Services for Pregnant Women with Opiate Use Disorder

The presentation will highlight the best practices of both Stable Cradle and The Ohio State University Wexner Medical Center's (OSUWMC) Substance Abuse, Treatment, Education and Prevention Program (STEPP) clinics as a model to address the issues of pregnant women with opiate use disorders. Wanda Dillard, MS, will provide a history of the Stable Cradle Program, and Dr. Mona Prasad will provide overview of the OSUWMC STEPP clinic operations and how the two programs work together. The presentation will further discuss current initiatives to address the opiate epidemic. In Franklin County, at least 353 people overdosed in 2016. The number of babies diagnosed with neonatal abstinence syndrome (NAS) increased by 750 percent in Ohio from 2004-2015. NAS is a set of symptoms associated with abrupt withdrawal of opioids and other drugs when infants are born to mothers with opiate use disorder. In 2013, there were 1,691 drug-dependent babies admitted to Ohio hospitals with a cost for their care at nearly $100 million. Since the beginning of 2017, 40 NAS infants have been admitted to Franklin County nurseries and treated for withdrawal symptoms with a length stay of 28 days (86 percent of the women were white and 13 percent were African American.) Since 1997, OSUWMC has provided outreach services to more than 2,000 pregnant women struggling with addiction in partnership with Maryhaven's Women Program. Since 2010, more than 500 expectant mothers with opiate use disorder have received high-risk obstetrics care at OSUWMC's STEPP clinic. Both programs work from a model of harm reduction rather than harm elimination. OSUWMC's STEPP clinic currently provides high-risk obstetric services for opiate disorders and resources one full day each week. The Maryhaven Women Program's addiction specialist and the two mentors each provide 40 hours a week to conduct outreach with pregnant women on substances.AUTHOR AFFILIATION: Wanda Dillard, Director of Community Development, The Ohio State UniversityWMC, [email protected] (Corresponding Author); Mona Prasad, Physician, Maternal Fetal Medicine, The Ohio State UniversityWMC.Learn about current initiatives to address services for pregnant women with opiate use disorder and babies diagnosed with neonatal abstinence syndrome. To address these myriad concerns, we created a unique community partnership between The Ohio State University Wexner Medical Center (OSUWMC) and Maryhaven's Women's Program. Since 1997, OSUWMC has provided outreach services to more than 2,000 pregnant women struggling with addiction in partnership with Maryhaven's Women Program. Since 2010, more than 500 expectant mothers with opiate use disorder have received high-risk obstetrics care at OSUWMC's Substance Abuse, Treatment, Education and Prevention Program (STEPP) clinic. Both programs work from a model of harm reduction rather than harm elimination

Large scale copy number variation (CNV) at 14q12 is associated with the presence of genomic abnormalities in neoplasia

BACKGROUND: Advances made in the area of microarray comparative genomic hybridization (aCGH) have enabled the interrogation of the entire genome at a previously unattainable resolution. This has lead to the discovery of a novel class of alternative entities called large-scale copy number variations (CNVs). These CNVs are often found in regions of closely linked sequence homology called duplicons that are thought to facilitate genomic rearrangements in some classes of neoplasia. Recently, it was proposed that duplicons located near the recurrent translocation break points on chromosomes 9 and 22 in chronic myeloid leukemia (CML) may facilitate this tumor-specific translocation. Furthermore, ~15–20% of CML patients also carry a microdeletion on the derivative 9 chromosome (der(9)) and these patients have a poor prognosis. It has been hypothesised that der(9) deletion patients have increased levels of chromosomal instability. RESULTS: In this study aCGH was performed and identified a CNV (RP11-125A5, hereafter called CNV14q12) that was present as a genomic gain or loss in 10% of control DNA samples derived from cytogenetically normal individuals. CNV14q12 was the same clone identified by Iafrate et al. as a CNV. Real-time polymerase chain reaction (Q-PCR) was used to determine the relative frequency of this CNV in DNA from a series of 16 CML patients (both with and without a der(9) deletion) together with DNA derived from 36 paediatric solid tumors in comparison to the incidence of CNV in control DNA. CNV14q12 was present in ~50% of both tumor and CML DNA, but was found in 72% of CML bearing a der(9) microdeletion. Chi square analysis found a statistically significant difference (p ≤ 0.001) between the incidence of this CNV in cancer and normal DNA and a slightly increased incidence in CML with deletions in comparison to those CML without a detectable deletion. CONCLUSION: The increased incidence of CNV14q12 in tumor samples suggests that either acquired or inherited genomic variation of this new class of variation may be associated with onset or progression of neoplasia

PROTECCIÓN QUE EL ESTADO MEXICANO DEBE BRINDAR AL ADULTO MAYOR RESPECTO DE SU PATRIMONIO: LOS JUZGADORES DEL ESTADO DE MÉXICO

La reforma constitucional de 2011, colocó en el centro del sistema jurídico mexicano a los Derechos Humanos así, el artículo 1° constitucional señala: “Todas las autoridades, en el ámbito de sus competencias, tienen la obligación de promover, respetar, proteger y garantizar los derechos humanos de conformidad con los principios de universalidad, interdependencia, indivisibilidad y progresividad. En consecuencia, el Estado deberá prevenir, investigar, sancionar y reparar las violaciones a los derechos humanos, en los términos que establezca la ley.” Para efectos de que los adultos mayores estén en aptitud de dinamizar sus derechos y estos no queden sólo en el terreno de ideal normativo, el Estado mexicano, como garante de los derechos de los gobernados debe ir adaptando las normas protectoras conforme se presenten cambios sociales. El derecho debe ser tan dinámico como la propia sociedad, la normatividad debe revisarse en forma permanente y el legislador debe de realizar las adecuaciones pertinentes para que los derechos se dinamicen en términos de efectividad. Respecto de la protección del patrimonio de los adultos mayores es una prioridad revisar no sólo la armónica normatividad que ha de aplicar el juzgador, ya que en el diario quehacer jurisdiccional se perciben las más variadas acciones que ejercen fundamentalmente familiares para despojar de sus bienes a los adultos mayores, sin que ellos reciban beneficio directo alguno.La presente tesis muestra a través de su desarrollo el marco jurídico existente en cuanto a la protección del patrimonio del hombre de la tercera edad en el estado de México. En conjunto con la información del párrafo anterior se muestran datos estadísticos acerca de esta rama de la población (las personas de la tercera edad), así como del sistema judicial en materia civil que existe en el estado de México para la protección de sus patrimonio

Using Colistin as a Trojan Horse: Inactivation of Gram-Negative Bacteria with Chlorophyllin

Colistin (polymyxin E) is a membrane-destabilizing antibiotic used against Gram-negative bacteria. We have recently reported that the outer membrane prevents the uptake of antibacterial chlorophyllin into Gram-negative cells. In this study, we used sub-toxic concentrations of colistin to weaken this barrier for a combination treatment of Escherichia coli and Salmonella enterica serovar Typhimurium with chlorophyllin. In the presence of 0.25 µg/mL colistin, chlorophyllin was able to inactivate both bacteria strains at concentrations of 5–10 mg/L for E. coli and 0.5–1 mg/L for S. Typhimurium, which showed a higher overall susceptibility to chlorophyllin treatment. In accordance with a previous study, chlorophyllin has proven antibacterial activity both as a photosensitizer, illuminated with 12 mW/cm2, and in darkness. Our data clearly confirmed the relevance of the outer membrane in protection against xenobiotics. Combination treatment with colistin broadens chlorophyllin’s application spectrum against Gram-negatives and gives rise to the assumption that chlorophyllin together with cell membrane-destabilizing substances may become a promising approach in bacteria control. Furthermore, we demonstrated that colistin acts as a door opener even for the photodynamic inactivation of colistin-resistant (mcr-1-positive) E. coli cells by chlorophyllin, which could help us to overcome this antimicrobial resistance

Modulation by decitabine of gene expression and growth of osteosarcoma U2OS cells in vitro and in xenografts: Identification of apoptotic genes as targets for demethylation

<p>Abstract</p> <p>Background</p> <p>Methylation-mediated silencing of genes is one epigenetic mechanism implicated in cancer. Studies regarding the role of modulation of gene expression utilizing inhibitors of DNA methylation, such as decitabine, in osteosarcoma (OS) have been limited. A biological understanding of the overall effects of decitabine in OS is important because this particular agent is currently undergoing clinical trials. The objective of this study was to measure the response of the OS cell line, U2OS, to decitabine treatment both <it>in vitro </it>and <it>in vivo</it>.</p> <p>Results</p> <p>Microarray expression profiling was used to distinguish decitabine-dependent changes in gene expression in U2OS cells, and to identify responsive loci with demethylated CpG promoter regions. U2OS xenografts were established under the sub-renal capsule of immune-deficient mice to study the effect of decitabine <it>in vivo </it>on tumor growth and differentiation. Reduced nuclear methylation levels could be detected in xenografts derived from treated mice by immunohistochemistry utilizing a 5-methylcytidine antibody. Decitabine treatment reduced tumor xenograft size significantly (p < 0.05). Histological analysis of treated U2OS xenograft sections revealed a lower mitotic activity (p < 0.0001), increased bone matrix production (p < 0.0001), and a higher number of apoptotic cells (p = 0.0329). Microarray expression profiling of U2OS cultured cells showed that decitabine treatment caused a significant induction (p < 0.0025) in the expression of 88 genes. Thirteen had a ≥2-fold change, 11 of which had CpG-island-associated promoters. Interestingly, 6 of these 11 were pro-apoptotic genes and decitabine resulted in a significant induction of cell death in U2OS cells <it>in vitro </it>(p < 0.05). The 6 pro-apoptotic genes (<it>GADD45A</it>, <it>HSPA9B</it>, <it>PAWR</it>, <it>PDCD5</it>, <it>NFKBIA</it>, and <it>TNFAIP3</it>) were also induced to ≥2-fold <it>in vivo</it>. Quantitative methylation pyrosequencing confirmed that the tested pro-apoptotic genes had CpG-island DNA demethylationas a result of U2OS decitabine treatment both <it>in vitro </it>and in xenografts</p> <p>Conclusion</p> <p>These data provide new insights regarding the use of epigenetic modifiers in OS, and have important implications for therapeutic trials involving demethylation drugs. Collectively, these data have provided biological evidence that one mode of action of decitabine may be the induction of apoptosis utilizing promoter-CpG demethylation of specific effectors in cell death pathways in OS.</p

Distributed Sensing, Computing, Communication, and Control Fabric: A Unified Service-Level Architecture for 6G

With the advent of the multimodal immersive communication system, people can interact with each other using multiple devices for sensing, communication and/or control either onsite or remotely. As a breakthrough concept, a distributed sensing, computing, communications, and control (DS3C) fabric is introduced in this paper for provisioning 6G services in multi-tenant environments in a unified manner. The DS3C fabric can be further enhanced by natively incorporating intelligent algorithms for network automation and managing networking, computing, and sensing resources efficiently to serve vertical use cases with extreme and/or conflicting requirements. As such, the paper proposes a novel end-to-end 6G system architecture with enhanced intelligence spanning across different network, computing, and business domains, identifies vertical use cases and presents an overview of the relevant standardization and pre-standardization landscape

Association of Recorded Estimated Fetal Weight and Cesarean Delivery in Attempted Vaginal Delivery at Term:

To evaluate the association between documentation of estimated fetal weight, and its value, with cesarean delivery

Loss of immune escape mutations during persistent HCV infection in pregnancy enhances replication of vertically transmitted viruses

Globally, about 1% of pregnant women are persistently infected with the hepatitis C virus (HCV)1. Vertical transmission occurs in 3–5% of cases2 and accounts for most new childhood HCV infections1,3. HCV-specific CD8+ cytotoxic T-lymphocytes (CTLs) play a vital role in the clearance of acute infections4–6, but in the 60–80% of infections that persist these cells become functionally exhausted or select mutant viruses that escape T-cell recognition7–9. Increased HCV replication during pregnancy10,11 suggests that maternofetal immune tolerance mechanisms12 may further impair HCV-specific CTLs, limiting their selection pressure on persistent viruses. To assess this possibility, we characterized the circulating viral quasispecies during and after consecutive pregnancies. This revealed a loss of some escape mutations in class I epitopes in pregnancy associated with emergence of more fit viruses13. CTL selection pressure was reimposed after childbirth, when escape mutations in these epitopes again predominated in the quasispecies and viral load dropped sharply14. Importantly, viruses transmitted perinatally were those with enhanced fitness due to reversion of escape mutations. Our findings indicate that immunoregulatory changes of pregnancy reduce CTL selection pressure on HCV class I epitopes, thereby facilitating vertical transmission of viruses with optimized replicative fitness

OpenFraming: open-sourced tool for computational framing analysis of multilingual data

When journalists cover a news story, they can cover the story from multiple angles or perspectives. These perspectives are called “frames,” and usage of one frame or another may influence public perception and opinion of the issue at hand. We develop a web-based system for analyzing frames in multilingual text documents. We propose and guide users through a five-step end-to-end computational framing analysis framework grounded in media framing theory in communication research. Users can use the framework to analyze multilingual text data, starting from the exploration of frames in user’s corpora and through review of previous framing literature (step 1-3) to frame classification (step 4) and prediction (step 5). The framework combines unsupervised and supervised machine learning and leverages a state-of-the-art (SoTA) multilingual language model, which can significantly enhance frame prediction performance while requiring a considerably small sample of manual annotations. Through the interactive website, anyone can perform the proposed computational framing analysis, making advanced computational analysis available to researchers without a programming background and bridging the digital divide within the communication research discipline in particular and the academic community in general. The system is available online at http://www.openframing.org, via an API http://www.openframing.org:5000/docs/, or through our GitHub page https://github.com/vibss2397/openFraming.Published versio