Abdominal Pain after Gastric Bypass: Labor, Uterine Rupture, or Obstruction and Internal Hernia

Background. Although gastric bypass may reduce obesity-related complications of subsequent pregnancies, surgical complications requiring antenatal and postpartum interventions are not uncommon. Case. A 26-year-old G4P1112 status post-Roux-en-Y gastric bypass required multiple urgent antenatal evaluations due to frequent episodes of abdominal pain. At 35 + 4 weeks, she presented with severe abdominal pain; initial evaluation was negative for gastrointestinal pathology. The patient was found to be in preterm labor and underwent a repeat cesarean section. The postoperative course was complicated by bowel obstruction due to internal hernia resulting in an emergent laparotomy and a prolonged hospital course. Conclusion. As more reproductive-aged women opt for surgical treatment of obesity, it is essential that obstetricians recognize complications to be able to counsel and appropriately care for these patients

Restricted streptomycin use in apple orchards did not adversely alter the soil bacteria communities

Streptomycin has been authorized for restricted use in the prevention of the fire blight disease of pome fruit orchards in the EU and Switzerland. This study addresses the important topic of the influence of the use of streptomycin in agriculture on the total bacteria community within the soil ecosystem. Soil samples were taken from soils under apple trees, prior to streptomycin application and 2 weeks post streptomycin application or water application (untreated control). High throughput 16S rRNA gene amplicon sequencing was used to generate datasets from the soils under apple trees in apple orchards from three different locations in Switzerland. We hypothesized that the use of streptomycin would reduce the bacterial diversity within the soil samples and enhance a reduction in the variety of taxa present. Bacterial species such as Pseudomonas, Burkholderia, and Stenotrophomonas are intrinsically resistant to many antibiotics and as such it is of interest to investigate if the use of streptomycin provided a selective advantage for these bacteria in the soil ecosystem. The application of streptomycin did not influence the abundance and diversities of major bacteria taxa of the soils or the Pseudomonas, Burkholderia, and Stenotrophomonas species. We also discovered that apple orchards under the same management practices, did not harbor the same bacterial communities. The restricted application of streptomycin in the protection of apple orchards from the fire blight pathogen Erwinia amylovora under the guidelines in Switzerland did not alter either the bacterial diversity or abundance within these soil ecosystems

Age, Period, and Cohort Trends in Mood Disorder and Suicide-Related Outcomes in a Nationally Representative Dataset, 2005-2017

Drawing from the National Survey on Drug Use and Health (NSDUH; N = 611,880), a nationally representative survey of U.S. adolescents and adults, we assess age, period, and cohort trends in mood disorder and suicide-related outcomes since the mid-2000s. Rates of major depressive episode in the last year among adolescents aged 12 to 17 increased by 52% 2005-2017; major depressive episode in the last year increased 63% between 2009 and 2017 among young adults 18-25. Serious psychological distress in the last month and suicide-related outcomes (suicidal ideation, plans, attempts, and deaths by suicide) in the last year also increased among young adults 18-25 between 2008 and 2017, with less consistent and weaker increases among adults ages 26 and over. Hierarchical linear modeling analyses separating the effects of age, period, and birth cohort suggest the trends among adults are primarily due to cohort, with a steady rise in mood disorder and suicide-related outcomes over birth cohorts from the early 1980s to the late 1990s. Cultural trends contributing to an increase in mood disorders and suicidal thoughts and behaviors since the mid-2000s, including the rise of electronic communication and digital media and declines in sleep duration, may have had a larger impact on younger people, creating a cohort effect

Coping strategies and self-esteem in the high-risk offspring of bipolar parents.

Objectives: This study investigated whether there were differences in coping strategies and self-esteem between offspring of parents with bipolar disorder (high-risk) and offspring of unaffected parents (control), and whether these psychological factors predicted the onset and recurrence of mood episodes. Methods: High-risk and control offspring were followed longitudinally as part of the Flourish Canadian high-risk bipolar offspring cohort study. Offspring were clinically assessed annually by a psychiatrist using semi-structured interviews and completed a measure of coping strategies and self-esteem. Results: In high-risk offspring, avoidant coping strategies significantly increased the hazard of a new onset Diagnostic and Statistical Manual of Mental Disorders, 4th Edition twice revised mood episode or recurrence (hazard ratio: 1.89, p = 0.04), while higher self-esteem significantly decreased this hazard (hazard ratio: 2.50, p < 0.01). Self-esteem and avoidant coping significantly interacted with one another (p < 0.05), where the risk of a Diagnostic and Statistical Manual of Mental Disorders, 4th Edition twice revised new onset mood episode or recurrence was only significantly increased among high-risk offspring with both high avoidant coping and low self-esteem. Conclusion: A reduction of avoidant coping strategies in response to stress and improvement of self-esteem may be useful intervention targets for preventing the new onset or recurrence of a clinically significant mood disorder among individuals at high familial risk

Artists on the edge of the world : an integrated approach to the study of Magdalenian engraved stone plaquettes from Jersey (Channel Islands)

Excavations at Les Varines were funded by Jersey Heritage through the States of Jersey Tourism Development Fund (https://www.gov.je/Leisure/Events/TourismDevelopmentFundTDF/pages/abouttdf.aspx) in 2013-15 and in 2017 (BS received the funding), by the British Museum research fund in 2016-18 (https://www.britishmuseum.org/research) (Grant nos EC164/EC208) (BS received the funding), in 2016 by British Academy (https://www.thebritishacademy.ac.uk) small grant SG152868 (CC received the funding) and Society of Antiquaries (https://www.sal.org.uk/) Research Grants R121086 in 2017 and BH181355 in 2018 (CC received the funding). Funding from the Universities of Manchester, Southampton and UCL supported student training at the excavation. Silvia Bello’s work was part of the ‘Human Behaviour in 3D’ Project funded by the Calleva Foundation. Beccy Scott’s work was also supported by the Calleva foundation (Pathways to Ancient Britain project).The Upper Palaeolithic is characterised by the appearance of iconographic expressions most often depicting animals, including anthropomorphic forms, and geometric signs. The Late Upper Palaeolithic Magdalenian saw a flourishing of such depictions, encompassing cave art, engraving of stone, bone and antler blanks and decoration of tools and weapons. Though Magdalenian settlement exists as far northwest as Britain, there is a limited range of art known from this region, possibly associated with only fleeting occupation of Britain during this period. Stone plaquettes, flat fragments of stone engraved on at least one surface, have been found in large quantities at numerous sites spanning the temporal and geographical spread of the Magdalenian, but they have been absent so far from the archaeological record of the British Isles. Between 2015 and 2018, ten fragments of stone plaquettes extensively engraved with abstract designs were uncovered at the Magdalenian site of Les Varines, Jersey, Channel Islands. In this paper, we report detailed analyses of these finds, which provide new evidence for technologies of abstract mark-making, and their significance within the lives of people on the edge of the Magdalenian world. These engraved stone fragments represent important, rare evidence of artistic expression in what is the far northern and western range of the Magdalenian and add new insight to the wider significance of dynamic practices of artistic expression during the Upper Palaeolithic.Publisher PDFPeer reviewe

Genomic evidence of recent European introgression into North American farmed and wild Atlantic salmon

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Resolving fine-scale population structure and fishery exploitation using sequenced microsatellites in a northern fish

Funding Information Natural Sciences and Engineering Research Council of Canada (NSERC) Strategic Project Atlantic Canada Opportunities Agency and Department of Tourism, Culture, Industry and Innovation grants allocated to the Labrador Institute (MC) Natural Sciences and Engineering Research Council of Canada (NSERC) Discovery Genomics Research and Development Initiative (GRDI) Weston Family AwardPeer reviewedPublisher PD

The brain microvasculature is a primary mediator of interferon-α neurotoxicity in human cerebral interferonopathies

Aicardi-Goutières syndrome (AGS) is an autoinflammatory disease characterized by aberrant interferon (IFN)- production. The major cause of morbidity in AGS is brain disease, yet the primary source and target of neurotoxic IFN- remains unclear. Here, we demonstrated that the brain was the primary source of neurotoxic IFN- in AGS, and confirmed neurotoxicity of intracerebral IFN- using astrocyte-driven Ifna1 misexpression in mice. Using single-cell RNA sequencing, we demonstrated that intracerebral IFN- activated IFNAR signaling within cerebral endothelial cells, caused a distinctive cerebral small vessel disease similarly observed in individuals with AGS. MRI and single-molecule ELISA revealed that central and not peripheral IFN- was the primary determinant of microvascular disease in humans. Ablation of endothelial Ifnar1 in mice rescued microvascular disease, stopped development of diffuse brain disease and prolonged lifespan. These results identify the cerebral microvasculature as a primary mediator of IFN- neurotoxicity in AGS, representing an accessible target for therapeutic intervention