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Turnover is particularly worrisome in Early Head Start/Head Start (EHS/HS) where consistency in relational-care systems and stable environments are critical quality indicators. Key adults in EHS/HS settings including teachers, administrators, specialists, and auxiliary personnel impact young children and families by providing care, education, and essential resources. This study addressed risk of turnover (job satisfaction, intentions to remain in position or profession) in a nation-wide sample of EHS/HS professionals (N = 1,076) through the lens of early childhood professional well-being (ECPW). Rch Findings: Three ECPW factors were identified: Community Belonging (CB; α = 0.90); Safety & Security (SS; α = 0.84); and Professional Identity (PI; α = 0.76). ANOVA results indicated administrators, and professionals with college and graduate degrees, and those over 20 years of experience in their settings and the field experienced the highest levels of ECPW. SEM confirmed that ECPW was predictive of risk of turnover. Pre and Policy: Results helped refine researchers' earlier conceptualizations of ECPW. Implications of ECPW and risk of turnover in EHS/HS settings are discussed. [ABSTRACT FROM AUTHOR]

Due to the low-volume, high-risk nature of simultaneous pancreas-kidney transplantation, the development of standardized education provided nurses the tools to support patients postoperatively. Creation of a standardized educational brochure assisted in improving nurse knowledge and confidence in the patient education process. [ABSTRACT FROM AUTHOR]

A group of monocysteine derivatives of Escherichia coli UmuD protein and the cysteine-specific photoactive cross-linker p-azidoiodoacetanilide (AIA) were employed to study not only the interactions of intact UmuD in the homodimer but also the interactions of UmuD with activated RecA. The reactivities of the individual UmuD monocysteine derivatives with AIA were identical to their reactivities with iodoacetate. The relavite efficiencies of cross-linking of the AIA-modified monocysteine UmuD derivatives in the homodimer form were also consistent with previous conclusions regarding the relative closeness of various UmuD residues to the dimer interface.

A second set of monocysteine UmuD derivatives with single cysteine substitutions at positions 30 and 42 in Escherichia coli was constructed and studied. Findings indicated that like the VC34 mutant, UmuD derivatives with monocysteine substitutions at positions 32 and 35 exhibited deficiencies in in vivo and in vitro RecA-mediated cleavage as well as in UV mutagenesis, indicating that position 32 to 35 may be significant for RecA-mediated cleavage of UmuD.

Disulfide-cross-linked UmuD2 derivatives from Escherichia coli were found to be cleaved poorly upon incubation with activated RecA. Reducing the disulfide bonds before incubating the derivatives with RecA substantially increased their extent of cleavage. These findings indicate that the UmuD monomer is a better substrate for the RecA-mediated cleavage reaction than the dimer.

Objective: To assess the efficacy and safety of closed-loop insulin delivery compared with sensor-augmented pump therapy among older adults with type 1 diabetes.Research Design and Methods: This open-label, randomized (1:1), crossover trial compared 4 months of closed-loop versus sensor-augmented pump therapy. Eligible adults were aged ≥60 years, with type 1 diabetes (duration ≥10 years), using an insulin pump. The primary outcome was continuous glucose monitoring (CGM) time in range (TIR; 3.9-10.0 mmol/L).Results: There were 30 participants (mean age 67 [SD 5] years), with median type 1 diabetes duration of 38 years (interquartile range [IQR] 20-47), randomized (n = 15 to each sequence); all completed the trial. The mean TIR was 75.2% (SD 6.3) during the closed-loop stage and 69.0% (9.1) during the sensor-augmented pump stage (difference of 6.2 percentage points [95% CI 4.4 to 8.0]; P < 0.0001). All prespecified CGM metrics favored closed loop over the sensor-augmented pump; benefits were greatest overnight. Closed loop reduced CGM time <3.9 mmol/L during 24 h/day by 0.5 percentage points (95% CI 0.3 to 1.1; P = 0.0005) and overnight by 0.8 percentage points (0.4 to 1.1; P < 0.0001) compared with sensor-augmented pump. There was no significant difference in HbA1c between closed-loop versus sensor-augmented pump stages (7.3% [IQR, 7.1-7.5] (56 mmol/mol [54-59]) vs. 7.5% [7.1-7.9] (59 mmol/mol [54-62]), respectively; P = 0.13). Three severe hypoglycemia events occurred during the closed-loop stage and two occurred during the sensor-augmented pump stage; no hypoglycemic events required hospitalization. One episode of diabetic ketoacidosis occurred during the sensor-augmented pump stage; no serious adverse events occurred during the closed-loop stage.Conclusions: Closed-loop therapy is an effective treatment option for older adults with long-duration type 1 diabetes, and no safety issues were identified. These older adults had higher TIR accompanied by less time below range during closed loop than during sensor-augmented pump therapy. Of particular clinical importance, closed loop reduced the time spent in hypoglycemic range overnight. [ABSTRACT FROM AUTHOR]

Objective: To compare glucose control with hybrid closed-loop (HCL) when challenged by high intensity exercise (HIE), moderate intensity exercise (MIE), and resistance exercise (RE) while profiling counterregulatory hormones, lactate, ketones, and kinetic data in adults with type 1 diabetes.Research Design and Methods: This study was an open-label multisite randomized crossover trial. Adults with type 1 diabetes undertook 40 min of HIE, MIE, and RE in random order while using HCL (Medtronic MiniMed 670G) with a temporary target set 2 h prior to and during exercise and 15 g carbohydrates if pre-exercise glucose was <126 mg/dL to prevent hypoglycemia. Primary outcome was median (interquartile range) continuous glucose monitoring time-in-range (TIR; 70-180 mg/dL) for 14 h post-exercise commencement. Accelerometer data and venous glucose, ketones, lactate, and counterregulatory hormones were measured for 280 min post-exercise commencement.Results: Median TIR was 81% (67, 93%), 91% (80, 94%), and 80% (73, 89%) for 0-14 h post-exercise commencement for HIE, MIE, and RE, respectively (n = 30), with no difference between exercise types (MIE vs. HIE; P = 0.11, MIE vs. RE, P = 0.11; and HIE vs. RE, P = 0.90). Time-below-range was 0% for all exercise bouts. For HIE and RE compared with MIE, there were greater increases, respectively, in noradrenaline (P = 0.01 and P = 0.004), cortisol (P < 0.001 and P = 0.001), lactate (P ≤ 0.001 and P ≤ 0.001), and heart rate (P = 0.007 and P = 0.015). During HIE compared with MIE, there were greater increases in growth hormone (P = 0.024).Conclusions: Under controlled conditions, HCL provided satisfactory glucose control with no difference between exercise type. Lactate, counterregulatory hormones, and kinetic data differentiate type and intensity of exercise, and their measurement may help inform insulin needs during exercise. However, their potential utility as modulators of insulin dosing will be limited by the pharmacokinetics of subcutaneous insulin delivery. [ABSTRACT FROM AUTHOR]

Use of the construction and characterization of monocysteine derivatives of the UmuD protein will help evaluate the participation of UmuD in protein-protein interaction, which is important in UV mutagenesis. The model for UmuD interactions proposes that ser-60, the center for the putative nucleophile in the cleavage reaction, is located in a cleft region and that ser-19 and s-67 are also not close to the dimer interface. The position of ser-67 and ser-19 as suggested by the SC67 mutant phenotype is important for the mutagenesis.

Objective: To evaluate glucose control using fast-acting insulin aspart (faster aspart) compared with insulin aspart (IAsp) delivered by the MiniMed Advanced Hybrid Closed-Loop (AHCL) system in adults with type 1 diabetes.Research Design and Methods: In this randomized, open-label, crossover study, participants were assigned to receive faster aspart or IAsp in random order. Stages 1 and 2 comprised of 6 weeks in closed loop, preceded by 2 weeks in open loop. This was followed by stage 3, whereby participants changed directly back to the insulin formulation used in stage 1 for 1 week in closed loop. Participants chose their own meals except for two standardized meal tests, a missed meal bolus and late meal bolus. The primary outcome was the percentage of time sensor glucose values were from 70 to 180 mg/dL (time in range; [TIR]).Results: Twenty-five adults (52% male) were recruited; the median (interquartile range) age was 48 (37, 57) years, and the median HbA1c was 7.0% (6.6, 7.2) (53 [49, 55] mmol/mol). Faster aspart demonstrated greater overall TIR compared with IAsp (82.3% [78.5, 83.7] vs. 79.6% [77.0, 83.4], respectively; mean difference 1.9% [0.5, 3.3]; P = 0.007). Four-hour postprandial glucose TIR was higher using faster aspart compared with IAsp for all meals combined (73.6% [69.4, 80.2] vs. 72.1% [64.5, 78.5], respectively; median difference 3.5% [1.0, 7.3]; P = 0.003). There was no ketoacidosis or severe hypoglycemia.Conclusions: Faster aspart safely improved glucose control compared with IAsp in a group of adults with well-controlled type 1 diabetes using AHCL. The modest improvement was mainly related to mealtime glycemia. While the primary outcome demonstrated statistical significance, the clinical impact may be small, given an overall difference in TIR of 1.9%. [ABSTRACT FROM AUTHOR]