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Early care and education teachers' (ECETs) dietary and feeding behaviors have the potential to influence children's health outcomes. This study sought to (1) gather data on the properties and performance of the CFQ and CFSQ in an ECET sample and compare properties to published parent samples and (2) examine relations between FI experiences by ECETs and reported feeding practices, and (3) examine relations between FI experiences by ECETs and reported feeding practices. 2-bromopalmitate inhibitor ECETs completed 506 cross-sectional surveys. Mean patterns, ranges, and internal consistency values on the adapted instruments for ECETs were consistent with those published for parents. Significant mean differences between parents and ECETs on established scales using one-sample t-tests were prevalent with medium to large effect sizes despite small, relative differences. The majority of ECETs were authoritarian (35.6%), followed by indulgent (29.2%), authoritative (17.9%), and uninvolved (17.3%). T-tests indicated that ECETs who were currently food insecure were significantly higher than teachers who were currently food secure on scales of perceived responsibility, concern about child weight, restriction, pressure to eat, monitoring, demandingness, and responsiveness (all p less then .001). Chi-square tests found that food insecurity was not independent from ECET feeding style, with a greater occurrence of authoritarian and less of indulgent feeding styles for ECETs who were food insecure. link2 Overall, analyses support that two popular measures of feeding practices function similarly in ECETs as they do in parents. Additionally, results demonstrate associations between food insecurity and ECETs' feeding practices.

Epidemiological studies suggest that there is a link between pneumococcal infection and adverse cardiovascular outcomes such as myocardial infarction. Multiple studies have evaluated the protective effect of the 23-valent polysaccharide pneumococcal vaccination (PPV23), but results have varied. Therefore, a meta-analysis was conducted to summarize available evidence on the impact of PPV23 on cardiovascular disease.

A literature search from January 1946 to September 2019 was conducted across Embase, Medline and Cochrane. All studies were included that evaluated PPV23 compared with a control (placebo, no vaccine or another vaccine) for any cardiovascular events, including myocardial infarction (MI), heart failure and cerebrovascular events. Risk ratios (RRs) were pooled using random effects models.

Eighteen studies were included, with a total of 716,108 participants. Vaccination with PPV23 was associated with decreased risk of any cardiovascular event (RR 0.91; 95% CI 0.84-0.99), and MI (RR 0.88; 95% CI 0cardiovascular diseases.

Drivers with diabetes are at increased risk of being involved in road accidents. Therefore, this study aimed to evaluate the effects of acute hyperglycaemia (AH) compared with euglycaemia on driving ability in patients with type 1 diabetes mellitus (T1DM).

Eighteen drivers with T1DM were asked to navigate twice through nine hazardous scenarios, using a driving simulator, during euglycaemia and then again during AH (mean blood glucose 138 ± 34 mg/dL and 321 ± 29 mg/dL, respectively) in a counterbalanced crossover study. Driving performance was continually monitored for driving speed, steering wheel angle, acceleration, and location and velocity of other vehicles and obstacles, with drivers wearing a mobile head-mounted eye-tracking system.

The main findings were that, during AH, participants were less likely to identify a hazard [probability of identification (POI) 0.5725 ± 0.5], glanced fewer times at the hazard (3.24 ± 5.9), maintained shorter headway (between-vehicle) distance (mean 40.87 ± 20.15 m) and had an increased number of braking events per km driven (6.69 ± 5.20) compared with driving during euglycaemia (POI 0.733 ± 0.4; number of glances 3.69 ± 6.99; headway distance 50.46 ± 26.2 m; number of braking events per km driven 4.31 ± 3.87; P <  0.05 for all parameters).

This study provides evidence that AH impairs driving performance in young T1DM patients by demonstrating the negative effects of AH on both hazard perception and speed management.

This study provides evidence that AH impairs driving performance in young T1DM patients by demonstrating the negative effects of AH on both hazard perception and speed management.

To evaluate the correlation between tear fluid and aqueous humor (AqH) cytokine levels in eyes with bullous keratopathy (BK) and with normal endothelium.

This prospective consecutive case-series study included 71 eyes of 71 patients 31 eyes with BK, 18 eyes with non-BK corneal diseases, and 22 eyes with uncomplicated cataract (healthy controls). Total protein and cytokine (interleukin [IL]-1α, IL-1β, IL-4, IL-6, IL-8, IL-10, MIP-1α, MIP-1β, monocyte chemotactic protein [MCP]-1, E-selectin, P-selectin, soluble intercellular adhesion molecule [sICAM]-1, and IP-10) levels in the tear fluid and AqH were measured using multiplex beads immunoassay. The correlations between tear and AqH cytokine levels were assessed.

The AqH protein level was significantly higher in BK eyes (1.09±0.08mg/mL) than in non-BK (0.63±0.11, P=0.0004) and healthy control (0.62±0.06, P=0.0002) eyes. The tear total protein and IL-4 levels were significantly higher in the BK group compared to healthy controls (P=0.0374 and 0.0032, respectively). The AqH IL-8 and sICAM-1 levels were significantly higher in the BK group compared to controls (P=0.0001 and 0.0083, respectively). In BK eyes, the tear IL-4 level was significantly correlated with the MCP-1(r=0.563, P=0.001) and total protein (r=0.589, P=0.001) AqH levels. The tear IL-8 level was significantly correlated with the MCP-1(r=0.598, p=0.001) and IL-4 (r=0.781, p<0.0001) AqH levels in BK eyes. However, no significant correlations were found between tear and AqH cytokine levels in non-BK and healthy controls eyes.

The tear cytokine levels are correlated with those of AqH only in BK, but not in non-BK and healthy controls.

The tear cytokine levels are correlated with those of AqH only in BK, but not in non-BK and healthy controls.

To validate an animal model of corneal stromal opacity by using objective vision-independent in vivo imaging metrics.

This was a prospective study, with two arms (i) observational human arm which included 14 patients with healed unilateral ulcerative keratitis; and (ii) experimental rabbit arm, which included 6 New Zealand white rabbits. A 3-mm central wound was created in the left eye of the rabbits by manually removing 200-250 μm of the superficial stroma, followed by rotating-burr application. Both groups underwent photography, high-resolution anterior segment optical coherence tomography, and Scheimpflug imaging using similar diagnostic platforms and standardized image capturing protocols. Parameters studied were relative change in (i) corneal thickness; (ii) corneal epithelial stromal (ES) reflectivity ratio; (iii) corneal stromal light scattering using densitometry; and (iv) central corneal keratometry.

In the experimental arm, there was a significant decrease in corneal thickness (273±51.3 vs. 407.3±10.3μm, p=0.0038), ES reflectivity ratio (0.71±0.09 vs. 0.99±0.06, p=0.0018), and keratometry (40.4±2.3 vs. 45.8±0.9D, p=0.0033) and increase in densitometry (54.2±11.65 vs.18.7±3.8 GSU, p=0.0001) from baseline, which stabilized at 4 to 8-weeks post-wounding (p>0.3632). link3 At 8-weeks, the relative change from baseline in corneal thickness (28.4±13.5% vs.22.4±13%, p=0.368), ES reflectivity ratio (28.1±11.5% vs. 30.6±8.9%, p=0.603), corneal densitometry (204.17±97.3% vs. 304.9±113.6%, p=0.1113), and central corneal keratometry (13.6±6.9% vs. 18.9±7.4%, p=0.1738) in rabbits was similar to human corneal scars.

The animal model of corneal opacification was objectively comparable to human post-keratitis scars and can be valuable for in vivo evaluation of emerging therapies for corneal opacities.

The animal model of corneal opacification was objectively comparable to human post-keratitis scars and can be valuable for in vivo evaluation of emerging therapies for corneal opacities.

Dry eye disease (DED) is a common and multifactor-induced autoimmune ocular surface disease. Environmental factors, such as desiccating stress (DS) and hyperosmolarity, affect the corneal epithelium to induce ocular surface inflammation in DED. We aimed to explore the potential mechanisms by which innate immunity and pyroptosis are initiated in the mucosal epithelium in response to environmental stress.

Experimental dry eye was established in C57BL/6J mice and genetic mice on the background of C57BL/6J mice by subcutaneous injection of scopolamine and exposure to a desiccating environment. SDHCEC cell line was subjected to hyperosmolarity stress (450 mOsM). The phenol red thread tear test and corneal epithelial defects evaluation were used as assessments of severity of DED. RNA-sequencing, quantitative real-time PCR, western blotting and immunofluorescence staining were performed in this study.

Loss-of-function studies indicated that genetic deletion of GSDMD alleviates DS-induced corneal epithelium defal defects in response to environmental stress. GSDMD is required for IL-33 processing and the subsequent amplification of inflammatory cascades. These findings reveal novel therapeutic targets for treating DED.Tufting enteropathy (TE) is a rare autosomal recessive congenital enteropathy that usually requires long-term parenteral nutrition (PN). In the Arabic Peninsula, four distinct EPCAM mutations have been identified to cause TE. As consanguineous marriages are socially favored, pre-marital and pre-conception testing has become a critical disease prevention strategy. This study aimed to identify the pathogenic EPCAM mutations causing TE in Qatari families and determine possible genotype-phenotype correlations. Twenty-two TE patients from seven multiplex families with TE were identified. Blood samples were collected from patients and first-degree relatives. Exons of the gene were amplified and sequenced. Retrospective chart review and/or family interviews were conducted to determine phenotypic characteristics of the disease. Sequence analysis revealed a single, previously described c.499dup mutation in exon 5 of all families tested, suggesting a founder effect. Of the 18 patients whose full clinical information was available, three patients (17%) were off PN with a good quality of life, without intestinal transplantation, and one (6%) was receiving partial PN. Our patients with TE were severely stunted compared to a similar group of patients receiving long-term PN for short bowel syndrome, suggesting that this could possibly be due to TE rather than secondary to inadequate nutrition. Our study identified the EPCAM mutation c.499dup as the genetic defect causing TE in all the participant Qatari families. This finding should facilitate early diagnosis of TE and genetic counseling. Furthermore, it should aid in the prevention of TE through pre-marital screening, antenatal diagnosis, and pre-implantation genetic diagnosis.

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