A translational approach to studying preterm labour

Preterm labour continues to be a major contributor to neonatal and infant morbidity. Recent data from the USA indicate that the number of preterm deliveries (including those associated with preterm labour) has risen in the last 20 years by 30%. This increase is despite considerable efforts to introduce new therapies for the prevention and treatment of preterm labour and highlights the need to assess research in this area from a fresh perspective. In this paper we discuss i) the limitations of our knowledge concerning prediction, prevention and treatment of preterm labour and ii) future multidisciplinary strategies for improving our approach

SARS-CoV-2 seroprevalence in pregnant women in Kilifi, Kenya from March 2020 to March 2022

BackgroundSeroprevalence studies are an alternative approach to estimating the extent of transmission of SARS-CoV-2 and the evolution of the pandemic in different geographical settings. We aimed to determine the SARS-CoV-2 seroprevalence from March 2020 to March 2022 in a rural and urban setting in Kilifi County, Kenya.MethodsWe obtained representative random samples of stored serum from a pregnancy cohort study for the period March 2020 to March 2022 and tested for antibodies against the spike protein using a qualitative SARS-CoV-2 ELISA kit (Wantai, total antibodies). All positive samples were retested for anti-SARS-CoV-2 anti-nucleocapsid antibodies (Euroimmun, ELISA kits, NCP, qualitative, IgG) and anti-spike protein antibodies (Euroimmun, ELISA kits, QuantiVac; quantitative, IgG).ResultsA total of 2,495 (of 4,703 available) samples were tested. There was an overall trend of increasing seropositivity from a low of 0% [95% CI 0–0.06] in March 2020 to a high of 89.4% [95% CI 83.36–93.82] in Feb 2022. Of the Wantai test-positive samples, 59.7% [95% CI 57.06–62.34] tested positive by the Euroimmun anti-SARS-CoV-2 NCP test and 37.4% [95% CI 34.83–40.04] tested positive by the Euroimmun anti-SARS-CoV-2 QuantiVac test. No differences were observed between the urban and rural hospital but villages adjacent to the major highway traversing the study area had a higher seroprevalence.ConclusionAnti-SARS-CoV-2 seroprevalence rose rapidly, with most of the population exposed to SARS-CoV-2 within 23 months of the first cases. The high cumulative seroprevalence suggests greater population exposure to SARS-CoV-2 than that reported from surveillance data

Evaluation of outcomes of a formative objective structured clinical examination for second-year UK medical students

OBJECTIVES: To explore how formative OSCEs influence student performance and perception when undertaking summative OSCEs. METHODS: We introduced formative OSCEs for second-year medical students at a large London medical school. Examination data from both formative and subsequent summative OSCEs were analysed to determine the effect on summative OSCE performance. We gathered student perceptions using an anonymous online survey tool. The data was investigated using a standard scale of 1 to 5 and qualitative analysis of free text. RESULTS: Overall, 46.6% and 85.0% of students passed the formative and summative OSCEs respectively. Formative OSCEs did not improve overall pass rates in summative OSCEs. Inclusion of an individual formative station was associated with improved performance in that station in summative OSCEs, with one exception. Formative OSCEs had a positive predictive value of 92.5% for passing the summative OSCE but limited negative predictive value. Students who passed fewer than two out of three formative OSCE stations were significantly more likely to fail the summative OSCE (78.2% vs 89.7%, p <0.001). Students felt formative OSCEs were good exam preparation and suggested logistical changes. CONCLUSION: Formative OSCEs were associated with improved performance in subsequent summative OSCEs only for identical stations. They did not improve overall pass rates in summative OSCEs, and did not predict performance well. Students viewed the formative OSCE as a positive and useful activity. However, to maximise its benefit as a tool for learning, students need better communication about the role and purpose of formative OSCEs

A role for voltage-gated, but not Ca(2+)-activated, K(+) channels in regulating spontaneous contractile activity in myometrium from virgin and pregnant rats

1. The roles of voltage-gated (K(V)) and large conductance Ca(2+)-activated K(+) (BK(Ca)) channels in regulating basal contractility in myometrial smooth muscle are unresolved. The aim of this study was to determine the effects of inhibition of these channels on spontaneous rhythmic contraction in myometrial strips from four groups of rats: nonpregnant and during early (day 7), mid- (day 14), and late (day 21) pregnancy. 2. BK(Ca) channels were inhibited using iberiotoxin (1–100 nM), paxilline (1–10 μM) or penitrem A (1–500, or 3000 nM); K(V) channels were inhibited using tetraethylammonium (TEA; 1–10 mM) and/or 4-aminopyridine (4-AP; 1–5 mM). Contractility was assessed as mean integral tension (MIT). Time/vehicle controls were also performed. 3. None of the selective BK(Ca) channel inhibitors significantly affected contractility in myometrial strips from either nonpregnant or pregnant animals. 4. 4-AP caused concentration-dependent increases in MIT in myometrium in all four groups. TEA (5 and 10 mM) significantly increased MIT in myometrium from nonpregnant, and mid- and late pregnant rats, but not in myometrium from early pregnant rats. TEA and 4-AP still caused an increase in MIT following treatment with 3000 nM penitrem A or a combination of propranolol, phentolamine, atropine (all 1 μM) and capsaicin (10 μM) in myometrial strips from nonpregnant rats. 5. These results indicate that whereas BK(Ca) channels play little or no part in controlling basal rhythmicity in rat myometrium, K(V) channels appear to play a crucial role in this regard, especially during mid- and late pregnancy