Maternal and fetal outcome in abruptio placentae at a tertiary care centre: a retrospective analysis

Background: Placental abruption is a major obstetric complication leading to increased risk of maternal and neonatal morbidity and mortality globally. Placental abruption is traditionally defined as premature separation of a normally implanted placenta after 20 weeks of gestation and before delivery of the fetus. Early recognition of the risk factors, timely diagnosis and early intervention can significantly reduce maternal and fetal morbidity and mortality. This study was aimed to identify the associated risk factors with abruptio placenta and to analyse the maternal and perinatal outcome in abruptio placenta.Methods: This was a retrospective observational study, from Jan 2016 to Dec 2019 at M.S. Ramaiah medical college and hospitals, Bangalore.Results: In our study, the incidence of abruptio placenta was 0.95%. Majority of our patients were between 20-24 years (41.5%). Primigravidae accounted for 46.15% of the cases. The unbooked cases were 92%. The commonest risk factor was hypertension complicating pregnancy which accounted for 26% .The live births were 64%. Postpartum haemorrhage was one of the major complications in our study. There was no maternal mortality, probably due to early intervention and availability of blood and blood products.Conclusions: Timely diagnosis and appropriate intervention preferably in tertiary care centre will significantly reduce mortality and morbidity in both mother and fetus.

Determinants of antibody persistence across doses and continents after single-dose rVSV-ZEBOV vaccination for Ebola virus disease: an observational cohort study.

BACKGROUND: The recombinant vesicular stomatitis virus (rVSV) vaccine expressing the Zaire Ebola virus (ZEBOV) glycoprotein is efficacious in the weeks following single-dose injection, but duration of immunity is unknown. We aimed to assess antibody persistence at 1 and 2 years in volunteers who received single-dose rVSV-ZEBOV in three previous trials. METHODS: In this observational cohort study, we prospectively followed-up participants from the African and European phase 1 rVSV-ZEBOV trials, who were vaccinated once in 2014-15 with 300 000 (low dose) or 10-50 million (high dose) plaque-forming units (pfu) of rVSV-ZEBOV vaccine to assess ZEBOV glycoprotein (IgG) antibody persistence. The primary outcome was ZEBOV glycoprotein-specific IgG geometric mean concentrations (GMCs) measured yearly by ELISA compared with 1 month (ie, 28 days) after immunisation. We report GMCs up to 2 years (Geneva, Switzerland, including neutralising antibodies up to 6 months) and 1 year (Lambaréné, Gabon; Kilifi, Kenya) after vaccination and factors associated with higher antibody persistence beyond 6 months, according to multivariable analyses. Trials and the observational study were registered at ClinicalTrials.gov (Geneva: NCT02287480 and NCT02933931; Kilifi: NCT02296983) and the Pan-African Clinical Trials Registry (Lambaréné PACTR201411000919191). FINDINGS: Of 217 vaccinees from the original studies (102 from the Geneva study, 75 from the Lambaréné study, and 40 from the Kilifi study), 197 returned and provided samples at 1 year (95 from the Geneva study, 63 from the Lambaréné, and 39 from the Kilifi study) and 90 at 2 years (all from the Geneva study). In the Geneva group, 44 (100%) of 44 participants who had been given a high dose (ie, 10-50 million pfu) of vaccine and who were seropositive at day 28 remained seropositive at 2 years, whereas 33 (89%) of 37 who had been given the low dose (ie, 300 000 pfu) remained seropositive for 2 years (p=0·042). In participants who had received a high dose, ZEBOV glycoprotein IgG GMCs decreased significantly between their peak (at 1-3 months) and month 6 after vaccination in Geneva (p0·05). Neutralising antibodies seem to be less durable, with seropositivity dropping from 64-71% at 28 days to 27-31% at 6 months in participants from the Geneva study. INTERPRETATION: Antibody responses to single-dose rVSV-ZEBOV vaccination are sustained across dose ranges and settings, a key criterion in countries where booster vaccinations would be impractical. FUNDING: The Wellcome Trust and Innovative Medicines Initiative 2 Joint Undertaking

Perceived biodiversity, sound, naturalness and safety enhance the restorative quality and wellbeing benefits of green and blue space in a neotropical city

Urban land cover expansion and human population growth are accelerating worldwide. This is resulting in the loss and degradation of green and blue spaces (e.g. parks, waterways, lakes) in cities, which provide resources to sustain biodiversity and improve human wellbeing. The specific characteristics of these spaces (e.g. sounds, species, safety) that enhance or detract from wellbeing are underexplored, yet this knowledge is needed to inform urban planning, management and policies that will ultimately benefit both people and biodiversity. Research of this kind is rarely conducted in the Global South, where rapid urbanisation threatens biodiversity-rich ecosystems of worldwide significance. Here, we examine how perceptions of green, waterway, and dense urban spaces relate to wellbeing in Georgetown, Guyana. Specifically, we use mediation models to test how perceptions of sound, bird species richness, naturalness, and safety concerns contribute to sites being perceived as restorative which, subsequently, influences wellbeing. We assess the accuracy of these site perceptions with objective measures of sound (using a bioacoustic sound index), bird species richness, and percent coverage of vegetation, water, and impervious surfaces. Results showed that if sites were perceived as species rich, containing natural sounds like birdsong, natural rather than artificial, and safe, they were perceived as more restorative, resulting in improved wellbeing. In general, people’s perceptions were consistent with objective measures. Green, compared with waterway and dense urban sites, contained more biophonic sounds, higher species richness, greater vegetation and water coverage. Although waterways were biodiverse, they were dominated by anthrophonic sounds, so were perceived as artificial and non-restorative. We shed light on how city planners might augment specific characteristics to improve the wellbeing of urban dwellers, with implications for biodiversity conservation. Our findings provide a scientific evidence base for urban design and management plans that could deliver multiple co-benefits, particularly in biodiversity-rich cities in neotropical regions

Peripheral brain-derived neurotrophic factor (BDNF) as a biomarker in bipolar disorder: a meta-analysis of 52 studies

Background: The neurotrophic hypothesis postulates that mood disorders such as bipolar disorder (BD) are associated with a lower expression of brain-derived neurotrophic factor (BDNF). However, its role in peripheral blood as a biomarker of disease activity and of stage for BD, transcending pathophysiology, is still disputed. In the last few years an increasing number of clinical studies assessing BDNF in serum and plasma have been published. Therefore, it is now possible to analyse the association between BDNF levels and the severity of affective symptoms in BD as well as the effects of acute drug treatment of mood episodes on BDNF levels. Methods: We conducted a systematic review and meta-analysis of all studies on serum and plasma BDNF levels in bipolar disorder. Results: Through a series of meta-analyses including a total of 52 studies with 6,481 participants, we show that, compared to healthy controls, peripheral BDNF levels are reduced to the same extent in manic (Hedges' g = -0.57, P = 0.010) and depressive (Hedges' g = -0.93, P = 0.001) episodes, while BDNF levels are not significantly altered in euthymia. In meta-regression analyses, BDNF levels additionally negatively correlate with the severity of both manic and depressive symptoms. We found no evidence for a significant impact of illness duration on BDNF levels. In addition, in plasma, but not serum, peripheral BDNF levels increase after the successful treatment of an acute mania episode, but not of a depressive one. Conclusions: In summary, our data suggest that peripheral BDNF levels, more clearly in plasma than in serum, is a potential biomarker of disease activity in BD, but not a biomarker of stage. We suggest that peripheral BDNF may, in future, be used as a part of a blood protein composite measure to assess disease activity in BD.BSF is supported by a postdoctoral scholarship and by a research grant MCTI/CNPQ/Universal 14/2014461833/2014-0, both from CNPq, Brazil. CAK is a recipient of a postdoctoral fellowship from CAPES, Brazil. JCS is supported by NIMH grant R01 085667, the Dunn Foundation and the JQ are supported by research fellowship awards from CNPq (Brazil, level IA). AFC is the recipient of a research fellowship from CNPq (Brazil, level II). MB is supported by a NHMRC Senior Principal Research Fellowship 1059660. None of these agencies had any role in the design and conduct of the study, or decision to submit the manuscript for publication. We thank all authors of the included papers, particularly Drs. Natalie L. Rasgon, Deniz Ceylan, Camilla Langan, Pedro Magalhaes, Antonio L. Teixeira, Yuan-Hwa Chou, Iria Grande, Chenyu Ye, Izabela Barbosa, Menan Rabie, Ru-Band Lu, Ana Gonzales-Pinto, Reiji Yoshimura, Flavio Kapczinski, and Christoph Laske, who kindly provided unpublished data for the paper

Using participatory video to share people’s experiences of neotropical urban green and blue space with decision-makers

Cities are complex, socio-ecological ecosystems providing both opportunity and detriment to human health and wellbeing. Specifically, urban green (e.g. parks) and blue space (e.g. coastline) can restore human psychological wellbeing. In the Global South, where rapid urbanisation is posing challenges for biodiversity conservation and the mental wellbeing of urban human populations, there has been little research on understanding the social and environmental benefits of urban green and blue spaces, which could inform decision-makers seeking sustainable land-use planning interventions. Here, we use participatory video (using film to co-produce research) to explore the relationships people have with urban green and blue spaces in Georgetown, Guyana, and communicate these findings to decision-makers. Short films created and discussed by city residents highlighted how specific characteristics of green and blue spaces contributed to restorative quality, a sense of place, and alleviated stress. At the same time, locally specific nuances were also revealed, such as folklore associated with urban wildlife and the importance of monuments framing Guyana’s complex history. A composite film was screened to government ministries, park managers, and the Mayor and City Council, who articulated intentions to change the way these spaces were managed (e.g. maintaining specific features, encouraging visitation, raising awareness, and increasing the planned distribution of new spaces). We demonstrate how participatory video can allow participants to reflect on and change their interactions with urban green/blue spaces, while facilitating a unique and engaging dialogue between multiple stakeholders, with important, applied implications for both public health and biodiversity conservation

ICES Viewpoint background document: Impact from exhaust gas cleaning systems (scrubbers) on the marine environment (Ad hoc).

Shipping is a diverse industry that connects the world. The distribution and intensity of commercial shipping is increasing and there is a growing need to assess and mitigate the impacts of vessel activities on the marine environment. New global standards on sulphur content in marine fuels have led to an increasing number of ships installing exhaust gas cleaning systems (EGCS), also known as scrubbers, to reduce their emissions of sulphur oxides to the atmosphere. Ships equipped with a scrubber can continue to use heavy fuel oil, and the process results in discharges of large volumes of acidified water that contain a mix of contaminants, such as heavy metals, polycyclic aromatic hydrocarbons (PAHs), oil residues, and nitrates. For the most common type of scrubber, open loop, this polluted water is directly discharged back to the sea, trading reductions in air pollution for increased water pollution. The scrubber discharge mixture has demonstrated toxic effects in laboratory studies, causing immediate mortality in plankton and exhibiting negative synergistic effects. The substances found in scrubber discharge water are likely to have further impacts in the marine environment through bioaccumulation, acidification and eutrophication. The impacts of scrubber discharge water can be completely avoided through the use of alternative fuels, such as distilled low sulphur fuels. Distilled fuels have the added benefit that they remove the threat of heavy fuel oil spills from shipping activities. If the use of alternative fuels is not adopted, and scrubbers continue to be considered an equivalent method to meet the sulphur emissions limits, then there is urgent need for:1) significant investment in technological advances and port reception facilities to allow zero discharge closed loop scrubber systems;2) improved protocols and standards for measuring, monitoring and reporting on scrubber discharge water acidity and pollutants;3) evidence-based regulations on scrubber water discharge limits that consider the full suite of contaminants

FAUNA IXODÍDEA DE ANIMAIS SILVESTRES DO ESTADO DO PARANÁ, BRASIL – DADOS PRELIMINARES

Os carrapatos são conhecidos por parasitar uma variedade de hospedeiros domésticos e silvestres, incluindo mamíferos, aves, répteis e anfíbios. Além disso, muitos animais silvestres participam do ciclo epidemiológico de doenças transmitidas por carrapatos. Nesse sentido, o objetivo desse estudo foi identificar as espécies de carrapatos parasitando animais silvestres atendidos no Hospital Veterinário, Universidade Federal do paraná, Curitiba, Brasil. Os carrapatos foram coletados de 28 animais silvestres: uma anta (Tapirus terrestres), um cervídeo (Mazama sp.), um javali (Sus scrofa), dois bugios (Alouatta guariba), duas capivaras (Hydrochoerus hydrochaeris), 9 ouriços-cacheiros (Sphiggurus villosus), quatro tamanduás-mirins (Tamandua tetradactyla), seis gambás (Didelphis spp.), um gato-mourisco (Herpailurus yagouaroundi) e um teiú (Tupinambis sp.). Ao todo, foram coletados 115 carrapatos (65 machos, 33 fêmeas e 17 ninfas): Amblyomma aureolatum (1M, 3F, 2N) em dois bugios, um gambá e um gato-mourisco; Amblyomma calcaratum (8M, 2F) em 4 tamanduás-mirins; Amblyomma dubitatum (6M, 1F, 7N) em duas capivaras e um gambá; Amblyomma fuscum (3F) em um teiú; Amblyomma longirostre (28M, 8F, 4N) e Amblyomma parkeri (4M, 3F, 3N) em nove ouriços-cacheiros; Amblyomma ovale (1F) em um javali; Amblyomma sculptum (6M, 7F) em uma anta e um javali; Haemaphysalis juxtakochi (1N) em um cervídeo e Ixodes loricatus (12M, 5F) em cinco gambás. Estudos são necessários para melhor avaliar o papel dessas espécies na epidemiologia das doenças transmitidas por carrapatos

Social stratification without genetic differentiation at the site of Kulubnarti in Christian Period Nubia

Relatively little is known about Nubia’s genetic landscape prior to the influence of the Islamic migrations that began in the late 1st millennium CE. Here, we increase the number of ancient individuals with genome-level data from the Nile Valley from three to 69, reporting data for 66 individuals from two cemeteries at the Christian Period (~650–1000 CE) site of Kulubnarti, where multiple lines of evidence suggest social stratification. The Kulubnarti Nubians had ~43% Nilotic-related ancestry (individual variation between ~36–54%) with the remaining ancestry consistent with being introduced through Egypt and ultimately deriving from an ancestry pool like that found in the Bronze and Iron Age Levant. The Kulubnarti gene pool – shaped over a millennium – harbors disproportionately female-associated West Eurasian-related ancestry. Genetic similarity among individuals from the two cemeteries supports a hypothesis of social division without genetic distinction. Seven pairs of inter-cemetery relatives suggest fluidity between cemetery groups. Present-day Nubians are not directly descended from the Kulubnarti Nubians, attesting to additional genetic input since the Christian Period.K.A.S. was supported by a Doctoral Dissertation Research Improvement Grant from the National Science Foundation (BCS-1613577). D.R. was funded by NSF HOMINID grant BCS-1032255; NIH (NIGMS) grant GM100233; the Allen Discovery Center program, a Paul G. Allen Frontiers Group advised program of the Paul G. Allen Family Foundation; the John Templeton Foundation grant 61220; and the Howard Hughes Medical Institute

Genetic diversity Goals and Targets have improved, but remain insufficient for clear implementation of the post-2020 global biodiversity framework

Genetic diversity among and within populations of all species is necessary for people and nature to survive and thrive in a changing world. Over the past three years, commitments for conserving genetic diversity have become more ambitious and specific under the Convention on Biological Diversity’s (CBD) draft post-2020 global biodiversity framework (GBF). This Perspective article comments on how goals and targets of the GBF have evolved, the improvements that are still needed, lessons learned from this process, and connections between goals and targets and the actions and reporting that will be needed to maintain, protect, manage and monitor genetic diversity. It is possible and necessary that the GBF strives to maintain genetic diversity within and among populations of all species, to restore genetic connectivity, and to develop national genetic conservation strategies, and to report on these using proposed, feasible indicators

TOI-2015b: A Warm Neptune with Transit Timing Variations Orbiting an Active mid M Dwarf

We report the discovery of a close-in ($P_{\mathrm{orb}} = 3.349\:\mathrm{days}$) warm Neptune with clear transit timing variations (TTVs) orbiting the nearby ($d=47.3\:\mathrm{pc}$) active M4 star, TOI-2015. We characterize the planet's properties using TESS photometry, precise near-infrared radial velocities (RV) with the Habitable-zone Planet Finder (HP) Spectrograph, ground-based photometry, and high-contrast imaging. A joint photometry and RV fit yields a radius $R_p~=~3.37_{-0.20}^{+0.15} \:\mathrm{R_\oplus}$, mass $m_p~=~16.4_{-4.1}^{+4.1}\:\mathrm{M_\oplus}$, and density $\rho_p~=~2.32_{-0.37}^{+0.38} \:\mathrm{g cm^{-3}}$ for TOI-2015b, suggesting a likely volatile-rich planet. The young, active host star has a rotation period of $P_{\mathrm{rot}}~=~8.7 \pm~0.9~\mathrm{days}$ and associated rotation-based age estimate of $1.1~\pm~0.1\:\mathrm{Gyr}$. Though no other transiting planets are seen in the TESS data, the system shows clear TTVs of super period $P_{\mathrm{sup}}~\approx~430\:\mathrm{days}$ and amplitude $\sim$$100\:\mathrm{minutes}$. After considering multiple likely period ratio models, we show an outer planet candidate near a 2:1 resonance can explain the observed TTVs while offering a dynamically stable solution. However, other possible two-planet solutions -- including 3:2 and 4:3 resonance -- cannot be conclusively excluded without further observations. Assuming a 2:1 resonance in the joint TTV-RV modeling suggests a mass of $m_b~=~13.3_{-4.5}^{+4.7}\:\mathrm{M_\oplus}$ for TOI-2015b and $m_c~=~6.8_{-2.3}^{+3.5}\:\mathrm{M_\oplus}$ for the outer candidate. Additional transit and RV observations will be beneficial to explicitly identify the resonance and further characterize the properties of the system.Comment: 28 pages, 15 figures, 6 tables. As submitted to AAS Journal