The impact of betel quid chewing during pregnancy on pregnancy outcomes in Bhutan

Betel (areca) nut is the fourth most widely used psychoactive substance globally, accounting for 10-20% of the world’s population. Its most basic form is betel ‘quid’ which consists of betel leaf, betel nut (the main psychoactive ingredient) and slaked lime. Evidence that betel quid and betel nut alone are associated with oral cancer has been established. Background: While there is a substantial body of evidence on the impact of health-risk behaviours including smoking and drinking alcohol on adverse pregnancy outcomes, studies on the impact of betel quid chewing on pregnancy outcomes are sparse and heterogeneous. Although several studies report the negative impact of betel quid chewing on pregnancy outcomes, the evidence is inconclusive. One of the challenges in understanding the impact of betel quid is to distinguish the impact of betel quid chewing from the impact of smoking. Bhutan, where low prevalence of smoking and high prevalence of betel-quid chewing are reported, provides a natural experimental environment for taking a close look at the impact of betel quid chewing alone. As a part of the global agenda to address preterm births (PTB) as a public health priority and in order to provide evidence to inform efforts to reduce neonatal morbidity and mortality in Bhutan, this study explores the impact of betel quid chewing on birth outcomes and its importance in relation to other risk factors. Methods: This study used a multi-centre case-control design. A case was defined as a mother of a singleton live born infant whose gestational age is less than 37 completed weeks and/or an infant whose birth weight is less than 2500 g. A control was defined as a mother of singleton live born term babies whose birth weight was more than 2500g and gestational age was greater than 37 weeks. Information was collected using a semi-structured questionnaire from February 2015 to the beginning of March 2016 at the three referral hospitals in Bhutan. Study participants were recruited by a trained interviewer during their post-delivery stay before discharge from each hospital. A statistical approach and a causal directed acyclic graph (DAG) approach were used for building logistic regression models. Results: Of the 669 study participants, 55% of the case mothers and 52% of the control mothers chewed betel quid during pregnancy. About 22% of cases and 22% of controls used commercial betel products during pregnancy. In total, 60% of the case mothers and 57% of the control mothers chewed either betel quid or packaged betel products during pregnancy. Neither the statistical approach nor DAG approach provided clear evidence of an association between betel quid use and low birth weight (LBW) or PTB. The adjusted odds ratio (aOR) of term LBW was 1.07 (95% CI: 8 0.54-2.13, p=0.845) in the statistical approach while the aOR of term LBW was 1.30 (95% CI: 0.74-2.27, p=0.439) in the DAG approach. Using the DAG approach, the aOR of PTB in association with betel quid chewing during pregnancy was 1.20 (95% CI: 0.72-2.00, p=0.614). When the total number of betel nuts consumed during the last three months of pregnancy was used as an exposure variable, the aOR for mothers who consumed more than one nut per day was 1.39 for term LBW (95%:0.52-3.68, p=0.514) and the aOR of PTB was 0.66 (95% CI: 0.27-1.66, p=0.383) compared to non-chewers. For a secondary outcome, the data suggest betel quid chewing is associated with increased odds of anaemia (aOR 2.09, 95% CI 1.27-3.43, p=0.004). Using the DAG approach, tobacco and alcohol use during pregnancy, low gestational weight gain, and urinary tract infection showed a clear association with term LBW and PTB. Conclusion: In the present study, the results provide no clear evidence of an association between term LBW or PTB and betel quid chewing during pregnancy. For a secondary outcome, the data suggest betel quid chewing is associated with increased odds of anaemia. The present study provides rich baseline data for mothers and established a cohort of cases and controls, which could be followed up to understand the short- and long-term effects of LBW and PTB and may help design effective interventions

L-Tryptophan Production by Auxotrophic and Analogue Resistant Mutants of Aureobacterium flavescens

A number of tyrosine plus phenylalanine double auxotrophic mutants were isolated by N-methyl-N-nitro-N-nitrosoguanidine (MNNG) treatment of a locally isolated strain of Aureobacterium flavescens of which 11A39 and 11A17 were selected on the basis of their tryptophan production in a mineral salt medium over other isolated mutant strains. The mutational block in the aromatic amino acid biosynthetic pathway of the selected double auxotrophs were determined. By controlling pH of the production medium to near neutrality, the active growth period could be extended up to 72 h and more tryptophan was accumulated compared to pH unregulated culture where the active growth ceased after 48 h. Further improvement of the tryptophan production has been achieved by stepwise isolation of a mutant strain resistant to the tryptophan analogues p-fluorotryptophan (FT) and 5-methyl tryptophan (MT) from the 11A39. Demand for L-tryptophan as food additive and therapeutic agent is increasing day by day throughout the World, particularly in the underdeveloped and developing countries like India. Still to date India depends on other countries for L-tryptophan. The aim of this work is to develop a potent high yielding, feed back insensitive mutant strain and optimization of its medium pH for maximum production of tryptophan

3D FCN Feature Driven Regression Forest-Based Pancreas Localization and Segmentation

This paper presents a fully automated atlas-based pancreas segmentation method from CT volumes utilizing 3D fully convolutional network (FCN) feature-based pancreas localization. Segmentation of the pancreas is difficult because it has larger inter-patient spatial variations than other organs. Previous pancreas segmentation methods failed to deal with such variations. We propose a fully automated pancreas segmentation method that contains novel localization and segmentation. Since the pancreas neighbors many other organs, its position and size are strongly related to the positions of the surrounding organs. We estimate the position and the size of the pancreas (localized) from global features by regression forests. As global features, we use intensity differences and 3D FCN deep learned features, which include automatically extracted essential features for segmentation. We chose 3D FCN features from a trained 3D U-Net, which is trained to perform multi-organ segmentation. The global features include both the pancreas and surrounding organ information. After localization, a patient-specific probabilistic atlas-based pancreas segmentation is performed. In evaluation results with 146 CT volumes, we achieved 60.6% of the Jaccard index and 73.9% of the Dice overlap.Comment: Presented in MICCAI 2017 workshop, DLMIA 2017 (Deep Learning in Medical Image Analysis and Multimodal Learning for Clinical Decision Support

Satellite DNA in Paphiopedilum subgenus Parvisepalum as revealed by high-throughput sequencing and fluorescent in situ hybridization

Background: Satellite DNA is a rapidly diverging, largely repetitive DNA component of many eukaryotic genomes. Here we analyse the evolutionary dynamics of a satellite DNA repeat in the genomes of a group of Asian subtropical lady slipper orchids (Paphiopedilum subgenus Parvisepalum and representative species in the other subgenera/sections across the genus). A new satellite repeat in Paphiopedilum subgenus Parvisepalum, SatA, was identified and characterized using the RepeatExplorer pipeline in HiSeq Illumina reads from P. armeniacum (2n = 26). Reconstructed monomers were used to design a satellite-specific fluorescent in situ hybridization (FISH) probe. The data were also analysed within a phylogenetic framework built using the internal transcribed spacer (ITS) sequences of 45S nuclear ribosomal DNA. Results: SatA comprises c. 14.5% of the P. armeniacum genome and is specific to subgenus Parvisepalum. It is composed of four primary monomers that range from 230 to 359 bp and contains multiple inverted repeat regions with hairpin loop motifs. A new karyotype of P. vietnamense (2n = 28) is presented and shows that the chromosome number in subgenus Parvisepalum is not conserved at 2n = 26, as previously reported. The physical locations of SatA sequences were visualised on the chromosomes of all seven Paphiopedilum species of subgenus Parvisepalum (2n = 26–28), together with the 5S and 45S rDNA loci using FISH. The SatA repeats were predominantly localisedin the centromeric, peri-centromeric and sub-telocentric chromosome regions, but the exact distribution pattern was species-specific. Conclusions: We conclude that the newly discovered, highly abundant and rapidly evolving satellite sequence SatA is specific to Paphiopedilum subgenus Parvisepalum. SatA and rDNA chromosomal distributions are characteristic of species, and comparisons between species reveal that the distribution patterns generate a strong phylogenetic signal. We also conclude that the ancestral chromosome number of subgenus Parvisepalum and indeed of all Paphiopedilum could be either 2n = 26 or 28, if P. vietnamense is sister to all species in the subgenus as suggested by the ITS data

Seroepidemiology of Toxoplasma gondii infection in patients with liver disease in eastern China

The role of the protozoan parasite Toxoplasma gondii in the pathogenesis of liver disease has recently gained much interest. The aim of this study was to determine the prevalence and risk factors associated with T. gondii infection in patients with liver disease from three cities in Shandong and Henan provinces, China. A case–control study was conducted from December 2014 to November 2015 and included 1142 patients with liver disease and 1142 healthy controls. Serum samples were collected from all individuals and were examined with enzyme-linked immunosorbent assay for the presence of anti-T. gondii IgG and IgM antibodies. Information on the demographics, clinical, and lifestyle characteristics of the participants was collected from the medical records and by the use of a questionnaire. The prevalence of anti-T. gondii IgG was 19·7% in patients with liver disease compared with 12·17% in the controls. Only 13 patients had anti-T. gondii IgM antibodies compared with 12 control individuals (1·14% vs. 1·05%, respectively). The highest seroprevalence was detected in patients with liver cancer (22·13%), followed by hepatitis patients (20·86%), liver cirrhosis patients (20·42%), and steatosis patients (20%). Multivariate logistic regression analysis indicated that consumption of raw meat (odds ratio (OR) = 1·32; 95% confidence interval (CI) 1·01–1·71; P = 0·03) and source of drinking water from wells (OR = 1·56; 95% CI 1·08–2·27; P = 0·01) were independent risk factors for T. gondii infection in liver disease patients. These findings indicate that T. gondii infection is more likely to be present in patients with liver disease. Therefore, efforts should be directed toward health education of populations at high risk of T. gondii infection and measures should be taken to protect vulnerable patients with liver disease

Quantum Gate Fidelity in Terms of Choi Matrices

We provide new results for computing and comparing the quantum gate fidelity of quantum channels via their Choi matrices. We extend recent work that showed there exist non-dual pairs of quantum channels with equal gate fidelity by providing an explicit characterization of all such channels. We use our characterization to show that when the dimension is 2 (or 3, under slightly stronger hypotheses), the gate fidelity of two channels is equal if and only if their difference equals the difference of some unital map and its dual -- a fact that has been shown to be false when the dimension is 4 or larger. We also present a formula for the minimum gate fidelity of a channel in terms of a well-studied norm on a compression of its Choi matrix. As a consequence, several new ways of bounding and approximating the minimum gate fidelity follow, including a simple semidefinite program to compute it for qubit channels.Comment: Minor corrections and updates since v1. 16 pages, 1 figur

The Ship of Theseus Puzzle

Does the Ship of Theseus present a genuine puzzle about persistence due to conflicting intuitions based on “continuity of form” and “continuity of matter” pulling in opposite directions? Philosophers are divided. Some claim that it presents a genuine puzzle but disagree over whether there is a solution. Others claim that there is no puzzle at all since the case has an obvious solution. To assess these proposals, we conducted a cross-cultural study involving nearly 3,000 people across twenty-two countries, speaking eighteen different languages. Our results speak against the proposal that there is no puzzle at all and against the proposal that there is a puzzle but one that has no solution. Our results suggest that there are two criteria—“continuity of form” and “continuity of matter”— that constitute our concept of persistence and these two criteria receive different weightings in settling matters concerning persistence

Carrier concentration dependence of optical Kerr nonlinearity in indium tin oxide films

Optical Kerr nonlinearity (n2) in n-type indium tin oxide (ITO) films coated on glass substrates has been measured using Z-scans with 200-fs laser pulses at wavelengths ranging from 720 to 780 nm. The magnitudes of the measured nonlinearity in the ITO films were found to be dependent on the carrier concentration with a maximum n2-value of 4.1 x 10-5 cm2/GW at 720-nm wavelength and an electron density of Nd = 5.8 x 1020 cm-3. The Kerr nonlinearity was also observed to be varied with the laser wavelength. By employing a femtosecond time-resolved optical Kerr effect (OKE) technique, the relaxation time of OKE in the ITO films is determined to be ~1 ps. These findings suggest that the Kerr nonlinearity in ITO can be tailored by controlling the carrier concentration, which should be highly desirable in optoelectronic devices for ultrafast all-optical switching.Comment: 15 pages, 1 table, 4 figure