214 research outputs found

    Monocyte Subpopulations from Pre-Eclamptic Patients Are Abnormally Skewed and Exhibit Exaggerated Responses to Toll-Like Receptor Ligands

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    The leading cause of pregnancy-associated mortality and morbidity is pre-eclampsia (PE). Although information regarding the etiology of this disease is scant, its pathophysiology is characterized by abnormal placentation, endothelial dysfunction as well as an exaggerated inflammatory response. Clinical evidence also indicates that the abundance of many immune cells at the feto-maternal interface and in the circulation of PE patients is abnormal, when compared with normal pregnant (NP) controls. In addition, the phenotype and function of some of these cells is altered. To further characterize the systemic effects of PE on circulating cells, we analyzed monocytic subpopulations in NP and PE patients by flow cytometry. We found that non-classical CD14lowCD16+ monocytes are significantly increased in women with PE and they display irregular expression of several chemokine receptors and antigen presentation molecules. The most striking phenotypic difference among the cell surface molecules was the marked upregulation of TLR4 expression, where both CD14highCD16+ and CD14lowCD16+ monocytes demonstrated higher levels than their NP counterparts. Stimulation of PE monocytes with TLR ligands resulted in profound secretion of various cytokines in comparison with NP controls. These data suggest that PE monocytes are hyper-responsive to TLR ligands and this may contribute to exacerbation of the disease

    How are hospitals in England caring for women at risk of preterm birth in 2021? The influence of national guidance on preterm birth care in England: a national questionnaire

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    Background National guidance (Saving Babies Lives Care Bundle Version 2 (SBLCBv2) Element 5) was published in 2019, with the aim to standardise preterm care in England. We plan to identify how many preterm birth surveillance clinics there are in England, and to define current national management in caring for women who are both asymptomatic and high-risk of preterm birth, and who arrive symptomatically in threatened preterm labour, to assist preterm management both nationally and internationally. Methods An online survey comprising of 27 questions was sent to all maternity units in England between February 2021 to July 2021. Results Data was obtained from 96 units. Quantitative analysis and free text analysis was then undertaken. We identified 78 preterm birth surveillance clinics in England, an increase from 30 preterm clinics in 2017. This is a staggering 160% increase in 4 years. SBLCBv2 has had a considerable impact in increasing preterm birth surveillance clinic services, with the majority (61%) of sites reporting that the NHS England publication influenced their unit in setting up their clinic. Variations exist at every step of the preterm pathway, such as deciding which risk factors warrant referral, distinguishing within particular risk factors, and offering screening tests and treatment options. Conclusions While variations in care still do persist, hospitals have done well to increase preterm surveillance clinics, under the difficult circumstances of the COVID pandemic and many without specific additional funding

    Soil biochemistry and microbial activity in vineyards under conventional and organic management at Northeast Brazil.

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    The São Francisco Submedium Valley is located at the Brazilian semiarid region and is an important center for irrigated fruit growing. This region is responsible for 97% of the national exportation of table grapes, including seedless grapes. Based on the fact that orgThe São Francisco Submedium Valley is located at the Brazilian semiarid region and is an important center for irrigated fruit growing. This region is responsible for 97% of the national exportation of table grapes, including seedless grapes. Based on the fact that organic fertilization can improve soil quality, we compared the effects of conventional and organic soil management on microbial activity and mycorrhization of seedless grape crops. We measured glomerospores number, most probable number (MPN) of propagules, richness of arbuscular mycorrhizal fungi (AMF) species, AMF root colonization, EE-BRSP production, carbon microbial biomass (C-MB), microbial respiration, fluorescein diacetate hydrolytic activity (FDA) and metabolic coefficient (qCO2). The organic management led to an increase in all variables with the exception of EE-BRSP and qCO2. Mycorrhizal colonization increased from 4.7% in conventional crops to 15.9% in organic crops. Spore number ranged from 4.1 to 12.4 per 50 g-1 soil in both management systems. The most probable number of AMF propagules increased from 79 cm-3 soil in the conventional system to 110 cm-3 soil in the organic system. Microbial carbon, CO2 emission, and FDA activity were increased by 100 to 200% in the organic crop. Thirteen species of AMF were identified, the majority in the organic cultivation system. Acaulospora excavata, Entrophospora infrequens, Glomus sp.3 and Scutellospora sp. were found only in the organically managed crop. S. gregaria was found only in the conventional crop. Organically managed vineyards increased mycorrhization and general soil microbial activity

    Placental microbial–metabolite profiles and inflammatory mechanisms associated with preterm birth

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    There is growing emphasis on the potential significance of the placental microbiome and microbiome–metabolite interactions in immune responses and subsequent pregnancy outcome, especially in relation to preterm birth (PTB). This review discusses in detail the pathomechanisms of placental inflammatory responses and the resultant maternal–fetal allograft rejection in both microbial-induced and sterile conditions. It also highlights some potential placental-associated predictive markers of PTB for future investigation. The existence of a placental microbiome remains debatable. Therefore, an overview of our current understanding of the state and role of the placental microbiome (if it exists) and metabolome in human pregnancy is also provided. We critical evaluate the evidence for a placental microbiome, discuss its functional capacity through the elaborated metabolic products and also describe the consequent and more established fetomaternal inflammatory responses that stimulate the pathway to preterm premature rupture of membranes, preterm labour and spontaneous PTB

    Ex Ante Impact Assessment of Policies Affecting Land Use, Part A: Analytical Framework

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    Contemporary policy making calls for scientific support to anticipate the possible consequences of optional policy decisions on sustainable development. This paper presents an analytical framework for ex ante assessment of economic, social, and environmental impacts of policy driven land use changes that can be used as an aid to policy making. The tasks were to (1) link policy scenarios with land use change simulations, (2) link land use change simulations with environmental, social, and economic impacts through indicators, and (3) valuate the impacts in the context of sustainable development. The outcome was a basis for dialogue at the science-policy interface in the process of developing new policies on the European level that impact on land and land use. The analytical approach provides a logical thread for ex ante impact assessment within the context of sustainable development, land use multifunctionality, and land use change and it provides a thorough discussion of achievements and open challenges related to the framework. It concludes with considerations on the potential for using evidence based ex ante assessments in the process of policy development. The paper is complemented by a B-paper providing exemplary results from two applications of the framework: a financial reform scenario of the Common Agricultural Policy of the European Union, and a bioenergy policy scenario for the case of Poland (Helming et al. 2011)

    The effect of COVID-19 on maternal newborn and child health (MNCH) services in Bangladesh, Nigeria and South Africa: call for a contextualised pandemic response in LMICs

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    Global response to COVID-19 pandemic has inadvertently undermined the achievement of existing public health priorities and laregely overlooked local context. Recent evidence suggests that this will cause additional maternal and childhood mortality and morbidity especially in low- and middle-income countries (LMICs). Here we have explored the contextual factors influencing maternal, neonatal and children health (MNCH) care in Bangladesh, Nigeria and South Africa amidst the pandemic. Our findings suggest that between March and May 2020, there was a reduction in utilisation of basic essential MNCH services such as antenatal care, family planning and immunization due to: a) the implementation of lockdown which triggered fear of contracting the COVID-19 and deterred people from accessing basic MNCH care, and b) a shift of focus towards pandemic, causing the detriment to other health services, and c) resource constraints. Taken together these issues have resulted in compromised provision of basic general healthcare. Given the likelihood of recurrent waves of the pandemic globally, COVID-19 mitigation plans therefore should be integrated with standard care provision to enhance system resilience to cope with all health needs. This commentary suggests a four-point contextualised mitigation plan to safeguard MNCH care during the pandemic using the observed countries as exemplars for LMIC health system adaptations to maintain the trajectory of progress regarding sustainable development goals (SDGs)

    A high-quality annually laminated sequence from Lake Belau, Northern Germany: Revised chronology and its implications for palynological and tephrochronological studies

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    The annually laminated record of Lake Belau offers an exceptional opportunity to investigate with high temporal resolution Holocene environmental change, aspects of climate history and human impact on the landscape. A new chronology based on varve counts, 14C-datings and heavy metal history has been established, covering the last 9400 years. Based on multiple varve counting on two core sequences, the easily countable laminated section spans about 7850 varve years (modelled age range c. 9430 to 1630 cal. BP). Not all of the record is of the same quality but approximately 69% of the varves sequence is classified to be of high quality and only c. 5% of low quality. The new chronology suggests dates generally c. 260 years older than previously assumed for the laminated section of the record. The implications for the vegetation and land-use history of the region as well as revised datings for pollen stratigraphical events are discussed. Tephra analysis allowed the identification of several cryptotephra layers. New dates for volcanic eruptions are presented for the Lairg B event (c. 6848 cal. BP, 2s range 6930–6713 cal. BP), the Hekla 4 event (c. 4396 cal. BP, 2s range 4417–4266 cal. BP), and Hekla 3 eruption (c. 3095 cal. BP, 2s range 3120–3068 cal. BP)

    Análise integrada de sistemas de produção de tomateiro com base em indicadores edafobiológicos.

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    A análise integrada de indicadores edafobiológicos ligados ao manejo do solo constitui uma ferramenta importante para estimar níveis de sustentabilidade do agroecossistema, detectando-se pontos críticos para a devida correção de manejo. Essa ferramenta foi empregada na avaliação de sistemas de produção orgânica e convencional de tomate, em cultivo protegido e a campo aberto, no estado de São Paulo. Tomaram-se como referência solos de mata nativa e/ou pastagem natural, dependendo do local de estudo. Em Serra Negra, o solo sob sistema orgânico apresentou maior capacidade de campo e teor de argila dispersa mais baixo, indicativos da estabilidade dos agregados. No sistema convencional observou-se uma elevada condutividade elétrica, evidenciando a alta disponibilidade de sais solúveis. A análise de componentes principais (ACP) permitiu concluir que há maior grau de similaridade entre o solo sob sistema orgânico e aqueles das bases referenciais, com respeito aos indicadores químicos e biológicos. Constatou-se que C org, N total, polissacarídeos, FDA (hidrólise de diacetato de fluoresceína) e atividade enzimática de desidrogenase estão positivamente relacionados com o sistema orgânico, a mata nativa e a pastagem. Em contrapartida, a saturação por bases (V%), pH, teores de Mn, Mg e Ca, bem como a razão de dispersão estão inversamente relacionadas ao manejo orgânico. Já em Araraquara, os resultados da ACP distinguiram as áreas organicamente cultivadas das matas nativas, principalmente, com base nos indicadores biológicos

    Routine Antenatal Anti-D Prophylaxis in Women Who Are Rh(D) Negative: Meta-Analyses Adjusted for Differences in Study Design and Quality

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    Background: To estimate the effectiveness of routine antenatal anti-D prophylaxis for preventing sensitisation in pregnant Rhesus negative women, and to explore whether this depends on the treatment regimen adopted. Methods: Ten studies identified in a previous systematic literature search were included. Potential sources of bias were systematically identified using bias checklists, and their impact and uncertainty were quantified using expert opinion. Study results were adjusted for biases and combined, first in a random-effects meta-analysis and then in a random-effects metaregression analysis. Results: In a conventional meta-analysis, the pooled odds ratio for sensitisation was estimated as 0.25 (95 % CI 0.18, 0.36), comparing routine antenatal anti-D prophylaxis to control, with some heterogeneity (I 2 = 19%). However, this naïve analysis ignores substantial differences in study quality and design. After adjusting for these, the pooled odds ratio for sensitisation was estimated as 0.31 (95 % CI 0.17, 0.56), with no evidence of heterogeneity (I 2 = 0%). A meta-regression analysis wa
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