Vitamins C and E and the risks of preeclampsia and perinatal complications

Copyright © 2006 Massachusetts Medical Society.Background: Supplementation with antioxidant vitamins has been proposed to reduce the risk of preeclampsia and perinatal complications, but the effects of this intervention are uncertain. Methods: We conducted a multicenter, randomized trial of nulliparous women between 14 and 22 weeks of gestation. Women were assigned to daily supplementation with 1000 mg of vitamin C and 400 IU of vitamin E or placebo (microcrystalline cellulose) until delivery. Primary outcomes were the risks of maternal preeclampsia, death or serious outcomes in the infants (on the basis of definitions used by the Australian and New Zealand Neonatal Network), and delivering an infant whose birth weight was below the 10th percentile for gestational age. Results: Of the 1877 women enrolled in the study, 935 were randomly assigned to the vitamin group and 942 to the placebo group. Baseline characteristics of the two groups were similar. There were no significant differences between the vitamin and placebo groups in the risk of preeclampsia (6.0 percent and 5.0 percent, respectively; relative risk, 1.20; 95 percent confidence interval, 0.82 to 1.75), death or serious outcomes in the infant (9.5 percent and 12.1 percent; relative risk, 0.79; 95 percent confidence interval, 0.61 to 1.02), or having an infant with a birth weight below the 10th percentile for gestational age (8.7 percent and 9.9 percent; relative risk, 0.87; 95 percent confidence interval, 0.66 to 1.16). Conclusions: Supplementation with vitamins C and E during pregnancy does not reduce the risk of preeclampsia in nulliparous women, the risk of intrauterine growth restriction, or the risk of death or other serious outcomes in their infants. (Controlledtrials.com number, ISRCTN00416244 [controlled-trials.com] .)Alice R. Rumbold, Caroline A. Crowther, Ross R. Haslam, Gustaaf A. Dekker and Jeffrey S. Robinso

Borderline gestational diabetes mellitus and pregnancy outcomes

Background: The impact of borderline gestational diabetes mellitus (BGDM), defined as a positive oral glucose challenge test (OGCT) and normal oral glucose tolerance test (OGTT), on maternal and infant health is unclear. We assessed maternal and infant health outcomes in women with BGDM and compared these to women who had a normal OGCT screen for gestational diabetes. Methods: We compared demographic, obstetric and neonatal outcomes between women participating in the Australian Collaborative Trial of Supplements with antioxidants Vitamin C and Vitamin E to pregnant women for the prevention of pre-eclampsia (ACTS) who had BGDM and who screened negative on OGCT. Results: Women who had BGDM were older (mean difference 1.3 years, [95% confidence interval (CI) 0.3, 2.2], p = 0.01) and more likely to be obese (27.1% vs 14.1%, relative risk (RR) 1.92, [95% CI 1.41, 2.62], p < 0.0001) than women who screened negative on OGCT. The risk of adverse maternal outcome overall was higher (12.9% vs 8.1%, RR 1.59, [95% CI 1.00, 2.52], p = 0.05) in women with BGDM compared with women with a normal OGCT. Women with BGDM were more likely to develop pregnancy induced hypertension (17.9% vs 11.8%, RR 1.51, [95% CI 1.03, 2.20], p = 0.03), have a caesarean for fetal distress (17.1% vs 10.5%, RR 1.63, [95% CI 1.10, 2.41], p = 0.01), and require a longer postnatal hospital stay (mean difference 0.4 day, [95% CI 0.1, 0.7], p = 0.01) than those with a normal glucose tolerance. Infants born to BGDM mothers were more likely to be born preterm (10.7% vs 6.4%, RR 1.68, [95% CI 1.00, 2.80], p = 0.05), have macrosomia (birthweight ≥4.5 kg) (4.3% vs 1.7%, RR 2.53, [95% CI 1.06, 6.03], p = 0.04), be admitted to the neonatal intensive care unit (NICU) (6.5% vs 3.0%, RR 2.18, [95% CI 1.09, 4.36], p = 0.03) or the neonatal nursery (40.3% vs 28.4%, RR 1.42, [95% CI 1.14, 1.76], p = 0.002), and have a longer hospital stay (p = 0.001). More infants in the BGDM group had Sarnat stage 2 or 3 neonatal encephalopathy (12.9% vs 7.8%, RR 1.65, [95% CI 1.04, 2.63], p = 0.03). Conclusion: Women with BGDM and their infants had an increased risk of adverse health outcomes compared with women with a negative OGCT. Intervention strategies to reduce the risks for these women and their infants need evaluation. Trial registration: Current Controlled Trials ISRCTN00416244Hong Ju, Alice R. Rumbold, Kristyn J. Willson and Caroline A. Crowthe

A Study of Interstellar Gas and Stars in the Gravitationally Lensed Galaxy `The Cosmic Eye' from Rest-Frame Ultraviolet Spectroscopy

We report the results of a study of the rest-frame UV spectrum of the Cosmic Eye, a luminous Lyman break galaxy at z=3.07331 gravitationally lensed by a factor of 25. The spectrum, recorded with the ESI spectrograph on the Keck II telescope, is rich in absorption features from the gas and massive stars in this galaxy. The interstellar absorption lines are resolved into two components of approximately equal strength and each spanning several hundred km/s in velocity. One component has a net blueshift of -70 km/s relative to the stars and H II regions and presumably arises in a galaxy-scale outflow similar to those seen in most star-forming galaxies at z = 2-3. The other is more unusual in showing a mean redshift of +350 km/s relative to the systemic redshift; possible interpretations include a merging clump, or material ejected by a previous star formation episode and now falling back onto the galaxy, or more simply a chance alignment with a foreground galaxy. In the metal absorption lines, both components only partially cover the OB stars against which they are being viewed. We tentatively associate the redshifted component with the strong damped Lyman alpha line, indicative of a column density N(H I) = (3.0 +/- 0.8) x 10(21) atoms/cm2, and propose that it provides the dust `foreground screen' responsible for the low ratio of far-infrared to UV luminosities of the Cosmic Eye. Compared to other well-studied examples of strongly lensed galaxies, we find that the young stellar population of the Cosmic Eye is essentially indistinguishable from those of the Cosmic Horseshoe and MS 1512-cB58, while the interstellar spectra of all three galaxies are markedly different, attesting to the real complexity of the interplay between starbursts and ambient interstellar matter in young galaxies (abridged).Comment: 14 pages, 6 Figures, Accepted for publication in Monthly Notices of the Royal Astronomical Society after minor revision

The risk of adverse pregnancy outcomes in women who are overweight or obese

Extent: 8p.Background: The prevalence of obesity amongst women bearing children in Australia is rising and has important implications for obstetric care. The aim of this study was to assess the prevalence and impact of mothers being overweight and obese in early to mid-pregnancy on maternal, peripartum and neonatal outcomes. Methods: A secondary analysis was performed on data collected from nulliparous women with a singleton pregnancy enrolled in the Australian Collaborative Trial of Supplements with antioxidants Vitamin C and Vitamin E to pregnant women for the prevention of pre-eclampsia (ACTS). Women were categorized into three groups according to their body mass index (BMI): normal (BMI 18.5-24.9 kg/m2); overweight (BMI 25-29.9 kg/m2) and; obese (BMI 30-34.9 kg/m2). Obstetric and perinatal outcomes were compared by univariate and multivariate analyses. Results: Of the 1661 women included, 43% were overweight or obese. Obese women were at increased risk of pre-eclampsia (relative risk (RR) 2.99 [95% confidence intervals (CI) 1.88, 4.73], p < 0.0001) and gestational diabetes (RR 2.10 [95%CI 1.17, 3.79], p = 0.01) compared with women with a normal BMI. Obese and overweight women were more likely to be induced and require a caesarean section compared with women of normal BMI (induction - RR 1.33 [95%CI 1.13, 1.57], p = 0.001 and 1.78 [95%CI 1.51, 2.09], p < 0.0001, caesarean section - RR 1.42 [95%CI 1.18, 1.70], p = 0.0002 and 1.63 [95%CI 1.34, 1.99], p < 0.0001). Babies of women who were obese were more likely to be large for gestational age (LFGA) (RR 2.08 [95%CI 1.47, 2.93], p < 0.0001) and macrosomic (RR 4.54 [95%CI 2.01, 10.24], p = 0.0003) compared with those of women with a normal BMI. Conclusion: The rate of overweight and obesity is increasing amongst the Australian obstetric population. Women who are overweight and obese have an increased risk of adverse pregnancy outcomes. In particular, obese women are at increased risk of gestational diabetes, pregnancy induced hypertension and pre-eclampsia. Effective preventative strategies are urgently needed.Chaturica Athukorala, Alice R Rumbold, Kristyn J Willson and Caroline A Crowthe

Delivery of maternal health care in Indigenous primary care services: baseline data for an ongoing quality improvement initiative

Extent: 10p.BACKGROUND: Australia's Aboriginal and Torres Strait Islander (Indigenous) populations have disproportionately high rates of adverse perinatal outcomes relative to other Australians. Poorer access to good quality maternal health care is a key driver of this disparity. The aim of this study was to describe patterns of delivery of maternity care and service gaps in primary care services in Australian Indigenous communities. METHODS: We undertook a cross-sectional baseline audit for a quality improvement intervention. Medical records of 535 women from 34 Indigenous community health centres in five regions (Top End of Northern Territory 13, Central Australia 2, Far West New South Wales 6, Western Australia 9, and North Queensland 4) were audited. The main outcome measures included: adherence to recommended protocols and procedures in the antenatal and postnatal periods including: clinical, laboratory and ultrasound investigations; screening for gestational diabetes and Group B Streptococcus; brief intervention/advice on health-related behaviours and risks; and follow up of identified health problems. RESULTS: The proportion of women presenting for their first antenatal visit in the first trimester ranged from 34% to 49% between regions; consequently, documentation of care early in pregnancy was poor. Overall, documentation of routine antenatal investigations and brief interventions/advice regarding health behaviours varied, and generally indicated that these services were underutilised. For example, 46% of known smokers received smoking cessation advice/counselling; 52% of all women received antenatal education and 51% had investigation for gestational diabetes. Overall, there was relatively good documentation of follow up of identified problems related to hypertension or diabetes, with over 70% of identified women being referred to a GP/Obstetrician. CONCLUSION: Participating services had both strengths and weaknesses in the delivery of maternal health care. Increasing access to evidence-based screening and health information (most notably around smoking cessation) were consistently identified as opportunities for improvement across services.Alice R. Rumbold, Ross S. Bailie, Damin Si, Michelle C. Dowden, Catherine M. Kennedy, Rhonda J. Cox, Lynette O’Donoghue, Helen E. Liddle, Ru K. Kwedza, Sandra C. Thompson, Hugh P. Burke, Alex D. H. Brown, Tarun Weeramanthri and Christine M. Connor

Progress towards a public chemogenomic set for protein kinases and a call for contributions

Protein kinases are highly tractable targets for drug discovery. However, the biological function and therapeutic potential of the majority of the 500+ human protein kinases remains unknown. We have developed physical and virtual collections of small molecule inhibitors, which we call chemogenomic sets, that are designed to inhibit the catalytic function of almost half the human protein kinases. In this manuscript we share our progress towards generation of a comprehensive kinase chemogenomic set (KCGS), release kinome profiling data of a large inhibitor set (Published Kinase Inhibitor Set 2 (PKIS2)), and outline a process through which the community can openly collaborate to create a KCGS that probes the full complement of human protein kinases

Norman Smith (éd.), Empire and Environment in the Making of Manchuria, Copenhague, Nordic Institute of Asian Studies Press (Studies in Asian Topics, 64), 2018.

Crowther Alice. Norman Smith (éd.), Empire and Environment in the Making of Manchuria, Copenhague, Nordic Institute of Asian Studies Press (Studies in Asian Topics, 64), 2018.. In: Bulletin de l'Ecole française d'Extrême-Orient. Tome 106, 2020. pp. 549-552

The Transformations of Our Lady: From the Taishan Precious Scroll to Daoist Paintings

１８９０ 年 、 北 京 の 白 雲 観 の 方 丈 、 高 仁 峒 は 、 あ る 無 名 の 画 家 に 二 十 一 連 の 絵 画 、 『 娘 娘 分 身 図 』 の 制 作 を 注 文 し た 。 こ の 絵 画 は 、 は じ め は た だ 普 通 の 一 女 性 が 、 苦 行 を 経 て さ ま ざ ま な 分 身 を 現 わ し 、 最 後 に 碧 霞 元 君 と な る ま で を 描 い た も の で あ る 。 こ の 女 性 は 、 内 丹 の 行 を 積 ん で 神 の 位 に ま で 上 り 詰 め た と 言 わ れ て い る 。 道 教 研 究 者 の Liu Xun (劉 迅 ) 氏 は 、 こ の 連 作 の 起 源 を 、 白 雲 観 と 清 朝 末 期 の 朝 廷 、 と く に 満 州 族 の 貴 族 の 令 嬢 た ち と の 結 び つ き に 求 め て い る 。 本 論 で は 、 白 雲 観 の こ の 絵 画 が 、 あ る 河 北 の 道 観 で 清 朝 初 期 に 描 か れ た 壁 画 を 発 想 源 と し た も の だ ろ う こ と 、 ま た そ の 内 容 が 、 北 京 周 辺 で 広 く 普 及 し て い た 宝 巻 『 天 仙 聖 母 源 流 泰 山 宝 巻 』 か ら 直 接 導 き 出 さ れ た も の で あ る こ と を 明 ら か に す る 。In 1890, the abbot of the Daoist monastery Baiyunguan in Beijing, Gao Rentong, commissioned a painter who remained anonymous to do a set of twenty-one paintings, The Transformations of Our Lady. These paintings show how Bixia yuanjun, an ordinary woman, transformed during her asceticism into a multitude of divided bodies before becoming the Primordial Sovereign of the Azure Clouds. Indeed, having become an adept of Daoist inner alchemy, she attained divine status. A specialist in Daoism, Liu Xun put forward the idea that this series owed its origin to the links between Baiyunguan and the imperial court at the end of the Qing (1644–1911), and above all to the Manchu noblewomen. In the article, the author demonstrates that the themes of the Baiyunguan paintings were probably based on the murals of a temple from the early Qing period in Hebei. In addition, she shows that their content, like that of the wall paintings, was taken directly from the Precious Scroll of the Taishan on the origins of the Celestial Immortal and the Holy Mother, a sacred writing (baojuan) that circulated widely in the capital region.En 1890, l’abbé du monastère taoïste Baiyunguan de Pékin, Gao Rentong, commanda à un peintre resté anonyme une série de vingt-et-une peintures, Les Transformations de Notre-Dame. Celles-ci montrent comment Bixia yuanjun, d’une femme ordinaire, se transforma au cours de son ascèse en une multitude de corps divisés avant de devenir la déesse des Nuages de l’aube. En effet, devenue une adepte de l’alchimie intérieure taoïste, elle accéda au statut divin. Un spécialiste du taoïsme, Liu Xun, a avancé l’idée que cette série devait son origine aux liens qui unissaient le Baiyunguan à la cour impériale à la fin des Qing (1644-1911), et par-dessus tout avec les jeunes filles de la noblesse mandchoue. Dans l’article, l’auteur démontre que les peintures du Baiyunguan s’inspirent probablement des peintures murales d’un temple du début des Qing dans le Hebei. De plus, elle établit que leur contenu, comme celui des peintures du temple, a été directement tiré du Précieux rouleau du Taishan sur les origines de l’Immortelle céleste et de la Sainte Mère, un écrit sacré (baojuan) qui circulait largement dans la région de la capitale.1890 年 ， 北 京 白 雲 觀 住 持 高 仁 峒 主 持 繪 製 了 一 套 表 現 碧 霞 元 君 成 神 經 過 的 畫 卷 《 娘 娘 分 身 圖 》 ， 講 述 碧 霞 元 君 從 凡 女 修 煉 內 丹 最 總 成 神 的 故 事 。 有 學 者 認 為 ， 這 套 畫 卷 的 繪 製 緣 由 應 該 從 白 雲 觀 與 晚 清 宮 廷 貴 族 ， 尤 其 是 女 性 貴 族 之 間 的 關 係 上 去 理 解 。 但 是 ， 《 娘 娘 分 身 圖 》 所 表 現 的 故 事 並 不 是 高 仁 峒 的 創 造 ， 它 與 河 北 涿 州 雞 鳴 驛 泰 山 行 宮 的 壁 畫 在 情 節 主 題 上 非 常 相 似 。 泰 山 行 宫 壁 畫 繪 製 於 清 早 期 ， 其 內 容 直 接 來 自 于 明 代 寶 卷 《 天 仙 圣 母 源 流 泰 山 寶 卷 》 ， 而 這 一 寶 卷 在 清 初 以 後 曾 在 北 京 及 周 邊 區 域 廣 泛 流 傳 。 因 此 ， 與 其 說 是 高 仁 峒 為 了 迎 合 上 層 婦 女 的 需 要 ， 製 造 出 了 這 樣 一 個 《 娘 娘 分 身 圖 》 的 故 事 ， 不 如 說 《 娘 娘 分 身 圖 》 来 自 于 華 北 碧 霞 元 君 信 仰 的 民 間 寶 卷 傳 統 ， 而 這 一 傳 統 對 慈 禧 等 宮 廷 婦 女 的 影 響 ， 是 值 得 繼 續 深 思 的 問 題 。Xi Ju, Crowther Alice. The Transformations of Our Lady: From the Taishan Precious Scroll to Daoist Paintings. In: Arts asiatiques, tome 74, 2019. pp. 45-68