Effect of Vitamin D Supplementation on Recurrent Wheezing in Black Infants Who Were Born Preterm: The D-Wheeze Randomized Clinical Trial.

Importance: Black infants born preterm face high rates of recurrent wheezing throughout infancy. Vitamin D supplementation has the potential to positively or negatively affect wheezing through modulation of the pulmonary and immune systems. Objective: To assess the effectiveness of 2 vitamin D dosing strategies in preventing recurrent wheezing. Design, Setting, and Participants: A randomized clinical trial enrolled 300 black infants born at 28 to 36 weeks' gestation between January 2013 and January 2016 at 4 sites in the United States, and followed them up through March 2017. Randomization was stratified by site and maternal milk exposure. Interventions: Patients were enrolled prior to discharge from the neonatal intensive care unit or newborn nursery and received open-label multivitamin until they were consuming 200 IU/d of cholecalciferol from formula or fortifier added to human milk, after which they received either 400 IU/d of cholecalciferol until 6 months of age adjusted for prematurity (sustained supplementation) or placebo (diet-limited supplementation). One-hundred fifty three infants were randomized to the sustained group, and 147 were randomized to the diet-limited group. Main Outcomes and Measures: Recurrent wheezing by 12 months' adjusted age was the primary outcome. Results: Among 300 patients who were randomized (mean gestational age, 33 weeks; median birth weight, 1.9 kg), 277 (92.3%) completed the trial. Recurrent wheezing was experienced by 31.1% of infants in the sustained supplementation group and 41.8% of infants in the diet-limited supplementation group (difference, -10.7% [95% CI, -27.4% to -2.9%]; relative risk, 0.66 [95% CI, 0.47 to 0.94]). Upper and lower respiratory tract infections were among the most commonly reported adverse events. Upper respiratory infections were experienced by 84 of 153 infants (54.9%) in the sustained group and 83 of 147 infants (56.5%) in the diet-limited group (difference, -1.6% [95% CI, -17.1% to 7.0%]). Lower respiratory infections were experienced by 33 of 153 infants (21.6%) in the sustained group and 37 of 147 infants (25.2%) in the diet-limited group (difference, -3.6% [95% CI, -16.4% to 4.4%]). Conclusions and Relevance: Among black infants born preterm, sustained supplementation with vitamin D, compared with diet-limited supplementation, resulted in a reduced risk of recurrent wheezing by 12 months' adjusted age. Future research is needed to better understand the mechanisms and longer-term effects of vitamin D supplementation on wheezing in children born preterm. Trial Registration: ClinicalTrials.gov Identifier: NCT01601847.

Direct sub-atmospheric pressure ionization mass spectrometry: Evaporation/sublimation-driven ionization is amazing, fundamentally, and practically.

This paper covers direct sub-atmospheric pressure ionization mass spectrometry (MS). The discovery, applications, and mechanistic aspects of novel ionization processes for use in MS that are not based on the high-energy input from voltage, laser, and/or high temperature but on sublimation/evaporation within a region linking a higher to lower pressure and modulated by heat and collisions, are discussed, including how this new reality has guided a series of discoveries, instrument developments, and commercialization. A research focus, inter alia, is on how best to understand, improve, and use these novel ionization processes, which convert volatile and nonvolatile compounds from solids (sublimation) or liquids (evaporation) into gas-phase ions for analysis by MS providing reproducible, accurate, sensitive, and prompt results. Our perception on how these unprecedented versus traditional ionization processes/methods relate to each other, how they can be made to coexist on the same mass spectrometer, and an outlook on new and expanded applications (e.g., clinical, portable, fast, safe, and autonomous) is presented, and is based on ST's Opening lecture presentation at the Nordic Mass spectrometry Conference, Geilo, Norway, January 2023. Focus will be on matrix-assisted ionization (MAI) and solvent-assisted ionization (SAI) MS covering the period from 2010 to 2023; a potential paradigm shift in the making.

Protein intake and postprandial hyperglycemia in children and adolescents with type 1 diabetes mellitus, a pilot study.

BACKGROUND AND AIMS: To describe the change in glucose and the resulting postprandial hyperglycemia (PPH) that occurs after dietary protein intake (PI) in children with type 1 diabetes (T1D). METHODS: We conducted a self-controlled, non-randomized, prospective pilot study in children with T1D who were given whey protein isolate drinks (carbohydrate-free, fat-free) of increasing protein amounts (0, 12.5, 25, 37.5, 50, and 62.5 gm) on 6 sequential nights. The glucose levels were monitored with continuous glucose monitors (CGM) and glucometers for 5 h after PI. PPH was defined as glucose elevations over baseline of ≥50 mg/dL. RESULTS: Thirty-eight subjects were recruited, and eleven subjects (6 females, 5 males) completed the intervention. Subjects had a mean (range) age of 11.6 (6-16) years, diabetes duration of 6.1 (1.4-15.5) years, HbA1c of 7.2 (5.2-8.6) % and weight of 44.5 (24.3-63.2) kg. PPH was detected in 1/11, 5/11, 6/10, 6/9, 5/9, and 8/9 subjects after receiving 0, 12.5, 25, 37.5, 50, and 62.5 gm of protein, respectively. CONCLUSIONS: In children with T1D, the association between PPH and PI was observed at smaller protein amounts compared to studies done in adults.

Burden of prematurity-associated recurrent wheezing: caregiver missed work in the D-Wheeze trial.

OBJECTIVE: This study describes the burden of prematurity-associated wheezing in black infants with respect to caregiver missed work. STUDY DESIGN: We analyzed data from the D-Wheeze trial (ClinicalTrials.gov identifier NCT01601847). Black infants between 28-0/7 to 36-6/7 weeks' gestational age at birth receiving <28 days of supplemental oxygen were enrolled. The primary outcome was missed work to care for the infant in the first year. RESULTS: 147/277 (53.1%) infants had caregivers who reported time off. In an adjusted model, vitamin D supplementation (OR 0.52 [95% CI 0.30-0.89]; P = 0.018), recurrent wheeze (OR 2.26 [95% CI, 1.15-4.44]; P = 0.018), and other children in the household <5 years old (OR 0.45 [95% CI 0.26-0.78]; P = 0.004) were significantly associated with caregiver missed work. CONCLUSIONS: Black premature infants had a significant burden of caregiver missed work, emphasizing the impact of prematurity-associated wheezing.

Hepatic minerals of white-tailed and mule deer in the southern Black Hills, South Dakota.

Because there is a paucity of information on the mineral requirements of free-ranging deer, data are needed from clinically healthy deer to provide a basis for the diagnosis of mineral deficiencies. To our knowledge, no reports are available on baseline hepatic mineral concentrations from sympatric white-tailed deer (Odocoileus virginianus) and mule deer (Odocoileus hemionus) using different habitats in the Northern Great Plains. We assessed variation in hepatic minerals of female white-tailed deer (n = 42) and mule deer (n = 41). Deer were collected in February and August 2002 and 2003 from study areas in Custer and Pennington Counties, South Dakota, in and adjacent to a wildfire burn. Hepatic samples were tested for levels (parts per million; ppm) of aluminum (Al), antimony (Sb), arsenic (As), barium (Ba), boron (B), cadmium (Cd), calcium (Ca), chromium (Cr), cobalt (Co), copper (Cu), iron (Fe), lead (Pb), magnesium (Mg), manganese (Mn), mercury (Hg), molybdenum (Mo), nickel (Ni), phosphorus (P), potassium (K), selenium (Se), sodium (Na), sulfur (S), thalium (Tl), and zinc (Zn). We predicted that variability in element concentrations would occur between burned and unburned habitat due to changes in plant communities and thereby forage availability. We determined that Zn, Cu, and Ba values differed (P

Congenital hypotrichosis in a white-tailed deer fawn from South Dakota.

On 1 October 2001, a 4-mo-old male white-tailed deer (Odocoileus virginianus) fawn was collected in Day County, South Dakota (USA), by South Dakota Department of Game, Fish and Parks personnel. The fawn had sparse hair development on the ventral thorax, the lateral caudal and caudal aspects of the rear legs, the muzzle, around the eyes, and inside the ears. Remaining skin surfaces were devoid of hair. Histologic examination revealed normal hair follicle density although follicles were empty or contained keratin debris and fragments of hair shaft. The epidermis of the fawn was mildly thickened and melanin pigment was prominent within deep layers of the epidermis. Based on histologic examination, the deer was diagnosed with congenital hypotrichosis. Although this condition has been reported in domestic species and humans, this specimen represents the first documented case of congenital hypotrichosis in a cervid.