Trends in Timing of Pregnancy Awareness Among US Women

OBJECTIVES: Early pregnancy detection is important for improving pregnancy outcomes as the first trimester is a critical window of fetal development; however, there has been no description of trends in timing of pregnancy awareness among US women. METHODS: We examined data from the 1995, 2002, 2006–2010 and 2011–2013 National Survey of Family Growth on self-reported timing of pregnancy awareness among women aged 15–44 years who reported at least one pregnancy in the 4 or 5 years prior to interview that did not result in induced abortion or adoption (n = 17, 406). We examined the associations between maternal characteristics and late pregnancy awareness (≥7 weeks’ gestation) using adjusted prevalence ratios from logistic regression models. Gestational age at time of pregnancy awareness (continuous) was regressed over year of pregnancy conception (1990–2012) in a linear model. RESULTS: Among all pregnancies reported, gestational age at time of pregnancy awareness was 5.5 weeks (standard error = 0.04) and the prevalence of late pregnancy awareness was 23 % (standard error = 1 %). Late pregnancy awareness decreased with maternal age, was more prevalent among non-Hispanic black and Hispanic women compared to non-Hispanic white women, and for unintended pregnancies versus those that were intended (p < 0.01). Mean time of pregnancy awareness did not change linearly over a 23-year time period after adjustment for maternal age at the time of conception (p < 0.16). CONCLUSIONS FOR PRACTICE: On average, timing of pregnancy awareness did not change linearly during 1990–2012 among US women and occurs later among certain groups of women who are at higher risk of adverse birth outcomes

Increased NMDA receptor inhibition at an increased Sevoflurane MAC

BACKGROUND: Sevoflurane potently enhances glycine receptor currents and more modestly decreases NMDA receptor currents, each of which may contribute to immobility. This modest NMDA receptor antagonism by sevoflurane at a minimum alveolar concentration (MAC) could be reciprocally related to large potentiation of other inhibitory ion channels. If so, then reduced glycine receptor potency should increase NMDA receptor antagonism by sevoflurane at MAC. METHODS: Indwelling lumbar subarachnoid catheters were surgically placed in 14 anesthetized rats. Rats were anesthetized with sevoflurane the next day, and a pre-infusion sevoflurane MAC was measured in duplicate using a tail clamp method. Artificial CSF (aCSF) containing either 0 or 4 mg/mL strychnine was then infused intrathecally at 4 μL/min, and the post-infusion baseline sevoflurane MAC was measured. Finally, aCSF containing strychnine (either 0 or 4 mg/mL) plus 0.4 mg/mL dizocilpine (MK-801) was administered intrathecally at 4 μL/min, and the post-dizocilpine sevoflurane MAC was measured. RESULTS: Pre-infusion sevoflurane MAC was 2.26%. Intrathecal aCSF alone did not affect MAC, but intrathecal strychnine significantly increased sevoflurane requirement. Addition of dizocilpine significantly decreased MAC in all rats, but this decrease was two times larger in rats without intrathecal strychnine compared to rats with intrathecal strychnine, a statistically significant (P < 0.005) difference that is consistent with increased NMDA receptor antagonism by sevoflurane in rats receiving strychnine. CONCLUSIONS: Glycine receptor antagonism increases NMDA receptor antagonism by sevoflurane at MAC. The magnitude of anesthetic effects on a given ion channel may therefore depend on the magnitude of its effects on other receptors that modulate neuronal excitability

Palaeozoic landscapes shaped by plant evolution

Fluvial landscapes diversified markedly over the 250 million years between the Cambrian and Pennsylvanian periods. The diversification occurred in tandem with the evolution of vascular plants and expanding vegetation cover. In the absence of widespread vegetation, landscapes during the Cambrian and Ordovican periods were dominated by rivers with wide sand-beds and aeolian tracts. During the late Silurian and Devonian periods, the appearance of vascular plants with root systems was associated with the development of channelled sand-bed rivers, meandering rivers and muddy floodplains. The widespread expansion of trees by the Early Pennsylvanian marks the appearance of narrow fixed channels, some representing anabranching systems, and braided rivers with vegetated islands. We conclude that the development of roots stabilized the banks of rivers and streams. The subsequent appearance of woody debris led to log jams that promoted the rapid formation of new river channels. Our contention is supported by studies of modern fluvial systems and laboratory experiments. In turn, fluvial styles influenced plant evolution as new ecological settings developed along the fluvial systems. We suggest that terrestrial plant and landscape evolution allowed colonization by an increasingly diverse array of organisms