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BACKGROUND/OBJECTIVE: Evidence is accumulating that the long-chain PUFA (LCPUFA) are associated with offspring growth and body composition. We investigated the relationship between LCPUFAs in red blood cells (RBCs) of pregnant women/breastfeeding mothers and umbilical cord RBCs of their neonates with infant growth and body composition ≤ 1 year of age. SUBJECTS/METHODS: In an open-label randomized, controlled trial, 208 healthy pregnant women received a dietary intervention (daily supplementation with 1200 mg n-3 LCPUFAs and dietary counseling to reduce arachidonic acid (AA) intake) from the 15th week of gestation until 4 months of lactation or followed their habitual diet. Fatty acids of plasma phospholipids (PLs) and RBCs from maternal and cord blood were determined and associated with infant body weight, body mass index (BMI), lean body mass and fat mass assessed by skinfold thickness measurements and ultrasonography. RESULTS: Dietary intervention significantly reduced the n-6/n-3 LCPUFA ratio in maternal and cord-blood plasma PLs and RBCs. Maternal RBCs docosahexaenoic acid (DHA), n-3 LCPUFAs and n-6 LCPUFAs at the 32nd week of gestation were positively related to birth weight. Maternal n-3 LCPUFAs, n-6 LCPUFAs and AA were positively associated with birth length. Maternal RBCs AA and n-6 LCPUFAs were significantly negatively related to BMI and Ponderal Index at 1 year postpartum, but not to fat mass. CONCLUSION: Maternal DHA, AA, total n-3 LCPUFAs and n-6 LCPUFAs might serve as prenatal growth factors, while n-6 LCPUFAs also seems to regulate postnatal growth. The maternal n-6/n-3 LCPUFA ratio does not appear to have a role in adipose tissue development during early postnatal life. European Journal of Clinical Nutrition (2013) 67, 282-288;doi:10.1038/ejcn.2013.2;published online 23 January 2013 Keywords: n-3 LCPUFA supplementation; childhood obesity; maternal diet; DHA; pregnancy; early infancy C 102 12.51 ± 2.30 95 10.15± 3.89 73 11.37± 3.28 58 11.70± 3.90 < 0.001 C 65 7.62± 4.85, INTRODUCTION Childhood obesity has become a global epidemic (1) and there is growing evidence that it starts very early in life, potentially during the perinatal period. (2,3) To date, little [...]

The aim of this research is to reflect on children's literacy learning practices through read-aloud method training for managers of community reading parks in metro cities. The method used is narrative inquiry. The instruments used were open questionnaires, interviews, and document analysis. The data analysis technique used is that, because this research is qualitative, the validity and reliability of the data need to be met. Thus, researchers use four criteria: credibility, transferability, dependability, and confirmability. The results of this research are that there is an increase in knowledge and skills, a positive impact on children's literacy, and increased collaboration in the community. Literacy activists are expected to be able to improve their competency in reading aloud through the training of trainers.

The era of globalization in Indonesia in the business sector has experienced very rapid development. This is because the number of consumptive age or millennial generation in Indonesia is increasing every year. This very rapid business development provides an opportunity to set up independent businesses for entrepreneurs. One of the many independent businesses established is a coffee shop. One of the independent businesses engaged in the coffee shop is Ueno Coffee. The rapid development of the coffee shop business has resulted in increasingly fierce competition between competitors so that coffee shop entrepreneurs make it a threat and a challenge. With these threats and challenges, Ueno Coffee wants to conduct a customer satisfaction analysis that can be used to evaluate customer satisfaction so that it can be used for business development that is better, superior and able to compete with competitors. This study using the SEM-PLS method is expected to be able to assist business owners in analyzing the factors that effect consumer satisfaction. This study applies a simple random sampling technique with a sample of 100 people. The results of the analysis show that the variables of product quality, service quality, price, promotion, location and halal label have a positive value and have a significant effect on Ueno Coffee's consumer satisfaction.

Indonesia is a country with a majority Muslim population. Therefore, Indonesian consumers have to be more thorough in assuring halal guarantees. One of some identities as a Muslim is consuming halal products. Various factors can affect consumers in purchasing halal products. However, the consumption of halal-certified products is still relatively low. This study was intended to analyze the factors that influenced consumer perceptions in purchasing halal products. A case study was carried out on the coffee product, one of Indonesia's most popular culinary products. The data were collected based on a survey of 170 respondents who live in Surakarta, Central Java Province, and are Muslim. This study suggested that the factors that significantly influenced the purchase were the variables of religiosity, halal label certification, and product prices. In contrast, the variables of halal awareness and brand image had no significant effect. Thus, the five variables simultaneously had a significant positive effect on purchasing decisions for halal products.

One of the activities of the Karawang ADM Engine Plant in component export is to mix part packing, which is the process of combining several component parts with a certain quantity box into one pallet. This is done to streamline delivery to the destination country. This research was conducted to analyze problems and make improvements in order to achieve the target of zero flow out with the Poké Yoke approach, to design processes or tools so that errors do not occur or at least can be detected or corrected. The flow out occurs when the clip hose part separates from the module and the part way brake actuator is left in the consumable area. Identify the problem using why analysis and the main factors that cause the flow out of man, methods, and environment factors. Some improvement ideas based on Poké Yoke ideas are presented at the end.

Background Research indicates that breast milk contains bioactive components that influence metabolism in infancy and may play a role in the prevention of obesity in early childhood. In our initial study, 147 breastfeeding mother/child pairs were followed from birth to 2 years of age to examine the relationship between breast milk leptin and total adiponectin (collected at 6 weeks and 4 months postpartum) and infant body composition. Higher breast milk total adiponectin was related to greater fat mass and weight gain in children at 1 and 2 years of age, whereas leptin showed no association. Objectives/Methods In this follow-up, we examined the relationship between both adipokines and children's body weight, body mass index percentiles, sum of four skin-folds, percentage of body fat, fat mass and lean body mass at 3, 4 and 5 years of age. Results Breast milk adipokines were largely unrelated to child anthropometric measures. Conclusion Our results do not provide significant evidence that breast milk adipokines can predict adiposity in preschool children. [ABSTRACT FROM AUTHOR]

This study aims to determine whether Google classroom can improve the students’ ability in articulation phonetics or pronunciation at the English Department of IAIN Metro The type of this research is classroom action research. It was conducted in 2 cycles. Data collection techniques of this study were observation, tests, documentation, interviews, and field notes. The results of this research showed that there was improvement the students’ ability in Articulation Phonetics. It can be seen from the average score in pre test was 60,3, post test cycle 1 was 64, 5, and post test cycle 2 was 75,8.From the results, it can be concluded that the use of google classroom can improve the ability of articulation phonetics at English Department of IAIN Metro.

The pregnancy outcomes in women with gestational diabetes mellitus (GDM) and 'overt diabetes in pregnancy' were compared and the need for further subclassification was investigated with respect to postpartum outcome risk. Data from 944 women who had been uniformly diagnosed as having GDM in Munich, Germany, between 1998 and 2010, were re-classified into GDM and 'overt diabetes in pregnancy'. Pregnancy related outcomes in the offspring were derived from Bavarian birth registry data. Classification and regression trees were used to identify further GDM sub-phenotypes. In total, 88 women (9.3 %) were re-classified as having 'overt diabetes in pregnancy'. Compared to women with GDM, women with 'overt diabetes in pregnancy' used insulin more frequently, and were at increased risk for large for gestational age infants [odds ratio 2.50 (95 % confidence interval 1.02, 6.13)], preterm delivery [odds ratio 3.28 (1.02, 10.50)], and low APGAR-score at 5 min [odds ratio 12.70 (1.58, 102.2)]. In the 856 women with GDM, classification and regression tree analyses provided further risk stratification in that a combination of fasting glucose > 5.3 mmol/l and 1-h glucose > 11.1 mmol/l at GDM diagnosis predicted insulin requirement [OR 5.57 (3.75, 8.27) compared to the rest], and maternal body mass index (BMI) ≥ 35 kg/m2 predicted large for gestational age status. The new differentiation between GDM and 'overt diabetes in pregnancy' is a first step towards refining classification relevant to fetal and maternal postpartum risk. A combination of glucose levels and maternal BMI at diagnosis of GDM may provide further improvement. [ABSTRACT FROM AUTHOR]

The purpose of this study is to develop a learning media model using the Macromedia Flash application to be used in English Phonology learning and to determine the feasibility of appropriate Macromedia Flash-based learning media to support English Phonology learning. This research is a Research and Development Research (R & D) with stages (1) Stages of Analysis, namely Identifying the objectives of Learning Media and Identifying Student Characteristics; (2) Design Stages, namely Designing learning materials and Designing learning media design using the Macromedia Flash program; (3) Production stages, namely Producing learning materials, Authoring materials, and Editing learning materials; (4) Evaluation Stages, namely Material Expert Review, Media Expert Review, and Test on students.The results show that the English Phonology learning media products have met the rules of research and development and are effectively used in the learning process for Students of the English Language Department of IAIN Metro Lampung.

The raw material is an essential aspect of ensuring smooth production. The selection of raw material suppliers needs to be done to the sustainability of the company's production and development. Wisanka company is an export-oriented furniture company. It uses water hyacinth (Eichhornia crassipes) as the primary raw material. The company is required to maintain and improve performance. The company needs to select the right supplier. This study uses the Multi-Criteria Decision Making (MCDM) the Fuzzy Analytical Hierarchy Process (FAHP) method. It was used for selecting suppliers with criteria like price, quality, flexibility, delivery, warranty, and service. The result of the study show FAHP effective in selecting suppliers.

Water pump machines are electronic products that are widely used by the community. Because of the high frequency of use, this product is quickly damaged. In order to reduce the environmental impact, the ease of the product to be repaired or recycled needs to be improved, especially the dismantling process because it is the initial process to separate components. This study aims to evaluate the ease of dismantling a water pump machine based on the ease of component to be reached and the complexity of the component and product design. Evaluation begins by identifying the initial product design and the relationships between components needed to determine the order of possible product demolition and as an attribute of calculating complexity and accessibility indexes. The calculation results show that the complexity and accessibility idex values for each component are the same in all disassembly sequences because the product design does not allow for sub-assembly. The most complex components are mechanical seal, water reservoirs and lids beside the pump body. While the components that are most difficult to access are impellers, mechanical seals and rator covers.

Global climate models have predicted a mean sea level rise between 0.18 m and 0.59 m by the end of the 21st century with high regional variability. The projected sea level rise due to global warming would inundate low-lying areas. A high-resolution unstructured-grid Finite-Volume Coastal and Ocean Model is applied to perform a simulation and prediction of the flooding process because of storm impacts around Hafen City under today's conditions and under scenarios of future sea level rise. The results show significant flooding under strong storm processes, such as the winter storm ' Anatol' in 1999. The flood coverage will be significantly increased under short-, middle- and long-term sea level rise scenarios. The peak flood levels will rise according to the respective sea level rise while the flood area will increase by 18% (2025), 34% (2055) and 54% (2085). The maximum flood height and area for the three sea level rise scenarios will reach ∼6.8 m and ∼4.1 × 105 m2, respectively. The most impacted area will be the region between the Baakenhafen (zone 12) and the Oberhafen/Oberhafenkanal. In the long-term scenario (2085), flooding near the Magdeburger Hafen and Norderelbe will also increase. Coastal defence measures should be taken to ensure flood protection around Hafen City. [ABSTRACT FROM AUTHOR]

Competition in the manufacturing industry continues to increase, along with the shift in consumer demands increasingly aware of environmental sustainability. Implementation of green supply chain management became one of the company's attention to answer the demands. The government has also regulated related regulations. In Indonesia, wood furniture industries related to environmental conservation have not applied Green Supply Chain Management (GSCM). This study examines the factors that encourage the implementation of GSCM in the wood furniture industry, by involving relevant stakeholders. The weight of the influencing factor is determined by the Analytical Hierarchy Process (AHP) method. The results show consumer behavior, support from top management, and organizational strategies that influence the application of GSCM predominantly.

In response to growing importance of household waste management issue, this article deals with the positioning of household waste transfer points from a government-organized waste perspective. By taking Surakarta, a municipality in Central Java, Indonesia as an example, the problem in the municipality is formulated as an MILP, is approached with a capacity-weighted set covering method, and finally is solved by using software LINGO 11. The article concludes that the transfer point alternatives of Sondakan Kuburan, Norowangsan, SPSA, Pajang Rel, Bonoloyo and Kedung Tungkul should be selected in order to be able to serve all the household waste producers for the maximum household waste generated. On the contrary, the selection of Sondakan Kuburan, Bonoloyo and Kedung Tungkul only should be able to provide service to all of the household waste produced for the scenario of minimum amount of household waste.

Penelitian ini bertujuan mengetahui apakah ada perbedaan yang siqnifikan dalam variabel dependen (Y) yang meliputi konsumen sering Beli (YO), Cukup (Y I) dan Jarang Beli (Y2), serta bertujuan mengetahui perilaku konsumen yang benar-benar berbeda, perbedaan dalam arti perilaku mereka sering membeli, cukup dan jarang membeli. Metode analisis yang digunakan adalah dengan Wilk's Lambda, Pairwise, F test. Canonical corellation, untuk mencari ada dan tidak perbedaan antar group variabel dependen dan menginterpretasikan berdasarkan function at group centroid untuk mengetahui variabel independen mana yang menjadi faktor diskriminannya. Hasil yang didapat dari penelitian ini adalah bahwa variabel menu merupakan faktor pembeda (diskriminan). Artinya konsumen grup (sering beli, cukup dan jarang beli) tidak terpengaruh dengan usia, harga, pendapatan, dan pelayanan yang diberikan oleh RM. Pak Kardi ditunjukkan dengan tanda (+) padafunction I. Jadi konsumen yang membeli di RM. Pak Kardi adalah mereka yang benar-benar menyukai menu (masakan khas kepiting) RM. Pak Kardi. Jarak antara grup Sering Beli dengan grup Jarang Beli adalah yang terbesar, yakni 7,350. Sedangkan jarak terkecil adalah antara grup Cukup dengan grup Jarang Beli (0.522). Dengan demikian dapat dikatakan bahwa Konsumen di grup Sering Beli paling berbeda selera Menu masakannya. Sebaliknya Menu yang disukai oleh konsumen di RM. Pak Kardi yang termasuk konsumen Cukup mempunyai perbedaan yang kecil dengan mereka yang jarang membeli

PT. Primatexco Indonesia merupakan perusahaan tekstil dengan produk benang tenun, kain, printing, dan waste. Di PT. Primatexco Indonesia terdapat bagian blowing yang bertugas menyuplai bahan baku untuk proses produksi. Artikel ini membahas mengenai alternatif jadwal perbaikan maupun perawatan dengan biaya terkecil untuk komponen mesin blowing. Dengan menghitung biaya perawatan untuk repair policy dan dibandingkan dengan biaya preventive maintenance policy, maka akan didapatkan jadwal perbaikan maupun perawatan yang optimal. Dari hasil perhitungan, diusulkan jadwal perawatan mengikuti kebijakan repair untuk kerusakan komponen klasifikasi A. Untuk kerusakan komponen klasifikasi B diterapkan kebijakan preventive maintenance setiap 5 bulan. Dan untuk kerusakan komponen klasifikasi C diterapkan kebijakan preventive maintenance setiap 7 bulan.

Trace elements pollution of soils became a global concern because of their persistence in the environment which can lead to accumulation in food chains up to toxic levels. At the same time, there is a shortage of arable land for growing food, fodder and industrial crops, which highlights the need for remediation/use of polluted land. Restoration of degraded lands has been included as a vital component of UN Sustainable Development Goals (SDGs). We summarize various sources of entry of important trace elements in the environment, available biological reclamation and management strategies and their limitations. Recent advances in phytomanagement approaches using aromatic crops to obtain economically valuable products such as essential oils and revalorize such polluted areas are reviewed. The worldwide application of this strategy in the last 10 years is illustrated through a choropleth map. Finally, the emerging concept of phytomanagement as a restorative and regenerative circular bio-economy is also discussed.

Background/objectives: Limited research suggests that exposure to long-chain PUFAs (LCPUFAs) during perinatal development can influence adipose tissue expansion later in life. In previous analyses, we observed that maternal LCPUFAs in late gestation promote offspring gestational growth, whereas breast milk n-3 LCPUFAS promote adipogenesis in infants up to 1 year. This follow-up analysis examines these relationships in offspring up to 5 years., Subjects/methods: In this observational study of 169 children, relationships between n-3, n-6 LCPUFAs, and the n-6/n-3 LCPUFA ratio in maternal blood at 32 weeks' gestation, cord blood, and breast milk, and anthropometry in offspring from 2 to 5 years were investigated. Body composition was assessed with indirect (i.e., body weight, BMI percentiles, sum of four skinfold thicknesses) and direct (i.e., ultrasonography, magnetic resonance imaging in a subgroup) measurement tools., Results: Maternal and cord blood LCPUFAs were largely not shown to be related to offspring body composition. Breast milk n-3 LCPUFAs were significantly positively related to several measurements of child anthropometry at 2 and 4 y, but only a positive relationship between n-3 LCPUFAs and lean body mass remained statistically significant at 5 y. Breast milk n-6/n-3 LCPUFA ratio was inversely related to weight and BMI percentiles at 2 y, and lean body mass at 4 and 5 y., Conclusions: Results from this follow-up do not provide sufficient evidence that LCPUFAs in maternal blood, cord blood, and breast milk predict offspring adiposity in children up to 5 years.

Background: To better understand children's adipose tissue (AT) development and distribution, longitudinal data from direct assessment methods are valuable. Previously, we reported sonographic data on abdominal subcutaneous and preperitoneal fat areas ≤1 year of age., Methods: Sonographic measurements were annually pursued to assess the development of fat compartments in 2-5 year-old children. The effect of sex and correlations with comprehensive anthropometry (e.g., BMI percentiles, skinfold thickness (SFT) measurements, and waist circumference) are presented., Results: Subcutaneous fat areas increased modestly and were significantly greater in females at each time point investigated. Preperitoneal fat area increased significantly over time (all P values < 0.001) with greater area in females from 3 years onward (e.g., at 3 years estimated mean difference -4.8 mm 2 ; 95% CI: -8.6, -0.9; P = 0.016). The strongest correlations for subcutaneous fat area were consistently observed for SFT measurements. Preperitoneal fat area showed rather weak to moderate correlations, with greater correlation coefficients for SFT measurements compared to waist circumference., Conclusion: For the first time, longitudinal ultrasound data on abdominal body fat covering preschool age are presented. Evaluation revealed a differential development of fat compartments, depending on children's age and sex with SFT measurements as the best predictor for both fat depots.

Dietary intake during pregnancy as a possible modifiable risk factor for childhood obesity is poorly explored. In a prospective observational study, two multivariable regression models were therefore used to associate maternal diet at 15 and 32 weeks&rsquo; gestation with offsprings&rsquo; body composition and fat distribution at birth, 1, 3, and 5 years. Mean energy intake was 2157 &plusmn; 375 kcal ( n = 186) in early and 2208 &plusmn; 460 kcal ( n = 167) in late gestation. The partition model showed mostly no significant associations between maternal diet in early pregnancy and offspring body composition. In late pregnancy, higher fat intake was negatively associated with clinical outcomes at birth, 1, and 5 years. Protein intake was negatively associated with BMI z score (zBMI) at 3 and 5 years. A 10 g increase in fiber was associated with an increase of 3.50 mm² abdominal subcutaneous fat at 1, 172.49 g fat mass at 3, and 0.23 zBMI at 5 years. Results were largely comparable in the substitution model. An incremental increase in fat and protein at the expense of carbohydrates in late but not early pregnancy may be associated with lower fat mass up to 5 years. Findings require confirmation by additional prospective studies.

Objective: Women with insulin-requiring gestational diabetes mellitus (GDM) are at high risk of developing diabetes within a few years postpartum. We implemented this phase II study to test the hypothesis that vildagliptin, a dipeptidyl peptidase-4 inhibitor, is superior to placebo in terms of reducing the risk of postpartum diabetes., Methods: Women with insulin-requiring GDM were randomized to either placebo or 50 mg vildagliptin twice daily for 24 months followed by a 12-month observation period (EudraCT: 2007-000634-39). Both groups received lifestyle counseling. The primary efficacy outcomes were the diagnosis of diabetes (American Diabetes Association (ADA) criteria) or impaired fasting glucose (IFG)/impaired glucose tolerance (IGT)., Results: Between 2008 and 2015, 113 patients (58 vildagliptin, 55 placebo) were randomized within 2.2-10.4 (median 8.6) months after delivery. At the interim analysis, nine diabetic events and 28 IFG/IGT events had occurred. Fifty-two women withdrew before completing the treatment phase. Because of the low diabetes rate, the study was terminated. Lifestyle adherence was similar in both groups. At 24 months, the cumulative probability of postpartum diabetes was 3% and 5% (hazard ratio: 1.03; 95% confidence interval: 0.15-7.36) and IFG/IGT was 43% and 22% (hazard ratio: 0.55; 95% confidence interval: 0.26-1.19) in the placebo and vildagliptin groups, respectively. Vildagliptin was well tolerated with no unexpected adverse events., Conclusions: The study did not show significant superiority of vildagliptin over placebo in terms of reducing the risk of postpartum diabetes. However, treatment was safe and suggested some improvements in glycemic control, insulin resistance, and β-cell function. The study identified critical issues in performing clinical trials in the early postpartum period in women with GDM hampering efficacy assessments. With this knowledge, we have set a basis for which properly powered trials could be performed in women with recent GDM. TRIAL REGISTRATION NUMBER AT CLINICALTRIALS.GOV: NCT01018602., (Copyright © 2018 The Authors. Published by Elsevier GmbH.. All rights reserved.)

Objective: Perinatal leptin exposure may modulate the risk of adiposity in early childhood. In previous analyses, negative associations between maternal (32 weeks' gestation) and cord blood leptin and offspring body composition at 2 years were observed., Methods: Associations between maternal/cord blood leptin were assessed with indirect (i.e., body weight, BMI percentiles, sum of 4 skinfold thicknesses), and direct (i.e., ultrasonography, magnetic resonance imaging in a subgroup) growth and adipose tissue (AT) measurements in 120 children aged 3 to 5 years., Results: Maternal leptin was not shown to be associated with offspring body composition in univariate analyses. In adjusted analyses, some weak negative associations were observed with weight and BMI percentiles but not with sum of 4 skinfold thicknesses or calculated body fat at 3 to 5 years. Cord blood leptin was inversely related to offspring body composition, but effect sizes were small and not consistently statistically significant. No evidence of associations with direct AT measurements was observed., Conclusions: Although some negative relationships with indirect measurements of AT mass were observed, the results of this study do not provide sufficient evidence that maternal plasma or cord blood leptin is clinically relevant predictors of obesity or body fat distribution in early childhood., (© 2017 The Obesity Society.)

Aims/hypothesis: Circulating metabolites have been shown to reflect metabolic changes during the development of type 2 diabetes. In this study we examined the association of metabolite levels and pairwise metabolite ratios with insulin responses after glucose, glucagon-like peptide-1 (GLP-1) and arginine stimulation. We then investigated if the identified metabolite ratios were associated with measures of OGTT-derived beta cell function and with prevalent and incident type 2 diabetes., Methods: We measured the levels of 188 metabolites in plasma samples from 130 healthy members of twin families (from the Netherlands Twin Register) at five time points during a modified 3 h hyperglycaemic clamp with glucose, GLP-1 and arginine stimulation. We validated our results in cohorts with OGTT data (n = 340) and epidemiological case-control studies of prevalent (n = 4925) and incident (n = 4277) diabetes. The data were analysed using regression models with adjustment for potential confounders., Results: There were dynamic changes in metabolite levels in response to the different secretagogues. Furthermore, several fasting pairwise metabolite ratios were associated with one or multiple clamp-derived measures of insulin secretion (all p < 9.2 × 10 -7 ). These associations were significantly stronger compared with the individual metabolite components. One of the ratios, valine to phosphatidylcholine acyl-alkyl C32:2 (PC ae C32:2), in addition showed a directionally consistent positive association with OGTT-derived measures of insulin secretion and resistance (p ≤ 5.4 × 10 -3 ) and prevalent type 2 diabetes (OR Val&#95;PC ae C32:2 2.64 [β 0.97 ± 0.09], p = 1.0 × 10 -27 ). Furthermore, Val&#95;PC ae C32:2 predicted incident diabetes independent of established risk factors in two epidemiological cohort studies (HR Val&#95;PC ae C32:2 1.57 [β 0.45 ± 0.06]; p = 1.3 × 10 -15 ), leading to modest improvements in the receiver operating characteristics when added to a model containing a set of established risk factors in both cohorts (increases from 0.780 to 0.801 and from 0.862 to 0.865 respectively, when added to the model containing traditional risk factors + glucose)., Conclusions/interpretation: In this study we have shown that the Val&#95;PC ae C32:2 metabolite ratio is associated with an increased risk of type 2 diabetes and measures of insulin secretion and resistance. The observed effects were stronger than that of the individual metabolites and independent of known risk factors.

Background: Few human studies have explored the role of adiponectin in early life on growth and adipose tissue development., Methods: High molecular weight (HMW) and total adiponectin levels from 141 cord blood samples and plasma blood samples from 40 3-y-old children were analyzed. Associations between adiponectin levels in cord blood and child plasma, and infant/child growth and fat mass measurements up to the age of 5 y were assessed using linear regression models., Results: HMW cord blood adiponectin was positively associated with weight, BMI percentiles, and lean body mass at birth only. At 3 and 4 y, positive associations were found with cord blood adiponectin and sum of four skinfold thickness measures and percentage of body fat following adjustment for maternal and child covariates, but did not persist at 5 y. There was no significant evidence of an association between child plasma HMW adiponectin and growth or body composition characteristics at 3-5 y., Conclusion: Our results do not support the hypothesis that HMW cord blood adiponectin is a useful biomarker for the prediction of adiposity at the age of 5 y. Additionally, there is no evidence that plasma HMW adiponectin levels predict body fat distribution between 3-5 y.

Objective: Midodrine hydrochloride is a short-acting pressor agent that raises blood pressure in the upright position in patients with orthostatic hypotension. The US Food and Drug Administration's Subpart H approval, under which midodrine was initially approved, requires post-marketing studies to confirm midodrine's clinical benefit in this indication. The purpose of this study was to evaluate the clinical benefit of midodrine with regard to symptom response., Methods: This was a double-blind, placebo-controlled, randomized, crossover, multicenter study (NCT01518946). Following screening, patients aged ≥18 years with severe symptomatic orthostatic hypotension and on a stable dose of midodrine for at least 3 months were randomized to treatment with either their previous midodrine dose or placebo on day 1 and the respective alternate treatment on day 2. The primary endpoint measured time to syncopal symptoms or near-syncope using a 45-min tilt-table test at 1 h post-dose., Results: Thirty-three patients were screened for inclusion: 19 received at least one dose of midodrine and had at least one post-dose measurement of the primary endpoint. The least-squares mean time to syncopal symptoms or near-syncope after tilt-table initiation (mean ± standard error) was 1626.6 ± 186.8 s for midodrine and 1105.6 ± 186.8 s for placebo (difference, 521.0 s; 95 % confidence interval 124.2-971.7 s; p = 0.0131). There were 15 adverse events in 10 patients; all of these were mild or moderate in severity, with none considered by the investigators to be related to midodrine., Interpretation: Midodrine is a well-tolerated and clinically effective treatment for symptomatic orthostatic hypotension.