Exposure to maternal hyperglycemia in utero has been associated with adverse metabolic outcomes in offspring. However, few studies have investigated the relationship between maternal hyperglycemia and offspring cortisol levels. We assessed associations of gestational diabetes mellitus (GDM) with cortisol biomarkers in two longitudinal prebirth cohorts: Project Viva included 928 mother–child pairs and Gen3G included 313 mother–child pairs. In Project Viva, GDM was diagnosed in N = 48 (5.2%) women using a two-step procedure (50 g glucose challenge test, if abnormal followed by 100 g oral glucose tolerance test [OGTT]), and in N = 29 (9.3%) women participating in Gen3G using one-step 75 g OGTT. In Project Viva, we measured cord blood glucocorticoids and child hair cortisol levels during mid-childhood (mean (SD) age: 7.8 (0.8) years) and early adolescence (mean (SD) age: 13.2 (0.9) years). In Gen3G, we measured hair cortisol at 5.4 (0.3) years. We used multivariable linear regression to examine associations of GDM with offspring cortisol, adjusting for child age and sex, maternal prepregnancy body mass index, education, and socioeconomic status. We additionally adjusted for child race/ethnicity in the cord blood analyses. In both Project Viva and Gen3G, we observed null associations of GDM and maternal glucose markers in pregnancy with cortisol biomarkers in cord blood at birth (β = 16.6 nmol/L, 95% CI −60.7, 94.0 in Project Viva) and in hair samples during childhood (β = −0.56 pg/mg, 95% CI −1.16, 0.04 in Project Viva; β = 0.09 pg/mg, 95% CI −0.38, 0.57 in Gen3G). Our findings do not support the hypothesis that maternal hyperglycemia is related to hypothalamic–pituitary–adrenal axis activity.

Introduction: Low acuity patients have been controversially tagged as a source of emergency department (ED) misuse. Authorities for many Canadian health regions have set up policies so these patients preferably present to walk-in clinics (WIC). We compared the cost and quality of the care given to low acuity patients in an academic ED and a WIC of Québec City during fiscal year 2015-16. Methods: We conducted an ambidirectional (prospective and retrospective) cohort study using a time-driven activity-based costing method. This method uses duration of care processes (e.g., triage) to allocate to patient care all direct costs (e.g., personnel, consumables), overheads (e.g., building maintenance) and physician charges. We included consecutive adult patients, ambulatory at all time and discharged from the ED or WIC with a diagnosis of upper respiratory tract infection (URTI), urinary tract infection (UTI) or low back pain. Mean cost [95%CI] per patient per condition was compared between settings after risk-adjustment for age, sex, vital signs, number of regular medications and co-morbidities using generalized log-gamma regression models. Proportions [95%CI] of antibiotic prescription and chest X-Ray use in URTI, compliance with provincial guidelines on use of antibiotics in UTI, and column X-Ray use in low back pain were compared between settings using a Pearson Chi-Square test. Results: A total of 409 patients were included. ED and WIC groups were similar in terms of age, sex and vital signs on presentation, but ED patients had a greater burden of comorbidities. Adjusted mean cost (2016 CAN$) of care was significantly higher in the ED than in the WIC (p < 0.0001) for URTI (78.42[64.85-94.82] vs. 59.43[50.43-70.06]), UTI (78.88[69.53-89.48] vs. 53.29[43.68-65.03]), and low back pain (87.97[68.30-113.32] vs. 61.71[47.90-79.51]). For URTI, antibiotics were more frequently prescribed in the WIC (44.1%[34.3-54.3] vs. 5.8%[1.2-16.0]; p < 0.0001) and chest X-Rays, more frequently used in the ED (26.9%[15.6-41.0] vs. 13.7%[7.7-22.0]; p = 0.05). No significant differences were observed in the compliance with guidelines on use of antibiotics in UTI and in the use of column X-Ray in low back pain. Conclusion: Total cost of care for low acuity patients is lower in walk-in clinics than in EDs. However, our results suggest that quality-of-care issues should be considered in determining the best alternate setting for treating ambulatory emergency patients.

Adsorption of metribuzin [4-amino-6-tert-butyl-3-(methylthio)-as-triazin-5(4H)-one], metolachlor [2-chloro-N-(2-ethyl-6-methylphenyl)-N-(2-methoxy-1-methylethyl)acetamide] and fluometuron [1,1-dimethyl-3-(α,α,α-trifluoro-m-tolyl)urea] on a Taloka silt loam (Mollic Albaqualf) and a Roxana silt loam (Typic Udifluvent) from the 10- to 20- and 40- to 50-cm soil depths was measured. The order of adsorption of the herbicides was fluometuron = metolachlor > metribuzin. Adsorptivity of the soil from the 10- to 20-cm depth was greater than from the 40- to 50-cm depth. At 7, 15, 23, and 37C, all herbicides degraded more rapidly as temperature increased. Metribuzin was least persistent and fluometuron and metolachlor were similarly persistent. The time required for the initial herbicide concentration to decrease by 50% in the Taloka silt loam from the 10- to 20-cm depth at 23C was 2.6, 9.4, and 10.1 weeks for metribuzin, fluometuron, and metolachlor, respectively.

CBC (2,5-dichlorobenzoyl chloride) and MCB (methyl-2,5-dichlorobenzoate) function as plant growth regulators in a gaseous phase or in an aqueous solution. Sorghum [Sorghum bicolor (L.) Moench. ‘Martin’] and soybean [Glycine bicolor (L.) Merr. ‘Lee’] seeds were temporarily inhibited or delayed from germinating, but overcame the inhibition in time so there was no significant reduction in total germination. Seedlings produced from sorghum and soybean seed germinated and grown in aqueous solution of 35 μg/ml CBC or MCB were shorter and weighed less than control seedlings. Soybean seed treated with the vapors of CBC and MCB produced seedlings significantly reduced in dry weight as compared with that of controls. Foliar application of 500 or 1000 μg/ml of CBC significantly reduced the growth of soybean but not sorghum seedlings. Soybean seedlings treated with the vapors or an aqueous solution produced leaflets more narrow and thicker than control seedlings. A lethal response attributable to CBC or MCB was not recorded.

Widespread access to the internet is offering new possibilities for data collection in surveillance. We explore, in this study, the possibility of using an electronic tool to monitor occurrence of the tick vector of Lyme disease, Ixodes scapularis. The study aimed to compare the capacity for ticks to be identified in web-based submissions of digital images/photographs, to the traditional specimen-based identification method used by the provincial public health laboratory in Quebec, Canada. Forty-one veterinary clinics participated in the study by submitting digital images of ticks collected from pets via a website for image-based identification by an entomologist. The tick specimens were then sent to the provincial public health laboratory to be identified by the ‘gold standard’ method using a microscope. Of the images submitted online, 74·3% (284/382) were considered of high-enough quality to allow identification. The laboratory identified 382 tick specimens from seven different species, with I. scapularis representing 76% of the total submissions. Of the 284 ticks suitable for image-based species identification, 276 (97·2%) were correctly identified (Kappa statistic of 0·92, Z = 15·46, P < 0·001). This study demonstrates that image-based tick identification may be an accurate and useful method of detecting ticks for surveillance when images are of suitable quality.

There is at present a need to develop a better technique for measuring the rate of icing on structures such as, for example, overhead transmission lines. For aircraft and helicopter icing, the most widely used method of measurement is the rotating cylinder. However, for measuring the icing of structures, this method is difficult to apply and also less accurate due to lower wind velocities. Different approaches are now being developed using fixed cylinders.

Icing tests were conducted with fixed and rotating cylinders in a wind tunnel. The rate of icing was obtained through measurements of volume, accretion cross-section and time of deposition. Tests were made using five different liquid water contents and droplet diameter spectra, and four cylinder diameters, keeping the wind velocity and temperature constant. The rate of icing is presented as a function of the diameters of the fixed and rotating cylinders for each of the liquid water contents tested. Results indicate that at lower wind velocities the accretion rate is overestimated for the smaller rotating cylinders. This difference is probably due to the variation of the collection efficiency with diameter. From these results it is suggested that the rate of ice accretion on structures should be based on at least two fixed cylinders of different small sizes in order to take into account the effect of the collection efficiency.

We describe in this work the BASS survey for brown dwarfs in young moving groups of the solar neighborhood, and summarize the results that it generated. These include the discovery of the 2MASS J01033563–5515561 (AB)b and 2MASS J02192210–3925225 B young companions near the deuterium-burning limit as well as 44 new low-mass stars and 69 new brown dwarfs with a spectroscopically confirmed low gravity. Among those, ~20 have estimated masses within the planetary regime, one is a new L4 γ bona fide member of AB Doradus, three are TW Hydrae candidates with later spectral types (L1–L4) than all of its previously known members and six are among the first contenders for low-gravity ≥ L5 β/γ brown dwarfs, reminiscent of WISEP J004701.06+680352.1, PSO J318.5338–22.8603 and VHS J125601.92–125723.9 b. Finally, we describe a future version of this survey, BASS-Ultracool, that will specifically target ≥ L5 candidate members of young moving groups. First experimentations in designing the survey have already led to the discovery of a new T dwarf bona fide member of AB Doradus, as well as the serendipitous discoveries of an L9 subdwarf and an L5 + T5 brown dwarf binary.

Twenty-six of 50 patients were investigated with nerve conduction studies and electromyography using a standard protocol and were compared to the findings in 50 normal control subjects. Almost all cases of typical Friedreich's ataxia had absent sensory action potentials (SAP) in the digital (92%) or sural (96%) nerves. The others had markedly decreased S.A.P's. In these same patients motor conduction auvelocities were either normal or only slightly decreased. In the second, atypical group of 9 patients, the motor conduction velocities were considerably decreased.

Because of the absence of sensory action potentials in Friedreich's ataxia, and that the absence was noted in our very mild cases, it is proposed that this measure be used to facilitate early diagnosis.

Neurotransmitter replacement therapy in Alzheimer's Disease is currently being attempted using bethanechol chloride (Urecholine) infused intracerebroventricularly with an Infusaid continuous infusion pump. The rationale of this therapy is based on the severe cortical pre-synaptic cholinergic deficit in the presence of relatively normal post-synaptic muscarinic receptor density. Patients are selected on the basis of strict clinical criteria at a functional stage 4 or 5 of Reisberg. A cortical biopsy at the time of pump and catheter implantation confirms the diagnosis by histological and biochemical examination. Pre-operative, post-operative and serial mental status assessments combined with functional ADL assessments monitor changes in behavior. A 6 months double-blind treatment period is done in every patient, who is then free to continue if he has improved on active treatment. This specific study is part of a multi-centre trial. Other therapeutic trials using somatostatin analogs, such as Sandostatin, could then be done. The biological effects of the latter compound are being studied currently in adult Green Vervet monkeys, prior to its use in Alzheimer patients. Furthermore autoradiography of bethanechol and peptides labeled with 14C administered in these animals by intracerebroventricular infusion will allow a better knowledge of their pharmacological site of action.

Using medical files, death certificates and an interview at home for the survivors, a long term retrospective follow-up study was done for 82 subjects operated for carotid stenosis. Causes of death, survival rates and medical history of survivors were studied. Subjects were classified in two preoperative risk categories according to their medical history prior to angiography: low risk (36 subjects) and medium risk (46 subjects). None of the subjects were lost during the follow-up period which varies from 81 to 105 months.

At seven years, observed survival rate is significantly lower for the medium risk patients than for the low risk patients (43.0 ±8.6 versus 80.6 ± 6.6; X2 M-H, p = 0.006). The difference between the survival rates is markedly noticeable after the fifth year of follow-up. Besides, the percentage of survivors who have developed cerebrovascular problems after the operation is significantly higher in the medium risk group than the low risk group (54.5% versus 25.0%, X2 p ≃ 0,04).

Does this mean that the preoperative risk classification separates two different stages or two different forms of atherosclerosis? Can. J. Neurol. Sci. 1983; 10:27–31

Genetic linkage analysis requires the identification and documentation of large families with many affected members present, preferably in more than one generation. The IMAGE Project has been establishing a population- based Alzheimer disease (AD) registry in the Saguenay - Lac-Saint-Jean region of the Province of Quebec. The population of this region has a well-documented ancestry, with reliable genealogical records (since 1842) computerized by SORER We have recently begun to investigate the pedigrees of selected probands (definite, probable and possible) from the IMAGE registry in order to identify informative pedigrees for genetic linkage analysis. Interviews were carried out with close relatives of the probands (at least one informant per sibship) to identify secondary AD cases. The questionnaires used pertain to the accuracy of genealogical records, to family medical history and to a retrospective diagnosis of AD for people with cognitive deficits. By these means, we have documented a large extended pedigree in which a total of 15 individuals with cognitive deficits were ascertained over three generations. Of these cases, 7 are still living and there is autopsy confirmation in another one. Computer simulations using the program SIMLINK revealed that this is a potentially informative family for linkage analysis. Horizontal extension of the pedigree to second cousins of the proband is now being carried out. This will render the family IMAGE/1 even more informative in genetic linkage analysis studies.

Since the discovery of a significant depletion of acetylcholine in discrete areas of the brain of patients affected by Alzheimer's disease, attempts at symptomatic therapy have concentrated on acetylcholine supplementation, an approach that is based upon the efficacy of dopaminergic supplementation therapy for Parkinson's disease. Choline, then lecithin, used orally, failed to improve symptoms but the hypothesis that long-term choline supplementation might stabilize the course of Alzheimer's disease remains to be tested. Nerve growth factor may also offer that possibility. Bethanechol administered intracerebroventricularly did not help when a fixed dose was used but individual titration of more selective muscarinic agonists may prove more effective. In this article we report that tetrahydroaminoacridine (THA), given together with highly concentrated lecithin, appears to bring improvement in cognition and in functional autonomy using the Mini Mental State and the Rapid Disability Rating Scale-2 respectively, without change in behavior as reflected by the Behave-AD. Double-blind cross-over studies are in progress to establish its efficacy. Improvement in study design and means of assessment of cognition, functional autonomy and behavior have been made possible by these drug trials.