Prevention of novel influenza infection in newborns in hospital settings: considerations and strategies during the 2009 H1N1 pandemic.

During the 2009 influenza A (H1N1) pandemic, many pregnant women experienced severe illness and some gave birth while ill with suspected or confirmed pandemic (H1N1) 2009 influenza. Because of concerns about possible transmission of this novel virus to immunologically naïve newborns, and the absence of definitive studies regarding this risk, the Centers for Disease Control and Prevention (CDC) reviewed relevant literature to understand the potential burden of disease and routes of transmission affecting newborns. This report describes the issues considered during the 2009 H1N1 pandemic as CDC developed guidance to protect newborns in hospital settings.

Associations of plasma 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D concentrations with death and progression to maintenance dialysis in patients with advanced kidney disease.

Background: Low vitamin D concentrations are prevalent in patients with chronic kidney disease (CKD). We investigated the relationship between plasma 25-hydroxyvitamin D (25[OH]D) or 1,25-dihydroxyvitamin D (1,25[OH](2)D) concentrations with death, cardiovascular events, and dialysis therapy initiation in patients with advanced CKD.

Study Design: The HOST (Homocysteinemia in Kidney and End Stage Renal Disease) Study was a randomized double-blind trial evaluating the effects of high doses of folic acid on death and long-term dialysis therapy initiation in patients with advanced CKD (stages 4 and 5 not yet on dialysis therapy).

The effect of combined calcium and cholecalciferol supplementation on bone mineral density in elderly women with moderate chronic kidney disease.

Aims: To examine the effect of combined calcium and vitamin D3 supplementation on bone mineral density (BMD) inpatients with chronic kidney disease (CKD).

Methods: We performed a post-hoc analysis of the DECALYOS II, a 2-year randomized, double-blind, placebo-controlled study of 610 women randomized to: calcium-vitamin D3 fixed combination, calcium plus vitamin D3 separate combination, or placebo. Both active treatment groups received the same daily amount of calcium (1,200 mg) and vitamin D3 (800 IU).

Empirical van der Waals corrections to solid-state density functional theory: Iodine and phosphorous containing molecular crystals.

Parameters are derived for a molecular mechanics type dispersive correction to solid-state density functional theory calculations on molecular crystals containing iodine and phosphorous. The molecular C(6) coefficients are derived from photoabsorption differential oscillator strength spectra determined from accurate (e,e) dipole spectra. The cross-over parameters, which ensure correct behavior at short internuclear distances, are obtained by fitting predicted crystal lattice parameters to experimental data.

Racial differences in markers of mineral metabolism in advanced chronic kidney disease.

Background And Objectives: This study examined differences in the concentration of markers of mineral metabolism across race in patients with advanced CKD not requiring dialysis and ESRD.

Design, Setting, Participants, & Measurements: Concentrations of 25-hydroxyvitamin D (25(OH)D), 1,25-dihydroxyvitamin D (1,25(OH)(2)D), intact parathyroid hormone (iPTH), and fibroblast growth factor 23 (FGF-23) were measured in stored plasma samples of 1497 patients with advanced CKD not yet on dialysis and ESRD who participated in the Homocysteine in Kidney and End Stage Renal Disease study. Linear regression models were used to examine the relationship between race and 25(OH)D, 1,25(OH)(2)D, iPTH, and FGF-23 concentrations.

Morbidity and mortality conference in obstetrics and gynecology: a tool for addressing the 6 core competencies.

Background: Residency program directors are challenged to effectively teach and assess the Accreditation Council for Graduate Medical Education's (ACGME) 6 competencies. The purpose of this study was to characterize the morbidity and mortality (M&M) conference as a cost-effective and efficient approach for addressing the ACGME competencies through evaluation of resident participation and case diversity.

Methods: In our modified M&M conference, senior residents submit a weekly list of cases to the conference proctors.

Towards crystal structure prediction of complex organic compounds--a report on the fifth blind test.

Following on from the success of the previous crystal structure prediction blind tests (CSP1999, CSP2001, CSP2004 and CSP2007), a fifth such collaborative project (CSP2010) was organized at the Cambridge Crystallographic Data Centre. A range of methodologies was used by the participating groups in order to evaluate the ability of the current computational methods to predict the crystal structures of the six organic molecules chosen as targets for this blind test. The first four targets, two rigid molecules, one semi-flexible molecule and a 1:1 salt, matched the criteria for the targets from CSP2007, while the last two targets belonged to two new challenging categories - a larger, much more flexible molecule and a hydrate with more than one polymorph.

Progress in crystal structure prediction.

The results of the application of a density functional theory method incorporating dispersive corrections in the 2010 crystal structure prediction blind test are reported. The method correctly predicted four out of the six experimental structures. Three of the four correct predictions were found to have the lowest lattice energy of any crystal structure for that molecule.

Predictability of the polymorphs of small organic compounds: crystal structure predictions of four benchmark blind test molecules.

Predicting the crystal structure of an organic molecule from first principles has been a major challenge in physical chemistry. Recently, the application of Density Functional Theory including a dispersive energy correction (the DFT(d) method) has been shown to be a reliable method for predicting experimental structures based purely on their ranking according to lattice energy. Further validation results of the application of the DFT(d) method to four organic molecules are presented here.

The role of phosphorus in the development and progression of vascular calcification.

Vascular calcification is associated with significant cardiovascular morbidity and mortality in patients with chronic kidney disease (CKD). Factors unique to patients with CKD, such as hyperphosphatemia, predispose these patients to early and progressive vascular calcification. Hyperphosphatemia appears to be involved in a number of mechanisms that trigger and advance the progression of vascular calcification, including (1) transition of vascular smooth muscle cells (VSMCs) from a contractile to an osteochondrogenic phenotype and mineralization of VSMC matrix through sodium-dependent phosphate cotransporters, (2) induction of VSMC apoptosis, (3) inhibition of monocyte/macrophage differentiation into osteoclast-like cells, (4) elevation of fibroblast growth factor 23 levels, and (5) decreases in klotho expression.

FGF-23 associates with death, cardiovascular events, and initiation of chronic dialysis.

Concentrations of the phosphate-regulating hormone fibroblast growth factor-23 (FGF-23) are elevated in patients with chronic kidney disease (CKD), but whether higher plasma FGF-23 concentrations associate with all-cause mortality, cardiovascular events, or initiation of chronic dialysis is not completely understood. Here, we measured FGF-23 concentration in stored plasma samples from 1099 patients with advanced CKD who participated in The Homocysteine in Kidney and End Stage Renal Disease study. Mean serum phosphorus concentration was 4.

Maternal smokeless tobacco use in Alaska Native women and singleton infant birth size.

Objective: To examine the effects of maternal prenatal smokeless tobacco use on infant birth size.

Design: A retrospective medical record review of 502 randomly selected deliveries.

Population And Setting: Singleton deliveries to Alaska Native women residing in a defined geographical region in western Alaska, 1997-2005.

Screening and diagnosing gestational diabetes mellitus revisited: implications from HAPO.

Screening and diagnosis of gestational diabetes has lacked uniform criteria both nationally and internationally. In addition, the relationship between the degree of hyperglycemia or glucose intolerance and the risk of maternal, fetal, and neonatal adverse outcomes has not been clearly established. The International Association of Diabetes and Pregnancy Study Groups (IADPSG) recently published their recommendation for diagnosing and classifying gestational hyperglycemia in pregnancy after evaluation of the results of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) observational study.

Pregnant and recently pregnant women's perceptions about influenza a pandemic (H1N1) 2009: implications for public health and provider communication.

The objective of this study was to explore pregnant and recently pregnant women's perceptions of influenza vaccine and antivirals during the 2009 H1N1 pandemic. We conducted 18 focus groups with pregnant and recently pregnant women in three US cities in September 2009. Participants were segmented into groups by insurance status (no or public insurance vs.

Ambivalence in living liver donors.

All right hepatic lobe (RHL) donors in our program are asked to participate in a longitudinal quality-of-life study that begins at their evaluation and continues throughout the first postdonation year. Here we report the characteristics of donor candidates who completed the donation process despite ambivalence. In all, 183 RHL candidates consented, and 133 became donors.

Phosphate and cardiovascular disease.

Hyperphosphatemia is a major risk factor for death, CVE, and vascular calcification among patients with and without kidney disease. Even serum phosphate levels within the "normal laboratory range" associate with a greater risk of death and CVE. Potential mechanisms by which increased phosphate results in adverse outcomes are not fully understood, but current evidence suggests a direct effect of phosphate on vascular calcification and modulation of key hormones fibroblast growth factor-23 and calcitriol.

Prenatal care providers and influenza prevention and treatment: lessons from the field.

To better understand the knowledge, attitudes, and behaviors of providers regarding influenza infection and vaccination in pregnancy, fourteen focus groups were conducted among 92 providers in Atlanta, GA; Dallas, TX; and Portland, OR in late 2009. NVivo 8.0 was used for analysis.

Extra-skeletal effects of vitamin D deficiency in chronic kidney disease.

Cardiovascular diseases (CVD) and infectious diseases represent the two most important causes of death in patients with chronic kidney disease (CKD). The traditional risk factors of CVD do not appear to account sufficiently for the increased risk of CVD in patients with CKD, and vitamin D deficiency appears to be an important non-traditional, and potentially modifiable, CVD risk factor in this patient population. 25-Hydroxyvitamin D (25(OH)D) is converted to its biologically active form, 1,25-dihydroxyvitamin D (1,25(OH)(2)D), by the enzyme 1α-hydroxylase in the kidneys.

Accuracy of physical activity monitors in pregnant women.

Purpose: To determine the step count accuracy of three pedometers and one accelerometer in pregnant women during treadmill walking.

Methods: Participants were 30 women in the second or third trimester (20-34 wk) who were screened for pregnancy-related risk factors. Each participant was fitted with a belt containing three physical activity monitors: Yamax Digiwalker SW-200 (DW), New Lifestyles NL 2000 (NL), and GT3X ActiGraph accelerometer (ACT).

Impact of a weekly multidisciplinary tumor board conference on the management of women with gynecologic malignancies.

Background: The objective of this study was to evaluate the impact of a weekly tumor board conference on the management of patients with gynecologic malignancies.

Methods: The medical records of consecutive patients referred to a multidisciplinary gynecologic oncology tumor board were reviewed. Patient demographics were abstracted from medical records and tumor board minutes.

Crystal structure prediction and isostructurality of three small molecules.

A crystal structure prediction (CSP) study of three small, rigid and structurally related organic compounds (differing only in the position and number of methyl groups) is presented. A tailor-made force field (TMFF; a non-transferable force field specific for each molecule) was constructed with the aid of a dispersion-corrected density functional theory method (the hybrid method). Parameters for all energy terms in each TMFF were fitted to reference data generated by the hybrid method.

Robotic surgery in gynecologic oncology fellowship programs in the USA: a survey of fellows and fellowship directors.

Background: In order to understand how robotic surgery impacts gynecologic oncology fellowship training and surgical practices, a survey of fellows and fellowship directors was conducted.

Methods: Questionnaires designed to determine the prevalence, application, and acceptance of robotics were sent to fellows and fellowship directors in approved U.S.

An experimental and computational study on the epimeric contribution to the infrared spectrum of budesonide.

Budesonide is a mixture of 22R and 22S epimers. The epimeric content of budesonide was reported in both British and European pharmacopoeias to be within the range of 60-49/40-51 for R and S epimers, respectively. In this work, contribution of the two epimers to the overall infrared spectrum of budesonide has been investigated by quantum chemical calculations.

Normative cerebrospinal fluid profiles in febrile infants.

Objective: To describe the cerebrospinal fluid (CSF) profiles of febrile infants aged 1 to 90 days with negative bacterial culture test results and negative results for enteroviruses with polymerase chain reaction.

Study Design: Statistical analysis of a retrospective cohort.

Results: CSF profiles from 823 infants with negative test results for infection were analyzed.