Birth Weight in Relation to Fetal and Maternal Leptin and Insulin: A Systematic Review and Meta-analysis

Abstract leptin and insulin have been implicated in fetal growth regulation and investigated repeatedly with controversial outcomes. A systematic review and meta-analysis were conducted according to MOOSE guidelines to establish if consistency exists in the reported literature so that the role of maternal and fetal insulin and leptin in fetal growth could be assessed. A robust recognised systematic methodology was used in the literature search and data extraction and analysis to avoid bias. SPSS version 16 and RevMan 4.2 were used for statistical analysis and the results presented as a Weighted Mean Difference (WMD) and 95% CI. Nineteen studies were included. Large for gestational age babies (LGA) had significantly higher cord serum insulin and leptin levels than was adequate for gestational age (AGA) ones[3.16 µIU/ml (0.85, 5.48) and -4.33 ng/ml (-5.30, -3.36) respectively]. Small for gestational age babies (SGA) had similar insulin levels but significantly lower cord leptin[21 µIU/ml (-5.69, 1.27)] than AGA babies [-3.07ng/ml (-4.57, -1.58)]. Maternal serum levels of leptin were similar between mothers of LGA, SGA and AGA babies. Conclusion: although both fetal insulin and leptin reflect the degree of fetal adiposity, leptin may have growth promoting properties

Rare Earth Group Separation after Extraction Using Sodium Diethyldithiocarbsamate/Polyvinyl Chloride from Lamprophyre Dykes Leachate

This study presents the first application of sodium diethyldithiocarbamate/polyvinyl chloride (DdTC/PVC) as a novel adsorbent for rare earth element (REE) sorption from leach liquors. DdTC/PVC has higher adsorption properties than other sorbents, the synthesis of DdTC/PVC is more accessible than other resins, and it is considered a more affordable sorbent. The three-liquid-phase extraction technique (TLPE) was applied to separate REEs into light, middle, and heavy rare earth elements as groups. The TLPE is an excellent achievable technique in the separation of REEs. DdTC/PVC was prepared as a sorbent to sorb rare-earth ions in chloride solution. It was described by XRD, SEM, TGA, and FTIR. The factors pH, initial rare-earth ion concentration, contact time, and DdTC/PVC dose were also analyzed. The ideal pH was 5.5, and the ideal equilibration time was found to be 45 min. The rare-earth ion uptake on DdTC/PVC was 156.2 mg/g. The rare-earth ion sorption on DdTC/PVC was fitted to Langmuir and pseudo-2nd-order models. The rare-earth ions’ thermodynamic adsorption was spontaneous and exothermic. In addition, rare-earth ion desorption from the loaded DdTC/PVC was scrutinized using 1 M HCl, 45 min time of contact, and a 1:60 S:L phase ratio. The obtained rare earth oxalate concentrate was utilized after dissolving it in HCl to extract and separate the RE ions into three groups—light (La, Ce, Nd, and Sm), middle (Gd, Ho, and Er), and heavy (Yb, Lu, and Y)—via three-liquid-phase extraction (TLPE). This technique is simple and suitable for extracting REEs. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.The authors express their gratitude to the Princess Nourah bint Abdulrahman University Researchers Supporting Project (PNURSP2022R2), Princess Nourah bint Abdulrahman University, Riyadh, Saudi ArabiaAcknowledgments: The authors express their gratitude to the Princess Nourah bint Abdulrahman University Researchers Supporting Project (PNURSP2022R2), Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia

Cetylpyridinium Bromide/Polyvinyl Chloride for Substantially Efficient Capture of Rare Earth Elements from Chloride Solution

A new sorbent cetylpyridinium bromide/polyvinylchloride (CPB/PVC) was prepared and tested to extract rare earth elements (REEs) from their chloride solutions. It was identified by FTIR, TGA, SEM, EDX, and XRD. The impact of various factors such as pH, RE ion initial concentration, contacting time, and dose amount via sorption process was inspected. The optimum pH was 6.0, and the equilibrium contact time was reached at 60 min at 25 °C. The prepared adsorbent (CPB/PVC) uptake capacity was 182.6 mg/g. The adsorption of RE ions onto the CPB/PVC sorbent was found to fit the Langmuir isotherm as well as pseudo-second-order models well. In addition, the thermodynamic parameters of RE ion sorption were found to be exothermic and spontaneous. The desorption of RE ions from the loaded CPB/PVC sorbent was investigated. It was observed that the optimum desorption was achieved at 1.0 M HCl for 60 min contact time at ambient room temperature and a 1:60 solid: liquid phase ratio (S:L). As a result, the prepared CPB/PVC sorbent was recognized as a competitor sorbent for REEs. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.The authors express their gratitude to Princess Nourah bint Abdulrahman University Researchers Supporting Project number (PNURSP2022R13), Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia

Anti-müllerian hormone is not associated with cardiometabolic risk factors in adolescent females

<p>Objectives: Epidemiological evidence for associations of Anti-Müllerian hormone (AMH) with cardiometabolic risk factors is lacking. Existing evidence comes from small studies in select adult populations, and findings are conflicting. We aimed to assess whether AMH is associated with cardiometabolic risk factors in a general population of adolescent females.</p> <p>Methods: AMH, fasting insulin, glucose, HDLc, LDLc, triglycerides and C-reactive protein (CRP) were measured at a mean age 15.5 years in 1,308 female participants in the Avon Longitudinal Study of Parents and Children (ALSPAC). Multivariable linear regression was used to examine associations of AMH with these cardiometabolic outcomes.</p> <p>Results: AMH values ranged from 0.16–35.84 ng/ml and median AMH was 3.57 ng/ml (IQR: 2.41, 5.49). For females classified as post-pubertal (n = 848) at the time of assessment median (IQR) AMH was 3.81 ng/ml (2.55, 5.82) compared with 3.25 ng/ml (2.23, 5.05) in those classed as early pubertal (n = 460, P≤0.001). After adjusting for birth weight, gestational age, pubertal stage, age, ethnicity, socioeconomic position, adiposity and use of hormonal contraceptives, there were no associations with any of the cardiometabolic outcomes. For example fasting insulin changed by 0% per doubling of AMH (95%CI: −3%,+2%) p = 0.70, with identical results if HOMA-IR was used. Results were similar after additional adjustment for smoking, physical activity and age at menarche, after exclusion of 3% of females with the highest AMH values, after excluding those that had not started menarche and after excluding those using hormonal contraceptives.</p> <p>Conclusion: Our results suggest that in healthy adolescent females, AMH is not associated with cardiometabolic risk factors.</p&gt

Anti-Mullerian hormone: correlation with testosterone and oligo- or amenorrhoea in female adolescence in a population-based cohort study

Study questions: Can serum anti-Müllerian hormone (AMH) levels measured in female adolescents predict polycystic ovary syndrome (PCOS)-associated features in adolescence and early adulthood? Summary answer: AMH levels associated well with PCOS-associated features (such as testosterone levels and oligoamenorrhoea) in adolescence, but was not an ideal marker to predict PCOS-associated features in early adulthood. What is known already: Several studies have reported that there is a strong correlation between antral follicle count and serum AMH levels and that women with PCOS/PCO have significantly higher serum AMH levels than women with normal ovaries. Other studies have reported an association between AMH serum levels and hyperandrogenism in adolescence, but none has prospectively assessed AMH as a risk predictor for developing features of PCOS during adulthood. Study design, size, duration: A subset of 400 girls was selected from the prospective population-based Northern Finland Birth Cohort 1986 (n = 4567 at age 16 and n = 4503 at age 26). The population has been followed from 1986 to the present. Participants/material, setting, methods: At age 16, 400 girls (100 from each testosterone quartile: 50 with oligo- or amenorrhoea and 50 with a normal menstrual cycle) were selected at random from the cohort for AMH measurement. Metabolic parameters were also assessed at age 16 in all participants. Postal questionnaires enquired about oligo- or amenorrhoea, hirsutism, contraceptive use and reproductive health at ages 16 and 26. Main results and role of chance: There was a significant correlation between AMH and testosterone at age 16 (r = 0.36, P < 0.001). AMH levels at age 16 were significantly higher among girls with oligo- or amenorrhoea compared with girls with normal menstrual cycles (35.9 pmol/l [95% CI: 33.2;38.6] versus 27.7 pmol/l [95% CI: 25.0;30.4], P < 0.001). AMH at age 16 was higher in girls who developed hirsutism at age 26 compared with the non-hirsute group (31.4 pmol/l [95% CI 27.1;36.5] versus 25.8 pmol/l [95% CI 23.3;28.6], P = 0.036). AMH at age 16 was also higher in women with PCOS at age 26 compared with the non-PCOS subjects (38.1 pmol/l [95% CI 29.1;48.4] versus 30.2 pmol/l [95% CI 27.9;32.4], P = 0.044). The sensitivity and specificity of the AMH (cut-off 22.5 pmol/l) for predicting PCOS at age 26 was 85.7 and 37.5%, respectively. The addition of testosterone did not significantly improve the accuracy of the test. There was no significant correlation between AMH levels and metabolic indices at age 16. Implications, reasons for cauntion: AMH is related to oligo- or amenorrhoea in adolescence, but it is not a good marker for metabolic factors. The relatively low rate of participation in the questionnaire at age 26 may also have affected the results. AMH was measured in a subset of the whole cohort. AMH measurement is lacking international standardization and therefore the concentrations and cut-off points are method dependent. Wider implications for the findings: Using a high enough cut-off value of AMH to predict which adolescents are likely to develop PCOS in adulthood could help to manage the condition from an early age due to a good sensitivity. However, because of its low specificity, it is not an ideal diagnostic marker, and its routine use in clinical practice cannot, at present, be recommended

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

Obesity and normal birth: A qualitative study of clinician’s management of obese pregnant women during labour

Background: Currently one-fifth of women in the UK are obese. Obese, pregnant woman are at an increased risk of experiencing complications of labour and serious morbidity. However, they are also more likely to undergo medical interventions such as induction of labour and caesarean section which in themselves confer additional health risks for obese women such as wound infection and deep vein thrombosis. Reducing unnecessary interventions and increasing normal birth rates for obese women would substantially improve their postnatal health and wellbeing and reduce the burden of NHS resources required to care for them post operatively. This research aimed to explore practitioners&rsquo; experiences of and strategies for providing intrapartum care to obese women.&nbsp; Method: A qualitative methodology was adopted, focus groups and individual interviews were conducted with health professionals. Audio recordings were transcribed verbatim and data analysed using a framework approach.&nbsp; Results: Twenty-four health professionals participated; Six Consultant Obstetricians two Consultant Anaesthetists and 16 midwives. Three key themes emerged from the data: medicalisation of obese birth; promotion of normal obese birth; and the complexities and contradictions in staff attitudes and behaviours. The overall interpretation is that positive approaches to obese birth offer opportunities to promote normal birth. However, many health professionals find the provision of intrapartum care to obese women challenging, and attitudes and behaviours towards the promotion of normal birth are heterogeneous, complex and contradictory.&nbsp; Conclusion: The care of obese women during labour is generally medicalised and focussed on the associated risks. However, although there are conflicting views on how to care for obese women, some practitioners do strive to promote normality and optimise the potential for normal birth by challenging current practices and utilise some &lsquo;interventions&rsquo; in order to facilitate normality and mobility during childbirth. Obesity is a major and growing health problem and a major cause of morbidity and mortality for pregnant women. It is essential that more positive proactive guidelines are available to maximise normal birth if the postnatal health of obese women is to be improved

Genetically unmatched human iPSC and ESC exhibit equivalent gene expression and neuronal differentiation potential

Abstract The potential uniformity between differentiation and therapeutic potential of human embryonic stem cells (hESCs) and human induced pluripotent stem cells (hiPSCs) remains debatable. We studied the gene expression profiles, pathways analysis and the ability to differentiated into neural progenitor cells (NPCs) and motor neurons (MNs) of genetically unmatched integration-free hiPSC versus hESC to highlight possible differences/similarities between them at the molecular level. We also provided the functional information of the neurons derived from the different hESCs and hiPSCs lines using the Neural Muscular Junction (NMJ) Assay. The hiPSC line was generated by transfecting human epidermal fibroblasts (HEF) with episomal DNAs expressing Oct4, Sox2, Klf4, Nanog, L-Myc and shRNA against p53. For the hESCs line, we used the NIH-approved H9 cell line. Using unsupervised clustering both hESCs and hiPSCs were clustered together implying homogeneous genetic states. The genetic profiles of hiPSCs and hESCs were clearly similar but not identical. Collectively, our data indicate close molecular similarities between genetically unmatched hESCs and hiPS in term of gene expression, and signaling pathways. Moreover, both cell types exhibited similar cholinergic motor neurons differentiation potential with marked ability of the differentiated hESCs and hiPSCs-derived MNs to induce contraction of myotubes after 4 days of co-culture

Assessment of proliferation in breast cancer: cell cycle or mitosis? An observational study

Background and aims: Proliferation is an important indicator of breast cancer (BC) prognosis, but is assessed using different approaches. Not all cells in the cell cycle are committed to division. This study aimed to characterise quantitative differences between BC cells in the cell cycle and those in mitosis and assess their relationship with other pathological parameters. Methods and results: A cohort of BC sections (n=621) was stained with haematoxylin and eosin and immunohistochemistry for Ki-67. The proportion of mitotic cells and Ki-67-positive cells was assessed in the same areas. The Cancer Genome Atlas (TCGA) BC cohort was used to assess MKI-67 transcriptome level and its association with the mitotic counts. The mean proportion of BC cells in the cell cycle was 24% (range=1–90%), while the mean proportion of BC cells in mitosis was 5% (range=0–73%). A low proportion of mitoses to whole cycling cells was associated with low histological grade tumours and the luminal A molecular subtype, while tumours with a high proportion of mitoses to the overall cycling cells were associated with triple-negative subtype, larger tumour size, grade 3 tumours and lymph node metastasis. The high mitosis/low Ki-67-positive cells tumours showed a significant association with variables of poor prognosis, including high-grade and triple-negative subtypes. Conclusion: The proportion of BC cells in the cell cycle and mitosis is variable. We show that not only the number of cells in the cell cycle or mitosis, but also the difference between them, provides valuable information on tumour aggressiveness