Why do niches develop in Caesarean uterine scars? Hypotheses on the aetiology of niche development

First published online: September 25, 2015Caesarean section (CS) results in the occurrence of the phenomenon 'niche'. A 'niche' describes the presence of a hypoechoic area within the myometrium of the lower uterine segment, reflecting a discontinuation of the myometrium at the site of a previous CS. Using gel or saline instillation sonohysterography, a niche is identified in the scar in more than half of the women who had had a CS, most with the uterus closed in one single layer, without closure of the peritoneum. An incompletely healed scar is a long-term complication of the CS and is associated with more gynaecological symptoms than is commonly acknowledged. Approximately 30% of women with a niche report spotting at 6-12 months after their CS. Other reported symptoms in women with a niche are dysmenorrhoea, chronic pelvic pain and dyspareunia. Given the association between a niche and gynaecological symptoms, obstetric complications and potentially with subfertility, it is important to elucidate the aetiology of niche development after CS in order to develop preventive strategies. Based on current published data and our observations during sonographic, hysteroscopic and laparoscopic evaluations of niches we postulate some hypotheses on niche development. Possible factors that could play a role in niche development include a very low incision through cervical tissue, inadequate suturing technique during closure of the uterine scar, surgical interventions that increase adhesion formation or patient-related factors that impair wound healing or increase inflammation or adhesion formation.A.J.M.W. Vervoort, L.B. Uittenbogaard, W.J.K. Hehenkamp, H.A.M. Brölmann, B.W.J. Mol, and J.A.F. Huirn

Слобожанщина: літературний вимір

To determine diurnal variations in the physical and biological state of Lake Garda in early spring, high-resolution measurements were made of the vertical distribution of temperature and fluorescence in the upper 100 meters during 5–7 March 2014. In this paper, the results of these measurements are presented and a preliminary analysis that focuses on the connection between the vertical mixing coefficient K_T and the chlorophyll-a (chl-a) concentration is given. From these first direct measurements of turbulence-related quantities in Lake Garda, it is found that mixed-layer values of K_Tdecrease, while surface chl-a concentrations increase, over the day. Variations in K_Tcan be connected to the changes in the surface wind stress, while variations in chl-a are negatively correlated with the amplitude of K_T. In addition, satellite observations of the surface chl-a concentration are analysed to test their use for the calibration of the fluorescence measurements and also for their potential utility in remotely determining vertical mixing in the upper layers of the lake

The neurogenic basic helix–loop–helix transcription factor NeuroD6 confers tolerance to oxidative stress by triggering an antioxidant response and sustaining the mitochondrial biomass

Preserving mitochondrial mass, bioenergetic functions and ROS (reactive oxygen species) homoeostasis is key to neuronal differentiation and survival, as mitochondria produce most of the energy in the form of ATP to execute and maintain these cellular processes. In view of our previous studies showing that NeuroD6 promotes neuronal differentiation and survival on trophic factor withdrawal, combined with its ability to stimulate the mitochondrial biomass and to trigger comprehensive antiapoptotic and molecular chaperone responses, we investigated whether NeuroD6 could concomitantly modulate the mitochondrial biomass and ROS homoeostasis on oxidative stress mediated by serum deprivation. In the present study, we report a novel role of NeuroD6 as a regulator of ROS homoeostasis, resulting in enhanced tolerance to oxidative stress. Using a combination of flow cytometry, confocal fluorescence microscopy and mitochondrial fractionation, we found that NeuroD6 sustains mitochondrial mass, intracellular ATP levels and expression of specific subunits of respiratory complexes upon oxidative stress triggered by withdrawal of trophic factors. NeuroD6 also maintains the expression of nuclear-encoded transcription factors, known to regulate mitochondrial biogenesis, such as PGC-1α (peroxisome-proliferator-activated receptor γ co-activator-1α), Tfam (transcription factor A, mitochondrial) and NRF-1 (nuclear respiratory factor-1). Finally, NeuroD6 triggers a comprehensive antioxidant response to endow PC12-ND6 cells with intracellular ROS scavenging capacity. The NeuroD6 effect is not limited to the classic induction of the ROS-scavenging enzymes, such as SOD2 (superoxide dismutase 2), GPx1 (glutathione peroxidase 1) and PRDX5 (peroxiredoxin 5), but also to the recently identified powerful ROS suppressors PGC-1α, PINK1 (phosphatase and tensin homologue-induced kinase 1) and SIRT1. Thus our collective results support the concept that the NeuroD6–PGC-1α–SIRT1 neuroprotective axis may be critical in co-ordinating the mitochondrial biomass with the antioxidant reserve to confer tolerance to oxidative stress

Quantifying measures to limit wind driven resuspension of sediments for improvement of the ecological quality in some shallow Dutch lakes

Although phosphorus loadings are considered the main pressure for most shallow lakes, wind-driven resuspension can cause additional problems for these aquatic ecosystems. We quantified the potential effectiveness of measures to reduce the contribution of resuspended sediments, resulting from wind action, to the overall light attenuation for three comparable shallow peat lakes with poor ecological status in the Netherlands: Loosdrecht, Nieuwkoop, and Reeuwijk (1.8–2.7 m depth, 1.6–2.5 km fetch). These measures are: 1. wave reducing barriers, 2. water level fluctuations, 3. capping of the sediment with sand, and 4. combinations of above. Critical shear stress of the sediments for resuspension (Vcrit), size distribution, and optical properties of the suspended material were quantified in the field (June 2009) and laboratory. Water quality monitoring data (2002–2009) showed that light attenuation by organic suspended matter in all lakes is high. Spatial modeling of the impact of these measures showed that in Lake Loosdrecht limiting wave action can have significant effects (reductions from 6% exceedance to 2% exceedance of Vcrit), whereas in Lake Nieuwkoop and Lake Reeuwijk this is less effective. The depth distribution and shape of Lake Nieuwkoop and Lake Reeuwijk limit the role of wind-driven resuspension in the total suspended matter concentration. Although the lakes are similar in general appearance (origin, size, and depth range) measures suitable to improve their ecological status differ. This calls for care when defining the programme of measures to improve the ecological status of a specific lake based on experience from other lakes.

Crime and the NTE: multi-classification crime (MCC) hot spots in time and space

This paper examines crime hot spots near licensed premises in the night-time economy (NTE) to investigate whether hot spots of four different classification of crime and disorder co-occur in time and place, namely violence, disorder, drugs and criminal damage. It introduces the concept of multi-classification crime (MCC) hot spots; the presence of hot spots of more than one crime classification at the same place. Furthermore, it explores the temporal patterns of identified MCC hot spots, to determine if they exhibit distinct spatio-temporal patterns. Getis Ord (GI*) hot spot analysis was used to identify locations of statistically significant hot spots of each of the four crime and disorder classifications. Strong spatial correlations were found between licensed premises and each of the four crime and disorder classifications analysed. MCC hot spots were also identified near licensed premises. Temporal profiling of the MCC hot spots revealed all four crime types were simultaneously present in time and place, near licensed premises, on Friday through Sunday in the early hours of the morning around premise closing times. At other times, criminal damage and drugs hot spots were found to occur earlier in the evening, and disorder and violence at later time periods. Criminal damage and drug hot spots flared for shorter time periods, 2–3 h, whereas disorder and violence hot spots were present for several hours. There was a small spatial lag between Friday and Saturday, with offences occurring approximately 1 h later on Saturdays. The implications of these findings for hot spot policing are discussed

Intra-week spatial-temporal patterns of crime

Since its original publication, routine activity theory has proven most instructive for understanding temporal patterns in crime. The most prominent of the temporal crime patterns investigated is seasonality: crime (most often assault) increases during the summer months and decreases once routine activities are less often outside. Despite the rather widespread literature on the seasonality of crime, there is very little research investigating temporal patterns of crime at shorter time intervals such as within the week or even within the day. This paper contributes to this literature through a spatial-temporal analysis of crime patterns for different days of the week. It is found that temporal patterns are present for different days of the week (more crime on weekends, as would be expected) and there is a spatial component to that temporal change. Specifically, aside from robbery and sexual assault at the micro-spatial unit of analysis (street segments) the spatial patterns of crime changed. With regard to the spatial pattern changes, we found that assaults and theft from vehicle had their spatial patterns change in predictable ways on Saturdays: assaults increased in the bar district and theft from vehicles increased in the downtown and recreational car park areas