Effects of twin pregnancy chorionic properties on fetal outcomes: a comparative study

Background: Twins carry significant risks to both mothers and babies. The purpose of this study was to evaluate chorionicity and its impact on perinatal outcomes in twins.Methods: This prospective observational study was conducted in the department of obstetrics and gynecology, Government T. D. Medical College, Alappuzha, Kerala. A total of 106 cases of twin pregnancies were included in the prospective descriptive study. Based on the ultrasound results and methods of the postpartum pathologic examination of the placental membranes, the cases were divided into the twin group with monochorionic diamniotic (MCDA) and twin group with dichorionic diamniotic (DCDA group). The relationships of different chorionic properties and fetal outcomes were determined by comparing various fetal outcomes.Results: Among 106 twin pregnancies, 61.3% were DCDA twins, 38.7% were MCDA. Average maternal age of monochorionic twin was 25 and that of dichorionic twin was 27. Perinatal mortality of monochorionic twin was 14.7% when compared to 8.6% for dichorionic twin. The mean gestational age for monochorionic twin pregnancy was 34.78 weeks whereas it was 35.91 weeks for dichorionic pregnancy. Elective and emergency LSCS was done more for dichorionic twin pregnancies compared to monochorionic twin pregnancies. Low Apgar scores were seen in monochorionic twins compared to dichorionic twins.Conclusions: The incidence of fetal outcomes in the monochorionic group was inferior to those in the dichorionic group. The fetal outcomes may be improved by determining the chorionic properties in early pregnancy by using ultrasound and consequently planning for pregnancy monitoring and intervention

Charge solitons and their dynamical mass in 1-D arrays of Josephson junctions

We investigate the charge transport in one-dimensional arrays of Josephson junctions. In the interesting regime of "small charge solitons" (polarons), the charge dynamics is strongly influenced by the polaronic effects, i.e., by dressing of a Cooper pair by charge dipoles. In particular, the soliton's mass in this regime scales approximately as inverse square of the Josephson energy. We employ two theoretical techniques: the many body tight-binding approach and the mean-field approach. Results of the two approaches agree in the regime of "small charge solitons".Comment: 10 pages, 10 figure

Estimates of Cl atom concentrations and hydrocarbon kinetic reactivity in surface air at Appledore Island, Maine (USA), during International Consortium for Atmospheric Research on Transport and Transformation/Chemistry of Halogens at the Isles of Shoals

Average hydroxyl radical (OH) to chlorine atom (Cl·) ratios ranging from 45 to 119 were determined from variability‐lifetime relationships for selected nonmethane hydrocarbons (NMHC) in surface air from six different transport sectors arriving at Appledore Island, Maine, during July 2004. Multiplying these ratios by an assumed average OH concentration of 2.5 × 106 cm−3 yielded estimates of Cl· concentrations of 2.2 to 5.6 × 104 cm−3. Summed reaction rates of methane and more than 30 abundant NMHCs with OH and Cl· suggest that Cl· reactions increased the kinetic reactivity of hydrocarbons by 16% to 30% over that due to OH alone in air associated with the various transport sectors. Isoprene and other abundant biogenic alkenes were the most important hydrocarbon contributors after methane to overall kinetic reactivity

Systematic review of the effect of individual and combined nutrition and exercise interventions on weight, adiposity and metabolic outcomes after delivery: evidence for developing behavioral guidelines for post-partum weight control

BACKGROUND: Post-partum weight retention contributes to the risk of chronic obesity and metabolic alterations. We conducted a systematic review of randomized controlled trials (RCTs) on the effect of post-partum nutrition and exercise interventions on weight loss and metabolic outcomes. DATA SOURCES: Four electronic databases were searched from inception to January, 2012. Two investigators reviewed titles and abstracts, performed data abstraction on full articles and assessed study quality. METHODS: We included RCTs comparing nutrition, exercise or combined nutrition and exercise interventions with a control condition. Thirteen studies met our inclusion criteria (N = 1,310 participants). Data were abstracted on study characteristics, intervention components, enrollment period, and length of follow-up. Outcomes of interest included weight, adiposity, cardio-metabolic measures (glucose, lipids) and obesity-related inflammatory markers. RESULTS: Nine trials compared combined interventions to standard post-partum care; three trials assessed the effect of exercise interventions, one trial evaluated a nutrition-only intervention. Four good quality RCTs on combined interventions had inconsistent findings, with the larger RCT (N = 450) reporting no difference in weight between groups. Four fair-to good quality RCTs reported greater weight loss in the combined intervention group vs. standard care, ranging from 0.17 kg to 4.9 kg. Results from exercise only interventions were inconclusive. Evidence for nutrition only interventions was insufficient. There was insufficient evidence for the effect of post-partum interventions on metabolic risk factors and inflammatory biomarkers. CONCLUSIONS: Combined nutrition and exercise interventions can achieve weight loss, but evidence is limited due to a small number of trials and limitations in study design. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/1471-2393-14-319) contains supplementary material, which is available to authorized users

Beta cell extracellular vesicle miR-21-5p cargo is increased in response to inflammatory cytokines and serves as a biomarker of type 1 diabetes

AIMS/HYPOTHESIS: Improved biomarkers are acutely needed for the detection of developing type 1 diabetes, prior to critical loss of beta cell mass. We previously demonstrated that elevated beta cell microRNA 21-5p (miR-21-5p) in rodent and human models of type 1 diabetes increased beta cell apoptosis. We hypothesised that the inflammatory milieu of developing diabetes may also increase miR-21-5p in beta cell extracellular vesicle (EV) cargo and that circulating EV miR-21-5p would be increased during type 1 diabetes development. METHODS: MIN6 and EndoC-βH1 beta cell lines and human islets were treated with IL-1β, IFN-γ and TNF-α to mimic the inflammatory milieu of early type 1 diabetes. Serum was collected weekly from 8-week-old female NOD mice until diabetes onset. Sera from a cross-section of 19 children at the time of type 1 diabetes diagnosis and 16 healthy children were also analysed. EVs were isolated from cell culture media or serum using sequential ultracentrifugation or ExoQuick precipitation and EV miRNAs were assayed. RESULTS: Cytokine treatment in beta cell lines and human islets resulted in a 1.5- to threefold increase in miR-21-5p. However, corresponding EVs were further enriched for this miRNA, with a three- to sixfold EV miR-21-5p increase in response to cytokine treatment. This difference was only partially reduced by pre-treatment of beta cells with Z-VAD-FMK to inhibit cytokine-induced caspase activity. Nanoparticle tracking analysis showed cytokines to have no effect on the number of EVs, implicating specific changes within EV cargo as being responsible for the increase in beta cell EV miR-21-5p. Sequential ultracentrifugation to separate EVs by size suggested that this effect was mostly due to cytokine-induced increases in exosome miR-21-5p. Longitudinal serum collections from NOD mice showed that EVs displayed progressive increases in miR-21-5p beginning 3 weeks prior to diabetes onset. To validate the relevance to human diabetes, we assayed serum from children with new-onset type 1 diabetes compared with healthy children. While total serum miR-21-5p and total serum EVs were reduced in diabetic participants, serum EV miR-21-5p was increased threefold compared with non-diabetic individuals. By contrast, both serum and EV miR-375-5p were increased in parallel among diabetic participants. CONCLUSIONS/INTERPRETATION: We propose that circulating EV miR-21-5p may be a promising marker of developing type 1 diabetes. Additionally, our findings highlight that, for certain miRNAs, total circulating miRNA levels are distinct from circulating EV miRNA content

A model of mentorship for students from historically underrepresented groups in STEM

Mentorship is critical to student academic success and persistence, especially for students from historically underrepresented (HU) groups. In a program designed to support the academic success of HU undergraduates in STEM who wish to pursue a PhD in those fields, students experience comprehensive support including financial aid, highly-engaged mentoring, dual faculty mentorship, professional development workshops, and summer research experiences. Scholars in this program, the Cal-Bridge program, consistently report that faculty mentorship is the most impactful feature. While mentorship was rated highly, preliminary evaluation indicated an early deficit in a sense of community among scholars. In response, faculty professional development and support for peer networking were implemented to expand and enhance the relationships that support scholar success. Here we present a promising multifaceted model of mentorship that can support the academic success of HU undergraduates.Comment: Submitted to Understanding Interventions. 23 pages. 4 figures. Comments welcome

Fossil Fuel Divestment in U.S. Higher Education: Endowment Dependence and Temporal Dynamics

Since 2012, students and others have pushed U.S. Higher Education Institutions (HEIs) to divest their endowments from fossil fuel producing industries. In the past decade, fossil fuel divestment has become the fastest growing divestment movement in history, with over 140 U.S. HEIs announcing divestment commitments. We conduct a quantitative analysis of the three phases of U.S. 4-year HEI divestment announcements (as well as rejections of divestment) to better understand the dynamics. Announcements began (2012-2017) with a number of schools divesting, followed by a second phase where new divestment announcements slowed. The current phase, which began around 2019, shows a renewed increase in divestments. Formal rejections of divestment followed a similar pattern in the early years, where rejections were slightly more common and represented more endowment value, but have declined as some schools reversed public positions. Schools that have divested from fossil fuels now represent roughly 3% of 4-year U.S. HEIs and 35% of endowment value. Roughly 85% more endowment value is now associated with U.S. schools that have divested from fossil fuels than with those that have rejected it. Our analysis points to endowment dependence (the share of operating expenses derived from the endowment) as a potentially important indicator of whether a school would divest, with early divestments from all fossil fuels coming nearly exclusively from schools with a relatively low endowment dependence. We discuss the implications of these findings in the context of different theories of change for the divestment movement. In particular, we note that over 99% of 4-year HEIs representing roughly 95% of endowment value are less dependent upon their endowment than at least one recently divested HEI, suggesting that large endowment or high dependence on endowment are no longer strict barriers to FFD for most schools

Engaging in Collaboration: Piloting an Interprofessional Population Health Course in a School of Public Health

In 2015 The Gillings School of Global Public Health engaged in an interprofessional collaboration across health affairs schools (medicine, nursing, social work, pharmacy) at the University of North Carolina at Chapel Hill to develop and implement an interprofessional graduate-level course on population health. This presentation will describe course development and implementation and describe case-based team building opportunities built into the didactic portion of the hybrid online/face-to-face course which was piloted with more than 20 students in the Fall of 2015. The presentation will also describe accompanying project-based activities at community clinical sites where students collaborated with primary care providers in quality improvement activities. Evaluation data from the pilot course will also be discussed