Does Delay in the Diagnosis of Rudimentary Horn Pregnancy in Patients with Unicornuate Uteri Impact Treatment Outcomes?

OBJECTIVE: Rudimentary horn pregnancy (RHP) is a very rare form of ectopic pregnancy (EP) that tends to rupture in the second trimester. Similar to other EPs, the treatment of RHPs is excision, hence delay in diagnosis (DID) can be detrimental. Our objective is to determine whether DID of RHP in patients with unicornuate uteri (UCU) impacts the treatment outcome. DESIGN: Retrospective cohort study of published case reports in PubMed database. MATERIALS AND METHODS: A computerized PubMed search of case reports of RHP from 2007 to 2020 was performed using the key words; unicornuate uterus, rudimentary horn, pregnancy, case. Data was analyzed with SPSS version 26. RESULTS: Of the 97 published cases, due to limited information available, 95 cases were included, 40 (42.1%) in which the diagnosis of RHP was made at first encounter and 55 (57.9%) in which the diagnosis was delayed. Out of these cases, it was possible to calculate the median [range] length of delay (35 [1-1825] days) in only 32 cases. Of 95 cases, 27 (28.4%), 5 (5.3%), 61 (64.2%), 1 (1.1%), underwent laparoscopy, laparoscopy converted to laparotomy, laparotomy, and methotrexate injection respectively. Diagnosis was made at autopsy in one case. CONCLUSIONS: Diagnosis of RHP was significantly more likely to be made at first encounter when patients were known to have a uterine anomaly. DID was associated with a significantly higher GA at the time of treatment but there was no significant difference in the proportion of fetuses that were alive upon entrance to the abdomen, rate of ruptured RH and hemoperitoneum. Out of all of the cases, only one maternal death was reported. Therefore, delaying surgery to confirm a diagnosis of RHP does not adversely impact the maternal fetal outcome

Why do avian responses to change in Arctic green-up vary?

Global climate change has altered the timing of seasonal events (i.e., phenology) for a diverse range of biota. Within and among species, however, the degree to which alterations in phenology match climate variability differ substantially. To better understand factors driving these differences, we evaluated variation in timing of nesting of eight Arctic-breeding shorebird species at 18 sites over a 23-year period. We used the Normalized Difference Vegetation Index as a proxy to determine the start of spring (SOS) growing season and quantified relationships between SOS and nest initiation dates as a measure of phenological responsiveness. Among species, we tested four life history traits (migration distance, seasonal timing of breeding, female body mass, expected female reproductive effort) as species-level predictors of responsiveness. For one species (Semipalmated Sandpiper), we also evaluated whether responsiveness varied across sites. Although no species in our study completely tracked annual variation in SOS, phenological responses were strongest for Western Sandpipers, Pectoral Sandpipers, and Red Phalaropes. Migration distance was the strongest additional predictor of responsiveness, with longer-distance migrant species generally tracking variation in SOS more closely than species that migrate shorter distances. Semipalmated Sandpipers are a widely distributed species, but adjustments in timing of nesting relative to variability in SOS did not vary across sites, suggesting that different breeding populations of this species were equally responsive to climate cues despite differing migration strategies. Our results unexpectedly show that long-distance migrants are more sensitive to local environmental conditions, which may help them to adapt to ongoing changes in climate. climate change, migration, NDVI, nest initiation, phenology, shorebirdspublishedVersio

PI3Kγ is a molecular switch that controls immune suppression

Macrophages play critical, but opposite, roles in acute and chronic inflammation and cancer1,2,3,4,5. In response to pathogens or injury, inflammatory macrophages express cytokines that stimulate cytotoxic T cells, whereas macrophages in neoplastic and parasitic diseases express anti-inflammatory cytokines that induce immune suppression and may promote resistance to T cell checkpoint inhibitors1,2,3,4,5,6,7. Here we show that macrophage PI 3-kinase γ controls a critical switch between immune stimulation and suppression during inflammation and cancer. PI3Kγ signalling through Akt and mTor inhibits NFκB activation while stimulating C/EBPβ activation, thereby inducing a transcriptional program that promotes immune suppression during inflammation and tumour growth. By contrast, selective inactivation of macrophage PI3Kγ stimulates and prolongs NFκB activation and inhibits C/EBPβ activation, thus promoting an immunostimulatory transcriptional program that restores CD8+ T cell activation and cytotoxicity. PI3Kγ synergizes with checkpoint inhibitor therapy to promote tumour regression and increased survival in mouse models of cancer. In addition, PI3Kγ-directed, anti-inflammatory gene expression can predict survival probability in cancer patients. Our work thus demonstrates that therapeutic targeting of intracellular signalling pathways that regulate the switch between macrophage polarization states can control immune suppression in cancer and other disorders

Unexpected diversity in socially synchronized rhythms of shorebirds

The behavioural rhythms of organisms are thought to be under strong selection, influenced by the rhythmicity of the environment. Such behavioural rhythms are well studied in isolated individuals under laboratory conditions, but free-living individuals have to temporally synchronize their activities with those of others, including potential mates, competitors, prey and predators. Individuals can temporally segregate their daily activities (for example, prey avoiding predators, subordinates avoiding dominants) or synchronize their activities (for example, group foraging, communal defence, pairs reproducing or caring for offspring). The behavioural rhythms that emerge from such social synchronization and the underlying evolutionary and ecological drivers that shape them remain poorly understood. Here we investigate these rhythms in the context of biparental care, a particularly sensitive phase of social synchronization where pair members potentially compromise their individual rhythms. Using data from 729 nests of 91 populations of 32 biparentally incubating shorebird species, where parents synchronize to achieve continuous coverage of developing eggs, we report remarkable within-and between-species diversity in incubation rhythms. Between species, the median length of one parent's incubation bout varied from 1-19 h, whereas period length-the time in which a parent's probability to incubate cycles once between its highest and lowest value-varied from 6-43 h. The length of incubation bouts was unrelated to variables reflecting energetic demands, but species relying on crypsis (the ability to avoid detection by other animals) had longer incubation bouts than those that are readily visible or who actively protect their nest against predators. Rhythms entrainable to the 24-h light-dark cycle were less prevalent at high latitudes and absent in 18 species. Our results indicate that even under similar environmental conditions and despite 24-h environmental cues, social synchronization can generate far more diverse behavioural rhythms than expected from studies of individuals in captivity. The risk of predation, not the risk of starvation, may be a key factor underlying the diversity in these rhythms.</p

Untangling the influence of Antarctic and Southern Ocean life on clouds

Polar environments are among the fastest changing regions on the planet. It is a crucial time to make significant improvements in our understanding of how ocean and ice biogeochemical processes are linked with the atmosphere. This is especially true over Antarctica and the Southern Ocean where observations are severely limited and the environment is far from anthropogenic influences. In this commentary, we outline major gaps in our knowledge, emerging research priorities, and upcoming opportunities and needs. We then give an overview of the large-scale measurement campaigns planned across Antarctica and the Southern Ocean in the next 5 years that will address the key issues. Until we do this, climate models will likely continue to exhibit biases in the simulated energy balance over this delicate region. Addressing these issues will require an international and interdisciplinary approach which we hope to foster and facilitate with ongoing community activities and collaborations

Unexpected diversity in socially synchronized rhythms of shorebirds

The behavioural rhythms of organisms are thought to be under strong selection, influenced by the rhythmicity of the environment1, 2, 3, 4. Such behavioural rhythms are well studied in isolated individuals under laboratory conditions1, 5, but free-living individuals have to temporally synchronize their activities with those of others, including potential mates, competitors, prey and predators6, 7, 8, 9, 10. Individuals can temporally segregate their daily activities (for example, prey avoiding predators, subordinates avoiding dominants) or synchronize their activities (for example, group foraging, communal defence, pairs reproducing or caring for offspring)6, 7, 8, 9, 11. The behavioural rhythms that emerge from such social synchronization and the underlying evolutionary and ecological drivers that shape them remain poorly understood5, 6, 7, 9. Here we investigate these rhythms in the context of biparental care, a particularly sensitive phase of social synchronization12 where pair members potentially compromise their individual rhythms. Using data from 729 nests of 91 populations of 32 biparentally incubating shorebird species, where parents synchronize to achieve continuous coverage of developing eggs, we report remarkable within- and between-species diversity in incubation rhythms. Between species, the median length of one parent’s incubation bout varied from 1–19 h, whereas period length—the time in which a parent’s probability to incubate cycles once between its highest and lowest value—varied from 6–43 h. The length of incubation bouts was unrelated to variables reflecting energetic demands, but species relying on crypsis (the ability to avoid detection by other animals) had longer incubation bouts than those that are readily visible or who actively protect their nest against predators. Rhythms entrainable to the 24-h light–dark cycle were less prevalent at high latitudes and absent in 18 species. Our results indicate that even under similar environmental conditions and despite 24-h environmental cues, social synchronization can generate far more diverse behavioural rhythms than expected from studies of individuals in captivity5, 6, 7, 9. The risk of predation, not the risk of starvation, may be a key factor underlying the diversity in these rhythms

Designing for a New Way of Living

This graduate thesis explores the ideas and exploration of creating architecture as an educational instrument that will inform its occupants about a new, more environmentally-friendly way of living. The design itself becomes an energy efficient, sustainable, and green design that ultimately strives to become a prototype for self sustaining designs that strive to leave the area better off then it was before. By designing holistic and humble designs in a self-sustaining campus community, situated on the University of Minnesota campus in Itasca State Park, will educate and inspire both students and the public about a new more environmentally-friendly way of living. Those students studying environmental engineering and/or the biological sciences will develop greater knowledge through hands on experience and training. Additionally, throughout the year the park visitors are invited onto the campus to become more educated and potentially inspired by this community’s ideals. Ranging in square footage from 24,000 to 8,000 square feet, The design will consists of four buildings: a visitor’s center, community center, biological lab, and environmental engineering lab. These various spaces will explore innovative and creative use of materials, community design strategies, and consider what is actually needed to live, allowing it to become an evolving, self-sustaining campus community for the University of Minnesota to further develop through education and research

Data Exchange Between Immunization Registry and Disease Surveillance System

Using existing immunization registry query functionality, an automated linkage was built for data exchange between immunization registry and disease surveillance system. A HL7 query file of reported pertussis cases was sent to immunization registry and a response file that contains vaccine related information was loaded into disease surveillance vaccine table. This process provides a timely and efficient way to get vaccine information for vaccine preventable reported cases

Data Exchange Between Immunization Registry and Disease Surveillance System

Using existing immunization registry query functionality, an automated linkage was built for data exchange between immunization registry and disease surveillance system. A HL7 query file of reported pertussis cases was sent to immunization registry and a response file that contains vaccine related information was loaded into disease surveillance vaccine table. This process provides a timely and efficient way to get vaccine information for vaccine preventable reported cases