Use of the Peanut Ball to Reduce Cesarean Rate

The high rate of cesarean section deliveries in the United States is greatly concerning for the health of our laboring women and their babies. Many physical, emotional, and financial risks are linked to this surgical procedure. This author felt the labor care model has been narrowed in many instances, creating an atmosphere where laboring women become fixed in a cycle of medical actions mostly due to continuous electronic fetal monitoring. Labor and delivery activities can be viewed as compulsory and integral pieces of care but in themselves are not always required. Methods to minimize unnecessary cesarean deliveries are being explored, especially interventions that improve pelvic opening, thus allowing the fetus to traverse the birth canal. The peanut ball is one such innovative intervention being offered in labor management in the past few years. Educational methods for utilization of the peanut ball vary and might be lacking among labor attendants. The intention of this project was to develop a clinical practice guideline for use of the peanut ball for those patients in labor to assist with opening the pelvis to facilitate fetal rotation, thereby shortening labors and ultimately reducing the rate of cesarean deliveries. To improve the efficacy of use, a retrospective analysis of articles on laboring women was performed to obtain statistical data of value for this project. Surveys distributed to experts in the care of laboring women were issued in two waves. They were collected and evaluated to determine education points necessary for inclusion in the guideline. The PICOT for the project with plans for a future research project was, “In pregnant women, how does the use of the peanut ball compared to no use of the peanut ball influence the rate of cesarean section during labor and delivery? Once the guideline was developed, an accompanying education document was created along with a pelvic positioning visual sheet. A succinct step-by-step instructional sheet explaining proper implementation of the guideline along with a policy template were created. Through development of the guideline, it was desired to facilitate a successful vaginal delivery, shorten labor times, decrease the discomfort of the woman, and promote satisfaction with her experience. By accomplishing these goals, it was projected a reduction in the cesarean rate would also be present. A research project could occur with the guideline and would be an undertaking of the organization. If a research project is completed, a data collection and analysis could be carried out to determine whether the expected objectives were met and continued use of the guideline would be beneficial for laboring women within the institution and whether the guideline could be disseminated to outside organizations. This research area could provide the catalyst to increase awareness and restructure the rigid, task-oriented processes currently being noted in labor care

Seiche- and storm-driven benthic oxygen uptake in a eutrophic freshwater bay determined with aquatic eddy covariance

Oxygen depletion in bottom waters of lakes and coastal regions is expanding worldwide. To examine the causes of hypoxia, we quantified the drivers of benthic oxygen uptake in Green Bay, Lake Michigan, USA, using 2 techniques, aquatic eddy covariance and sediment core incubation. We investigated benthic oxygen uptake along a gradient in C deposition, including shallow water near the riverine source of eutrophication and deeper waters of lower Green Bay where high net sediment deposition occurs. Time-averaged eddy covariance oxygen uptake was high near the source of eutrophication (11.5 mmol m−2 d−1) and at the shallower of the high deposition sites (9.8 mmol m−2 d−1). The eddy covariance technique revealed a decrease in benthic oxygen uptake with depth at the high deposition sites. These patterns were consistent with benthic uptake being driven by the deposition of autochthonous production. Additionally, eddy covariance revealed a nearly proportional relationship between benthic oxygen uptake and current velocity at all sites. Specifically, because of the lake seiche, water velocity typically varied 3× at a site and caused a 3× variation in benthic oxygen uptake. A summer storm also doubled bottom-water velocities and caused a further doubling of uptake to 28 mmol m−2 d−1. This high sensitivity of benthic oxygen uptake to seiche-driven water velocities indicates that redox conditions in surficial cohesive sediments are highly dynamic

Using person‐specific neural networks to characterize heterogeneity in eating disorders: Illustrative links between emotional eating and ovarian hormones

ObjectiveEmotional eating has been linked to ovarian hormone functioning, but no studies to‐date have considered the role of brain function. This knowledge gap may stem from methodological challenges: Data are heterogeneous, violating assumptions of homogeneity made by between‐subjects analyses. The primary aim of this paper is to describe an innovative within‐subjects analysis that models heterogeneity and has potential for filling knowledge gaps in eating disorder research. We illustrate its utility in an application to pilot neuroimaging, hormone, and emotional eating data across the menstrual cycle.MethodGroup iterative multiple model estimation (GIMME) is a person‐specific network approach for estimating sample‐, subgroup‐, and individual‐level connections between brain regions. To illustrate its potential for eating disorder research, we apply it to pilot data from 10 female twins (N = 5 pairs) discordant for emotional eating and/or anxiety, who provided two resting state fMRI scans and hormone assays. We then demonstrate how the multimodal data can be linked in multilevel models.ResultsGIMME generated person‐specific neural networks that contained connections common across the sample, shared between co‐twins, and unique to individuals. Illustrative analyses revealed positive relations between hormones and default mode connectivity strength for control twins, but no relations for their co‐twins who engage in emotional eating or who had anxiety.DiscussionThis paper showcases the value of person‐specific neuroimaging network analysis and its multimodal associations in the study of heterogeneous biopsychosocial phenomena, such as eating behavior.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146371/1/eat22902.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146371/2/eat22902_am.pd

Evidence for the role of EPHX2 gene variants in anorexia nervosa.

Anorexia nervosa (AN) and related eating disorders are complex, multifactorial neuropsychiatric conditions with likely rare and common genetic and environmental determinants. To identify genetic variants associated with AN, we pursued a series of sequencing and genotyping studies focusing on the coding regions and upstream sequence of 152 candidate genes in a total of 1205 AN cases and 1948 controls. We identified individual variant associations in the Estrogen Receptor-ß (ESR2) gene, as well as a set of rare and common variants in the Epoxide Hydrolase 2 (EPHX2) gene, in an initial sequencing study of 261 early-onset severe AN cases and 73 controls (P=0.0004). The association of EPHX2 variants was further delineated in: (1) a pooling-based replication study involving an additional 500 AN patients and 500 controls (replication set P=0.00000016); (2) single-locus studies in a cohort of 386 previously genotyped broadly defined AN cases and 295 female population controls from the Bogalusa Heart Study (BHS) and a cohort of 58 individuals with self-reported eating disturbances and 851 controls (combined smallest single locus P<0.01). As EPHX2 is known to influence cholesterol metabolism, and AN is often associated with elevated cholesterol levels, we also investigated the association of EPHX2 variants and longitudinal body mass index (BMI) and cholesterol in BHS female and male subjects (N=229) and found evidence for a modifying effect of a subset of variants on the relationship between cholesterol and BMI (P<0.01). These findings suggest a novel association of gene variants within EPHX2 to susceptibility to AN and provide a foundation for future study of this important yet poorly understood condition

DNA barcoding identifies cryptic animal tool materials

Funding: Biotechnology and Biological Sciences Research Council (BBSRC) (Grants BB/G023913/1 and BB/G023913/2 to C.R., and studentship to B.C.K.), the School of Biology at the University of St Andrews (studentships to M.P.S. and B.C.K.), and the Leverhulme Trust (Grant RPG-2015-273 to P.M.H.).Some animals fashion tools or constructions out of plant materials to aid foraging, reproduction, self-maintenance, or protection. Their choice of raw materials can affect the structure and properties of the resulting artifacts, with considerable fitness consequences. Documenting animals’ material preferences is challenging, however, as manufacture behavior is often difficult to observe directly, and materials may be processed so heavily that they lack identifying features. Here, we use DNA barcoding to identify, from just a few recovered tool specimens, the plant species New Caledonian crows (Corvus moneduloides) use for crafting elaborate hooked stick tools in one of our long-term study populations. The method succeeded where extensive fieldwork using an array of conventional approaches—including targeted observations, camera traps, radio-tracking, bird-mounted video cameras, and behavioral experiments with wild and temporarily captive subjects—had failed. We believe that DNA barcoding will prove useful for investigating many other tool and construction behaviors, helping to unlock significant research potential across a wide range of study systems.Publisher PDFPeer reviewe

Towards a data publishing framework for primary biodiversity data: challenges and potentials for the biodiversity informatics community

Background: Currently primary scientific data, especially that dealing with biodiversity, is neither easily discoverable nor accessible. Amongst several impediments, one is a lack of professional recognition of scientific data publishing efforts. A possible solution is establishment of a ‘Data Publishing Framework’ which would encourage and recognise investments and efforts by institutions and individuals towards management, and publishing of primary scientific data potentially on a par with recognitions received for scholarly publications. Discussion: This paper reviews the state-of-the-art of primary biodiversity data publishing, and conceptualises a ‘Data Publishing Framework’ that would help incentivise efforts and investments by institutions and individuals in facilitating free and open access to biodiversity data. It further postulates the institutionalisation of a ‘Data Usage Index (DUI)’, that would attribute due recognition to multiple players in the data collection/creation, management and publishing cycle. Conclusion: We believe that institutionalisation of such a ‘Data Publishing Framework’ that offers socio-cultural, legal, technical, economic and policy environment conducive for data publishing will facilitate expedited discovery and mobilisation of an exponential increase in quantity of ‘fit-for-use’ primary biodiversity data, much of which is currently invisible

Heart-Kidney Interaction: Epidemiology of Cardiorenal Syndromes

Cardiac and kidney diseases are common, increasingly encountered, and often coexist. Recently, the Acute Dialysis Quality Initiative (ADQI) Working Group convened a consensus conference to develop a classification scheme for the CRS and for five discrete subtypes. These CRS subtypes likely share pathophysiologic mechanisms, however, also have distinguishing clinical features, in terms of precipitating events, risk identification, natural history, and outcomes. Knowledge of the epidemiology of heart-kidney interaction stratified by the proposed CRS subtypes is increasingly important for understanding the overall burden of disease for each CRS subtype, along with associated morbidity, mortality, and health resource utilization. Likewise, an understanding of the epidemiology of CRS is necessary for characterizing whether there exists important knowledge gaps and to aid in the design of clinical studies. This paper will provide a summary of the epidemiology of the cardiorenal syndrome and its subtypes

Discovery of species-wide tool use in the Hawaiian crow

Funding from the Biotechnology and Biological Sciences Research Council, UK (BBSRC; grant BB/G023913/2 to C.R., and studentship to B.C.K.), the University of St Andrews (C.R.), JASSO (S.S.), and the Royal Society of London (M.B.M.). Funding for thecaptive ‘Alala propagation programme was provided by the U.S. Fish and Wildlife Service, Hawai‘i Division of Forestry and Wildlife, Moore Family Foundation, Marisla Foundation, several anonymous donors, and San Diego Zoo Global.Only a handful of bird species are known to use foraging tools in the wild1. Amongst them, the New Caledonian crow (Corvus moneduloides) stands out with its sophisticated tool-making skills2, 3. Despite considerable speculation, the evolutionary origins of this species’ remarkable tool behaviour remain largely unknown, not least because no naturally tool-using congeners have yet been identified that would enable informative comparisons4. Here we show that another tropical corvid, the ‘Alalā (C. hawaiiensis; Hawaiian crow), is a highly dexterous tool user. Although the ‘Alalā became extinct in the wild in the early 2000s, and currently survives only in captivity5, at least two lines of evidence suggest that tool use is part of the species’ natural behavioural repertoire: juveniles develop functional tool use without training, or social input from adults; and proficient tool use is a species-wide capacity. ‘Alalā and New Caledonian crows evolved in similar environments on remote tropical islands, yet are only distantly related6, suggesting that their technical abilities arose convergently. This supports the idea that avian foraging tool use is facilitated by ecological conditions typical of islands, such as reduced competition for embedded prey and low predation risk4, 7. Our discovery creates exciting opportunities for comparative research on multiple tool-using and non-tool-using corvid species. Such work will in turn pave the way for replicated cross-taxonomic comparisons with the primate lineage, enabling valuable insights into the evolutionary origins of tool-using behaviour.PostprintPeer reviewe