The use of Complementary and Alternative Medicine in pregnancy: Data from the Avon Longitudinal Study of Parents and Children (ALSPAC)

Objectives - To report the frequency of Complementary and Alternative Medicine (CAM) use by a population of pregnant women in the UK. Design - Four postal self-completion questionnaires completed at 8, 12, 18 and 32 weeks’ gestation provided the source of CAMs used. Questions asked for written descriptions about the use of any treatments, pills, medicines, ointments, homeopathic medicines, herbal medicines, supplements, drinks and herbal teas. Setting - An observational, population-based, cohort study of parents and children of 14,541 pregnant women residing within the former county of Avon in south-west England. Data was available for 14,115 women. Results - Over a quarter (26.7%; n = 3774) of women had used a CAM at least once in pregnancy, the use rising from 6% in the 1st trimester to 12.4% in the 2nd to 26.3% in the 3rd. Herbal teas were the most commonly reported CAM at any time in pregnancy (17.7%; n = 2499) followed by homeopathic medicine (14.4%; n = 2038) and then herbal medicine (5.8%; n = 813). The most commonly used herbal product was chamomile used by 14.6% of women, the most commonly used homeopathic product was Arnica used by 3.1% of women. Other CAMs (osteopathy, aromatherapy, acupuncture/acupressure, Chinese herbal medicine, chiropractic, cranial sacral therapy, hypnosis, non-specific massage and reflexology) accounted for less than 1% of users. Conclusions - CAM use in pregnancy, where a wide range of CAMs has been assessed, has not been widely reported. Studies that have been conducted report varying results to this study (26.7%) by between 13.3% and 87% of pregnant women. Survey results will be affected by a number of factors namely the inclusion/exclusion of vitamins and minerals, the timing of data collection, the country of source, the number of women surveyed, and the different selection criteria of either recruiting women to the study or of categorising and identifying a CAM treatment or product

European Food Safety Authority; Outcome of the Public consultation on the Draft Opinion of the Scientific Panel on Dietetic products, Nutrition, and Allergies (NDA) on Dietary Reference Values for fats, including saturated fatty acids, polyunsaturated fatty acids, monounsaturated fatty acids, trans fatty acids, and cholesterol

On 2 July 2009, the EFSA Panel on Dietetic products, Nutrition and Allergies (NDA) endorsed a draft Opinion on Dietary Reference Values for fats to be released for public consultation. This Scientific Report summarises the comments received through the public consultation and outlines how these were taken into account in the final opinion. EFSA had received contributions from 40 interested parties (individuals, non-governmental organisations, industry organisations, academia and national assessment bodies). The main comments which were received during the public consultation related to: the availability of more recent data, the nomenclature used, the use of a non-European food composition data base, the impact of genetic factors in modulating the absorption, metabolism and health effects of different fatty acids, the definition of “nutritionally adequate diet”, the use of Dietary Reference Values in the labelling of foods, the translation of advice into food-based dietary guidelines, nutrient goals and recommendations, certain risk management issues, and to Dietary Reference Values of fats, individual fatty acids, and cholesterol. All the public comments received that related to the remit of EFSA were assessed and the Opinion on Dietary Reference Values for fats has been revised taking relevant comments into consideration

Whole-genome sequencing reveals host factors underlying critical COVID-19

Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care1 or hospitalization2,3,4 after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genes—including reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)—in critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease

Not all activated satellite cell progeny commit to differentiation

Satellite cells provide skeletal muscle with a remarkable capacity for repeated repair and regeneration. Quiescent satellite cells are MyoD-ve, with MyoD being induced in >98% of satellite cells within 24hrs of activation (Zammit, Exp. Cell Res. 281, 39, 2002). Here, we explore the subsequent fate of these satellite cells, as they proliferate and begin to differentiate. Satellite cells associated with myofibres, cultured without exposure to serum/CEE, still activated MyoD but the majority failed to divide, demonstrating an uncoupling of the two events. In contrast, myofibres cultured with serum/CEE had clones of satellite cells. MyoD-ve cells were detected in these clones, in which the rest of the cells were MyoD+ve, implying they had arisen after division but were not adopting the same fate. Three possible explanations for MyoD-ve cells were explored: phosphorylated histone markers and BrdU labelling showed that the lack of MyoD was not cell cycle dependent; myogenin immunostaining demonstrated that satellite cells committing to differentiation initially contained MyoD; Pax7 expression was generally down-regulated in the majority of satellite cells by 72hrs, but some remained strongly Pax7+ve. Together, these data suggest that MyoD-ve cells are returning to a quiescent state

Maintaining the regenerative compartment of adult skeletal muscle

Skeletal muscle is predominantly composed of highly specialised contractile myofibres, each maintained by hundreds of postmitotic myonuclei. Throughout adult life, new myonuclei are required to meet the persistent demands of myofibre turnover, growth and repair. These are provided by the differentiation of myoblasts, generated from the satellite cells that reside between the plasmalemma and surrounding basal lamina of mature myofibres. Although the progression from satellite cell to myonucleus is well established, the mechanisms by which an effective regenerative compartment is maintained remain controversial. Indeed, it has been suggested that satellite cells are “arrested” myogenic precursors that are replenished from other stem cells located within the muscle interstitium and/or from outside the tissue. Using an isolated myofibre culture system to investigate early events of satellite cell activation, proliferation and differentiation, we have shown that in the context of the sublaminal niche, satellite cell progeny can adopt divergent fates. In this model system, quiescent Pax7+ve/MyoD-ve satellite cells are synchronously activated to produce a homogenous Pax7+ve/MyoD+ve population. These cells proliferate and generate clusters of myoblasts, most of which become Pax7-ve/myogenin+ve and are fated to undergo terminal differentiation. Significantly, some cells within the clusters maintain expression of Pax7 and down regulate MyoD, apparently returning to a state of quiescence comparable to that of the initial Pax7+ve/MyoD-ve population. Our observations demonstrate that satellite cells have the potential to generate both myonuclei and new satellite cells and suggest that the alternate fate decisions may be extrinsically imposed on a homogeneous population. Most importantly, these findings suggest that the satellite cell pool may be maintained by self-renewal and does not necessarily require a contribution from elsewhere

Long term reactivity of CO2 in a low salinity reservoir-seal complex

An understanding of the long-term reactivity of different rock types to injected CO is needed for sequestration site assessment. Relative to saline aquifer studies, the long term reactivity of CO in low salinity aquifers has received little attention. Currently in Australia, the Surat Basin is being appraised for its large-scale CO storage potential within low salinity aquifers. Sixteen core samples from the Precipice Sandstone and Evergreen Formation – the notional target reservoir and seal complex – were characterized for mineral content; helium, mercury-injection and micro CT porosities; air permeability; and, imaged with SEM-EDS. Samples consisted of quartz rich reservoir sandstones, feldspar and clay rich or calcite cemented sandstones (secondary reservoir), mudstones (sealing complex), and oolitic ironstones (sealing complex) derived from braided river, fluvial-deltaic, and restricted marine shoal depositional environments, respectively. The reservoir sandstone samples characterized here had measured total porosity that ranged from 11 to 23% with pore throats mainly between 90 and 100 μm, and core air permeability from 558 to 3397 mD. In the Precipice Sandstone reservoir sample μCT plugs, 98% of the pore space was connected with calculated vertical permeability 145–4611 mD and horizontal 4291–8200 mD. Feldspar and clay rich sandstone and mudstone samples from the overlying Evergreen Formation had porosity that ranged between 0.2 and 22.9%, with a wide range of pore throat sizes from ~0.005 to 30 μm, and permeability from 0.2 to 28.1 mD, respectively. Ironstone and mudstone samples from the Westgrove Ironstone Member (Evergreen Formation) had porosity from 0.7 to 9.7% and a low permeability of 0.04 mD. Kinetic geochemical CO reactivity models made predictions over two time-scales: 30 or 1000 years. Selected models also accounted for the potential presence of 10 ppm SO gas. The Precipice Sandstone quartz-rich reservoir sandstones had consistently small amounts of reactive minerals and mineral trapping or scaling of the reservoir was not predicted over 30 years, with the pH approximately 4.5 after 30 years. Samples from the Evergreen Formation included feldspar and clay rich sandstones and mudstones, several contained variable amounts of carbonate cement. Their response to CO was more influenced by mineral content than rock type. Plagioclase feldspars and Fe-rich chlorite were the main silicate minerals that reacted to produce siderite and ankerite mineral trapping up to 2.57 kg/m CO. In the very unlikely event that CO rich fluids migrated upwards as far as the Westgrove Ironstone Member, chlorite is predicted to alter to siderite. This study indicates that the Precipice Sandstone reservoir in the study region has a low likelihood of mineral scaling which is favorable to avoid CO injectivity issues. Mineral trapping as ankerite and siderite could be expected to trap CO in the chlorite and plagioclase rich Evergreen Formation seal lithologies. Further work is suggested on validating long term predictions with observation data from natural analogue studies

Maternal fatty acids in pregnancy, <em>FADS</em> polymorphisms, and child intelligence quotient at 8 y of age.

BACKGROUND: Brain tissue is selectively enriched with highly unsaturated fatty acids (FAs). Altering the maternal FA status in pregnancy may improve fetal neural development with lasting consequences for child development. OBJECTIVE: We explored whether maternal FAs in erythrocytes, either measured directly or indirectly by maternal FADS genetic variants, are associated with child intelligence quotient (IQ). DESIGN: Linear regression analyses, adjusted for 18 confounders, were used to investigate the associations in 2839 mother-child pairs from the population-based Avon Longitudinal Study of Parents and Children cohort. RESULTS: Low levels of arachidonic acid (20:4n-6) were associated with lower performance IQ (-2.0 points; 95% CI: -3.5, -0.6 points; P = 0.007, increased R(2) = 0.27%), high levels of osbond acid (22:5n-6) were associated with verbal IQ (-1.8 points; 95% CI: -3.2, -0.4 points; P = 0.014, R(2) = 0.20%), and high levels of adrenic acid (22:4n-6) were associated with verbal IQ (-1.7 points; 95% CI:-3.1, -0.3 points; P = 0.016, R(2) = 0.19%). There was some evidence to support a negative association of low docosahexaenoic acid (DHA; 22:6n-3) with full-scale IQ (R(2) = 0.15%). Novel weak associations were also observed for low levels of osbond acid (R(2) &le; 0.29%) and FADS variants with opposite effects for intron variants and variants in the promoter region such as rs3834458 (R(2) &le; 0.38%). CONCLUSIONS: These results support the positive role of maternal arachidonic acid and DHA on fetal neural development, although the effects on child IQ by 8 y of age were small (0.1 SD), with other factors contributing more substantially. The endogenous synthesis of these FAs by FADS genes, especially FADS2, may also be important. The replication of these results is recommended. &nbsp