The effect of modern intensive monitoring in obstetrics on infant mortality and the incidence of hypoxia and acidosis

Peer Reviewe

Activity and movement of small mammal tick hosts at the urban fringes of Sydney, Australia

Context. Small mammals may traverse the urban fringe and use both natural and anthropogenic resources. In Australia, human commensal black rats (Rattus rattus) and native long-nosed bandicoots (Perameles nasuta) are important tick hosts, which can be found persisting at the urban fringe, leading to human–wildlife conflict. Aims. We aimed to (1) determine the relative activity of small mammals in yards and associations with yard attributes, (2) compare activity of black rats and long-nosed bandicoots in bushland with activity in yards and (3) determine the proportion of black rats and long-nosed bandicoots that crossed the urban fringe. We predicted that native bandicoots would be more active in bushland habitats and that black rats would be more active in yards. Methods. We used camera trapping in 56 residential yards, 18 of which were paired with adjacent bushland to measure small mammal activity in the two habitats. We recorded yard attributes and examined these associations using generalised linear models. We used isodar analysis to investigate black rat preferences of bushland habitat compared with yards, and we used Rhodamine B baiting to investigate movement at the urban fringe. Key results. We found that black rats were the most active small mammal in residential yards and were detected in more yards than other small mammals, followed by bandicoots. Black rat activity was greater in yards adjacent to bushland, but no other yard attributes were associated with black rat and bandicoot activity. Overall, activity tended to be higher in bushland than in yards at paired locations. Conclusions. Our findings suggest residential yards likely provide high-quality resources for long-nosed bandicoots. Low rates of movement at the urban fringe (6%), and a preference for bushland at low densities suggests that black rats may be synanthropic rather than commensal, occupying an urban niche but not depending on anthropogenic resources as expected. Implications. Residential properties located adjacent to bushland may be exposed to increased black rat activity in yards. Future work should consider how introduced rats may be controlled in bushland to assist urban rat control efforts and avoid non-target impacts. Residential yards are likely to be important habitat for the persistence of long- nosed bandicoots in urban environments

Urbanisation and wing asymmetry in the western honey bee (Apis mellifera, Linnaeus 1758) at multiple scales

Changes in the mean and variance of phenotypic traits like wing and head morphology are frequently used as indicators of environmental stress experienced during development and may serve as a convenient index of urbanization exposure. To test this claim, we collected adult western honey bee (Apis mellifera Linnaeus 1758, Hymenoptera, Apidae) workers from colonies located across an urbanization gradient, and quantified associations between the symmetries of both wing size and wing shape, and several landscape traits associated with urbanization. Landscape traits were assessed at two spatial scales (three km and 500 m) and included vegetation and anthropogenic land cover, total road length, road proximity and, population and dwelling density. We then used geometric morphometric techniques to determine two wing asymmetry scores—centroid size, a measure of wing size asymmetry and Procrustes distance, a measure of wing shape asymmetry. We found colony dependent differences in both wing size and shape asymmetry. Additionally, we found a negative association between wing shape asymmetry and road proximity at the three km buffer, and associations between wing shape asymmetry and road proximity, anthropogenic land cover and vegetation cover at the 500 m buffer. Whilst we were unable to account for additional variables that may influence asymmetry including temperature, pesticide presence, and parasitism our results demonstrate the potential usefulness of wing shape asymmetry for assessing the impact of certain landscape traits associated with urbanization. Furthermore, they highlight important spatial scale considerations that warrant investigation in future phenotypic studies assessing urbanization impact

Urban forest invertebrates : how they shape and respond to the urban environment

Invertebrates comprise the most diversified animal group on Earth. Due to their long evolutionary history and small size, invertebrates occupy a remarkable range of ecological niches, and play an important role as "ecosystem engineers" by structuring networks of mutualistic and antagonistic ecological interactions in almost all terrestrial ecosystems. Urban forests provide critical ecosystem services to humans, and, as in other systems, invertebrates are central to structuring and maintaining the functioning of urban forests. Identifying the role of invertebrates in urban forests can help elucidate their importance to practitioners and the public, not only to preserve biodiversity in urban environments, but also to make the public aware of their functional importance in maintaining healthy greenspaces. In this review, we examine the multiple functional roles that invertebrates play in urban forests that contribute to ecosystem service provisioning, including pollination, predation, herbivory, seed and microorganism dispersal and organic matter decomposition, but also those that lead to disservices, primarily from a public health perspective, e.g., transmission of invertebrate-borne diseases. We then identify a number of ecological filters that structure urban forest invertebrate communities, such as changes in habitat structure, increased landscape imperviousness, microclimatic changes and pollution. We also discuss the complexity of ways that forest invertebrates respond to urbanisation, including acclimation, local extinction and evolution. Finally, we present management recommendations to support and conserve viable and diverse urban forest invertebrate populations into the future.Peer reviewe

Cross-sectional observational study of 208 patients with non-classical urea cycle disorders.

Urea cycle disorders (UCDs) are inherited disorders of ammonia detoxification often regarded as mainly of relevance to pediatricians. Based on an increasing number of case studies it has become obvious that a significant number of UCD patients are affected by their disease in a non-classical way: presenting outside the newborn period, following a mild course, presenting with unusual clinical features, or asymptomatic patients with only biochemical signs of a UCD. These patients are surviving into adolescence and adulthood, rendering this group of diseases clinically relevant to adult physicians as well as pediatricians. In preparation for an international workshop we collected data on all patients with non-classical UCDs treated by the participants in 20 European metabolic centres. Information was collected on a cohort of 208 patients 50% of which were ≥ 16 years old. The largest subgroup (121 patients) had X-linked ornithine transcarbamylase deficiency (OTCD) of whom 83 were female and 29% of these were asymptomatic. In index patients, there was a mean delay from first symptoms to diagnosis of 1.6 years. Cognitive impairment was present in 36% of all patients including female OTCD patients (in 31%) and those 41 patients identified presymptomatically following positive newborn screening (in 12%). In conclusion, UCD patients with non-classical clinical presentations require the interest and care of adult physicians and have a high risk of neurological complications. To improve the outcome of UCDs, a greater awareness by health professionals of the importance of hyperammonemia and UCDs, and ultimately avoidance of the still long delay to correctly diagnose the patients, is crucial

The role of acyl-coenzyme A carboxylase complex in lipstatin biosynthesis of Streptomyces toxytricini

Streptomyces toxytricini produces lipstatin, a specific inhibitor of pancreatic lipase, which is derived from two fatty acid moieties with eight and 14 carbon atoms. The pccB gene locus in 10.6 kb fragment of S. toxytricini chromosomal DNA contains three genes for acyl-coenzyme A carboxylase (ACCase) complex accA3, pccB, and pccE that are presumed to be involved in secondary metabolism. The pccB gene encoding a β subunit of ACCase [carboxyltransferase (CT)] was identified upstream of pccE gene for a small protein of ε subunit. The accA3 encoding the α subunit of ACCase [biotin carboxylase (BC)] was also identified downstream of pccB gene. When the pccB and pccE genes were inactivated by homologous recombination, the lipstatin production was reduced as much as 80%. In contrast, the accumulation of another compound, tetradeca-5.8-dienoic acid (the major lipstatin precursor), was 4.5-fold increased in disruptant compared with wild-type. It implies that PccB of S. toxytricini is involved in the activation of octanoic acid to hexylmalonic acid for lipstatin biosynthesis

A generic emergency protocol for patients with inborn errors of metabolism causing fasting intolerance: A retrospective, single-center study and the generation of www.emergencyprotocol.net

Patients with inborn errors of metabolism causing fasting intolerance can experience acute metabolic decompensations. Long-term data on outcomes using emergency letters are lacking. This is a retrospective, observational, single-center study of the use of emergency letters based on a generic emergency protocol in patients with hepatic glycogen storage diseases (GSD) or fatty acid oxidation disorders (FAOD). Data on hospital admissions, initial laboratory results, and serious adverse events were collected. Subsequently, the website www.emergencyprotocol.net was generated in the context of the CONNECT MetabERN eHealth project following multiple meetings, protocol revisions, and translations. Representing 470 emergency protocol years, 127 hospital admissions were documented in 54/128 (42%) patients who made use of emergency letters generated based on the generic emergency protocol. Hypoglycemia (here defined as glucose concentration 5 years. Convulsions, coma, or death was not documented. By providing basic information, emergency letters for individual patients with hepatic GSD or the main FAOD can be generated at www.emergencyprotocol.net, in nine different languages. Generic emergency protocols are safe and easy for home management by the caregivers and the first hour in-hospital management to prevent metabolic emergencies in patients with hepatic GSD and medium-chain Acyl CoA dehydrogenase deficiency. The website www.emergencyprotocol.net is designed to support families and healthcare providers to generate personalized emergency letters for patients with hepatic GSD and the main FAOD

The natural history of classic galactosemia: lessons from the GalNet registry.

BACKGROUND Classic galactosemia is a rare inborn error of carbohydrate metabolism, caused by a severe deficiency of the enzyme galactose-1-phosphate uridylyltransferase (GALT). A galactose-restricted diet has proven to be very effective to treat the neonatal life-threatening manifestations and has been the cornerstone of treatment for this severe disease. However, burdensome complications occur despite a lifelong diet. For rare diseases, a patient disease specific registry is fundamental to monitor the lifespan pathology and to evaluate the safety and efficacy of potential therapies. In 2014, the international Galactosemias Network (GalNet) developed a web-based patient registry for this disease, the GalNet Registry. The aim was to delineate the natural history of classic galactosemia based on a large dataset of patients. METHODS Observational data derived from 15 countries and 32 centers including 509 patients were acquired between December 2014 and July 2018. RESULTS Most affected patients experienced neonatal manifestations (79.8%) and despite following a diet developed brain impairments (85.0%), primary ovarian insufficiency (79.7%) and a diminished bone mineral density (26.5%). Newborn screening, age at onset of dietary treatment, strictness of the galactose-restricted diet, p.Gln188Arg mutation and GALT enzyme activity influenced the clinical picture. Detection by newborn screening and commencement of diet in the first week of life were associated with a more favorable outcome. A homozygous p.Gln188Arg mutation, GALT enzyme activity of ≤ 1% and strict galactose restriction were associated with a less favorable outcome. CONCLUSION This study describes the natural history of classic galactosemia based on the hitherto largest data set

Selective inhibitors of cardiac ADPR cyclase as novel anti-arrhythmic compounds

ADP-ribosyl cyclases (ADPRCs) catalyse the conversion of nicotinamide adenine dinucleotide to cyclic adenosine diphosphoribose (cADPR) which is a second messenger involved in Ca2+ mobilisation from intracellular stores. Via its interaction with the ryanodine receptor Ca2+ channel in the heart, cADPR may exert arrhythmogenic activity. To test this hypothesis, we have studied the effect of novel cardiac ADPRC inhibitors in vitro and in vivo in models of ventricular arrhythmias. Using a high-throughput screening approach on cardiac sarcoplasmic reticulum membranes isolated from pig and rat and nicotinamide hypoxanthine dinuleotide as a surrogate substrate, we have identified potent and selective inhibitors of an intracellular, membrane-bound cardiac ADPRC that are different from the two known mammalian ADPRCs, CD38 and CD157/Bst1. We show that two structurally distinct cardiac ADPRC inhibitors, SAN2589 and SAN4825, prevent the formation of spontaneous action potentials in guinea pig papillary muscle in vitro and that compound SAN4825 is active in vivo in delaying ventricular fibrillation and cardiac arrest in a guinea pig model of Ca2+ overload-induced arrhythmia. Inhibition of cardiac ADPRC prevents Ca2+ overload-induced spontaneous depolarizations and ventricular fibrillation and may thus provide a novel therapeutic principle for the treatment of cardiac arrhythmias