Maternal diabetes mellitus negatively affects embryonic development and increases the risk for congenital malformations. Besides direct teratogenicity, diabetic intrauterine milieu can predispose an individual to chronic diseases later in life, including cardiovascular diseases, obesity, and diabetes mellitus, in a process termed fetal programing. Molecular mechanisms of embryonic and fetal responses to maternal diabetes are still not fully elucidated. Using mouse model, we show that maternal diabetes induces gene expression changes in the hearts of developing embryos. The most significant changes in the expression of 11 selected genes were detected at the developmental stage associated with completion of cardiac septation, myocardial mass expansion, and increased insulin production in the embryonic pancreas. These affected genes encode products involved in the epithelial-to-mesenchymal transition, a crucial process in heart development. Using immunohistochemistry, we detected increased hypoxia in the diabetes-exposed hearts at the critical stage of cardiac development. Correspondingly to increased hypoxia, the expression of hypoxia-inducible factor 1α (HIF1α) and vascular endothelial growth factor A was increased in the heart of diabetes-exposed embryos. Based on our results indicating the...

The purpose of this quantitative study was to examine data describing nitrate concentration and cases of congenital cardiac defects. Residents with private wells and other stakeholders need data to make informed environmental decisions about the adverse health implications of nitrate contamination of private well water. Researchers have examined the exposure of nitrate in contaminated groundwater, but they have not examined nitrate levels in unregulated water systems. This gap in the literature highlighted the need to provide nitrate data for future research and private well users. Guided by the social ecological model, a quantitative, cross-sectional, nonexperimental design was used to survey 231 adult participants about community perceptions of stakeholders' collaboration about groundwater and the sustainability of private water wells. Multiple linear regression was used to test the hypotheses. Survey results showed that gender, age group, and distance from animal waste sites or farmland were associated with barriers to community collaboration to achieve groundwater sustainability. Use of private wells for irrigation and distance from animal waste sites or farmland were associated with community members' perceptions of community collaboration to achieve groundwater sustainability. Community perceptions and barriers to stakeholders' collaboration were not affected by any demographic factors. The data will facilitate the design and implementation of effective public health outreach services for private well users. The implications for positive social change include increased understanding of stakeholders' perceptions of private well nitrate contamination and reduction of the risk factors for birth defects.