planning, needs assessment, and an awareness of local resources and limitations of cross-cultural project management. Accurate medical record keeping and timely follow-up is important for a transient surgical population. Integration with local health systems is essential and will help facilitate longer term surgical health system strengthening.

Limb amputations are frequently performed as a result of trauma inflicted during conflict or disasters. As demonstrated during the 2010 earthquake in Haiti, coordinating care of these patients in austere settings is complex. During the 2011 Humanitarian Action Summit, consensus statements were developed for international organizations providing care to limb amputation patients during disasters or humanitarian emergencies. Expanded planning is needed for a multidisciplinary surgical care team, inclusive of surgeons, anesthesiologists, rehabilitation specialists and mental health professionals. Surgical providers should approach amputation using an operative technique that optimizes limb length and prosthetic fitting. Appropriate anesthesia care involves both peri-operative and long-term pain control. Rehabilitation specialists must be involved early in treatment, ideally before amputation, and should educate the surgical team in prosthetic considerations. Mental health specialists must be included to help the patient with community reintegration. A key step in developing local health systemsis the establishment of surgical outcomes monitoring. Such monitoring can optimizepatient follow-up and foster professional accountability for the treatment of amputation patients in disaster settings and humanitarian emergencies.