Maternal demographic and clinical variables do not predict intrauterine contraception placement: Evidence for postplacental intrauterine contraception placement

Objective: Determine if specific demographic and clinical variables are associated with intra-uterine contraception (IUC) placement by eight weeks postpartum. Methods: This retrospective cohort study included all patients who delivered at Dartmouth-Hitchcock Medical Center (DHMC) (July-December 2008) who identified IUC as their preferred postpartum contraceptive method. Medical records of patients identified from the birth log were reviewed for preferred contraception, demographics, medical, obstetric, and social histories, as well as payer status. Chi-squared analysis was performed for categorical variables, and Mann-Whitney U test was used for continuous variables. Nonparametric continuous variables were categorized for regression modeling. Results: 224 (34%) patients who delivered identified IUC as their preferred method of postpartum contraception. Of these, 94 (49.7%) women had an IUC placed by 8 weeks postpartum. In univariate analyses comparing those who received an IUC versus those patients who did not, only mean interdelivery interval in months (39.7 vs. 35.5, p=0.027) and mean gravidity (2.3 vs. 2.8, p=0.036) were statistically significant. In multivariate regression modeling, no variables were significantly associated with IUC placement. Conclusions: While statically significant interdelivery interval and gravidity are not likely to be clinically significant. Multivariate modeling failed to identify a model associated with IUC placement suggesting that postpartum IUC placement is not well predicted by patient variables. Lack of identifying factors may support offering postplacental IUC placement to all patients who indicate IUC as their preferred contraceptive method

A novel inactivated virus system (InViS) for a fast and inexpensive assessment of viral disintegration.

The COVID-19 pandemic has caused considerable interest worldwide in antiviral surfaces, and there has been a dramatic increase in the research and development of innovative material systems to reduce virus transmission in the past few years. The International Organization for Standardization (ISO) norms 18,184 and 21,702 are two standard methods to characterize the antiviral properties of porous and non-porous surfaces. However, during the last years of the pandemic, a need for faster and inexpensive characterization of antiviral material was identified. Therefore, a complementary method based on an Inactivated Virus System (InViS) was developed to facilitate the early-stage development of antiviral technologies and quality surveillance of the production of antiviral materials safely and efficiently. The InViS is loaded with a self-quenched fluorescent dye that produces a measurable increase in fluorescence when the viral envelope disintegrates. In the present work, the sensitivity of InViS to viral disintegration by known antiviral agents is demonstrated and its potential to characterize novel materials and surfaces is explored. Finally, the InViS is used to determine the fate of viral particles within facemasks layers, rendering it an interesting tool to support the development of antiviral surface systems for technical and medical applications

Patients’ attitude towards a sham-controlled trial on pulmonary vein isolation in atrial fibrillation

Background!#!The interpretation of recent trials on pulmonary vein ablation (PVI) for the treatment of atrial fibrillation (AF) is hampered by the lack of blinding and sham controls. The feasibility of a sham-controlled trial has been questioned. We aimed to assess the attitude of potential participants regarding a sham-controlled trial in a common AF-patient population planned for PVI.!##!Methods!#!Patients in two tertiary care centres planned for PVI were asked for their current AF symptoms using the Atrial Fibrillation Effect on QualiTy of Life (AFEQT) questionnaire 1 day before catheter ablation. Subsequently, the study design of a hypothetical sham-controlled PVI-study was introduced, and patients were asked for their agreement in participation. Telephone follow-up of the AFEQT questionnaire was conducted 3 months after PVI.!##!Results!#!One hundred and ninety-six patients (mean age 64 ± 11 years, 63% male) were included. Seventy-nine (40%) patients expressed their agreement to participate in the hypothetical sham-controlled trial. An additional 7% agreed to participate if a cross-over option after three months was offered. Agreement rate was similar in patients with first and Redo-PVI and minimal, moderate or severe symptoms. Mean overall AFEQT at baseline was 55 ± 19 and improved by 25 ± 20 points after 3 months (p < 0.001 versus baseline).!##!Conclusion!#!With a participation rate of 40% in potential study participants, a sham-controlled trial for pulmonary vein isolation seems feasible. Patient-reported symptom relief after pulmonary vein isolation is in accordance with previous randomized open studies. The benefit of PVI should be rigorously evaluated in a sham-controlled trial

On the importance of the innervation of the human cervical longitudinal ligaments at vertebral level

Purpose In our aging society, the prevalence of degenerative spinal diseases rose drastically within the last years. However, up till now, the origin of cervical pain is incompletely understood. While animal and small cadaver studies indicate that a complex system of sensory and nociceptive nerve fibers in the anterior (ALL) and posterior longitudinal ligament (PLL) at the level of the intervertebral disc might be involved, there is a lack of data exploring whether such a network exists and is equally distributed within the cervical vertebrae (VB). We, therefore, aimed to investigate the spatial distribution of the mentioned nerve networks in human tissue. Methods We performed macroscopic (Sihler staining, Spalteholz technique, and Plastination) and microscopic (immunohistochemistry for PGP 9.5 and CGRP) studies to characterize spatial differences in sensory and nociceptive innervation patterns. Therefore, 23 human body donors were dissected from level C3–C6. Results We could show that there is a focal increase in sensory and nociceptive nerve fibers at the level of C4 and C5 for both ALL and PLL, while we observed less nerve fiber density at the level of C3 and C6. An anatomical vicinity between nerve and vessels was observed. Conclusion To our knowledge, these findings for the first time report spatial differences in sensory and nociceptive nerve fibers in the human cervical spine at VB level. The interconnection between nerves and vessels supports the importance of the perivascular plexus. These findings might be of special interest for clinical practice as many patients suffer from pain after cervical spine surgery

Individual differences in human fear generalization-pattern identification and implications for anxiety disorders

Previous research indicates that anxiety disorders are characterized by an overgeneralization of conditioned fear as compared with healthy participants. Therefore, fear generalization is considered a key mechanism for the development of anxiety disorders. However, systematic investigations on the variance in fear generalization are lacking. Therefore, the current study aims at identifying distinctive phenotypes of fear generalization among healthy participants. To this end, 1175 participants completed a differential fear conditioning phase followed by a generalization test. To identify patterns of fear generalization, we used a k-means clustering algorithm based on individual arousal generalization gradients. Subsequently, we examined the reliability and validity of the clusters and phenotypical differences between subgroups on the basis of psychometric data and markers of fear expression. Cluster analysis reliably revealed five clusters that systematically differed in mean responses, differentiation between conditioned threat and safety, and linearity of the generalization gradients, though mean response levels accounted for most variance. Remarkably, the patterns of mean responses were already evident during fear acquisition and corresponded most closely to psychometric measures of anxiety traits. The identified clusters reliably described subgroups of healthy individuals with distinct response characteristics in a fear generalization test. Following a dimensional view of psychopathology, these clusters likely delineate risk factors for anxiety disorders. As crucial group characteristics were already evident during fear acquisition, our results emphasize the importance of average fear responses and differentiation between conditioned threat and safety as risk factors for anxiety disorders

How to Measure Fear Generalization? Reliability and Validity of Commonly Used Indices

The ability to adaptively transfer acquired fear to novel situations is fundamental for survival in ever-changing environments and may contribute to the emergence and persistence of anxiety disorders. Consequently, research has focused on the assessment of fear generalization profiles to predict individual differences in trait anxiousness. However, substantial heterogeneity in the measurement and operationalization of generalization hampers comparisons across studies and poses a risk to the replicability of findings. To address these issues, we reviewed the literature to identify commonly used methods for characterizing fear generalization profiles. We then conducted simulation analyses to examine correlations between indices and probe their robustness against measurement noise. Finally, we used two large empirical datasets (N = 1,175 and N = 256) to examine the reliability of these indices and their validity in predicting psychopathology. All identified indices were substantially correlated but highly sensitive to measurement noise, with only minimal differences between methods. Reliabilities were moderate for subjective ratings but poor for skin conductance responses. All indices of fear generalization were unrelated to individual levels of anxiousness. Overall, a more comprehensive discussion of conceptual and methodological issues is needed to better understand how fear generalization contributes to the etiology and maintenance of anxiety disorders

Author Correction: CHD3 helicase domain mutations cause a neurodevelopmental syndrome with macrocephaly and impaired speech and language

The original version of this Article contained an error in the spelling of the author Laurence Faivre, which was incorrectly given as Laurence Faive. This has now been corrected in both the PDF and HTML versions of the Article