Background Bisphenol exposure is widespread and correlated with diabetes and cardiovascular disease. Previous intervention studies have successfully lowered bisphenol exposure among women of normal weight. The primary objective of this study was to develop and test the feasibility of a 3-week behavioral change intervention, rooted in social cognitive theory, to lower a broad range of bisphenols (BPA, BPS, and BPF) in women with obesity. Methods Thirty women with obesity (31.1 ± 5.6 kg/m2, 21.1 ± 3.1 years) were randomly assigned to an intervention or control. The intervention included weekly face-to-face meetings to reduce bisphenol exposures from food, cosmetics, and packaged products. Fasting urinary bisphenols, creatinine, and weight were assessed at study entry and after 3 weeks. Results The intervention was evaluated as feasible (100% of enrollment and recruitment, 96% of retention and attendance at lesson plan visits, and 96% of a collection of urine samples). Adherence to the intervention was estimated based on completion of self-monitoring records; the number of daily records completed was 7.7 ± 1.3 (mean ± SD) after week 1, 7.1 ± 1.5 after week 2, and 4.4 ± 0.9 after week 3. In secondary analysis, there was a significant treatment × time effect on creatinine-corrected urinary BPS (− 1.42 μg/g creatinine in the intervention vs. − 0.09 μg/g creatinine in the control group). Conclusion In women with obesity, the 3-week intervention was considered feasible with promising preliminary results of decreasing BPS concentrations. These data warrant future large-scale clinical trial interventions to reduce bisphenol exposure and determine whether reductions in bisphenols positively impact diabetes and cardiovascular disease risk markers. This study was retroactively registered at ClinicalTrial.gov Identifier NCT03440307.

Objective To determine the effects of varying doses of orally administered BPA on indices of glucose metabolism. Methods Eleven college students (21.0 ± 0.8 years; 24.2 ± 3.9 kg/m2) were randomized in a double-blinded, crossover fashion separated by >1 week to placebo (PL), deuterated BPA at 4 µg/kg body weight (BPA-4), and deuterated BPA at 50 µg/kg body weight (BPA-50). Total BPA, glucose, insulin, and C-peptide were assessed at baseline, minutes 15, 30, 45, 60, and every 30 minutes for 2 hours in response to a glucose tolerance test. Results There was a significant condition × time interaction for total BPA (P < 0.001) such that BPA increased more rapidly in BPA-50 than BPA-4 and PL (P = 0.003) and increased more rapidly in BPA-4 than PL (P < 0.001). There were no significant condition × time interactions on glucose, insulin, and C-peptide. Significant condition main effects were observed for glucose such that BPA-50 was significantly lower than PL (P = 0.036) and nearly lower for BPA-4 vs PL (P = 0.056). Significant condition main effects were observed such that insulin in BPA-50 was lower than BPA-4 (P = 0.021), and C-peptide in BPA-50 was lower than BPA-4 (t18 = 3.95; Tukey-adjusted P = 0.003). Glucose, insulin, and C-peptide areas under the curve for the 3-hour profile were significantly lower in BPA-50 vs PL (P < 0.05). Conclusion Orally administered BPA protocol appeared feasible and has immediate effects on glucose, insulin, and C-peptide concentrations.

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The aim of this study was to reduce time-to-segmentation for analysis of muscle quality across a large volume of the hip abductors in individuals with hip osteoarthritis by developing an automatic segmentation network. The gluteus medius (GMED), gluteus minimus (GMIN), and tensor fasciae latae (TFL) were manually segmented on fat-water separated IDEAL MR images in 44 subjects. A 3D V-Net was trained, validated, and tested using these manually segmented image volumes and resulted in a mean Dice coefficient of 0.94, 0.87, and 0.91 for GMED, GMIN, and TFL. The automatic segmentation network demonstrated strong performance and provides drastically reduced time-to-segmentation.

We report a rare case of hypoplastic left heart syndrome (HLHS) occurring in two pregnancies of a mother with diabetes mellitus. The first pregnancy occurred three years following the diagnosis of type 2 diabetes. HbA1c during this pregnancy was 7.13% and insulin was commenced at 20 weeks gestation. Following delivery at 35 weeks the female baby showed signs of cyanotic congenital heart disease, was diagnosed with hypoplastic left heart syndrome and sadly died on day 12 of life. The mother remained on insulin. Two later pregnancies resulted in deliveries of live male babies, one with no evidence of congenital heart disease and the other with a large ventricular septal defect. The booking HbA1c level in these pregnancies was 6.1% and 11.2% respectively. In the final pregnancy, which was unplanned, the booking HbA1c level had been 9.2%. HLHS was again diagnosed, this time at 24 weeks gestation, and the pregnancy was subsequently terminated. A clinical geneticist had counselled the parents following their first pregnancy and a 1-2% recurrence risk of congenital heart disease was given. The sibling recurrence risk of HLHS has since been quoted as high as 8% (Hinton et al 2007). Research into the relationship between hypoplastic left heart syndrome and maternal diabetes has been conflicting (Loffredo 2001, Moore 2000, Ferencz 1997, Becerra 1990) but one study suggested that maternal insulin dependent diabetes is a significant risk factor for HLHS (Abu-Sulaimain 2004). This rare case may support the findings reported in this study. It also highlights the importance of preconception counselling with particular reference to achieving satisfactory glycaemic control prior to conception.