Bile acids are recognised as bioactive signalling molecules. While they are known to influence arrhythmia susceptibility in cholestasis, there is limited knowledge about the underlying mechanisms. To ...delineate mechanisms underlying fetal heart rhythm disturbances in cholestatic pregnancy, we used FRET microscopy to monitor cAMP release and contraction measurements in isolated rodent neonatal cardiomyocytes. The unconjugated bile acids CDCA, DCA and UDCA and, to a lesser extent, CA were found to be relatively potent agonists for the GPBAR1 (TGR5) receptor and elicit cAMP release, whereas all glyco- and tauro- conjugated bile acids are weak agonists. The bile acid-induced cAMP production does not lead to an increase in contraction rate, and seems to be mediated by the RI isoform of adenylate cyclase, unlike adrenaline-dependent release which is mediated by the RII isoform. In contrast, bile acids elicited slowing of neonatal cardiomyocyte contraction indicating that other signalling pathways are involved. The conjugated bile acids were found to be partial agonists of the muscarinic M
but not sphingosin-1-phosphate-2, receptors, and act partially through the G
pathway. Furthermore, the contraction slowing effect of unconjugated bile acids may also relate to cytotoxicity at higher concentrations.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
When activated by proinflammatory stimuli, microglia release substantial levels of glutamate, and mounting evidence suggests this contributes to neuronal damage during neuroinflammation. Prior ...studies indicated a role for the Xc exchange system, an amino acid transporter that antiports glutamate for cystine. Because cystine is used for synthesis of glutathione (GSH) synthesis, we hypothesized that glutamate release is an indirect consequence of GSH depletion by the respiratory burst, which produces superoxide from NADPH oxidase. Microglial glutamate release triggered by lipopolysaccharide was blocked by diphenylene iodonium chloride and apocynin, inhibitors of NADPH oxidase. This glutamate release was also blocked by vitamin E and elicited by lipid peroxidation products 4-hydroxynonenal and acrolein, suggesting that lipid peroxidation makes crucial demands on GSH. Although NADPH oxidase inhibitors also suppressed nitrite accumulation, vitamin E did not; moreover, glutamate release was largely unaffected by nitric oxide donors, inhibitors of nitric oxide synthase, or changes in gene expression. These findings indicate that a considerable degree of the neurodegenerative consequences of neuroinflammation may result from conversion of oxidative stress to excitotoxic stress. This phenomenon entails a biochemical chain of events initiated by a programmed oxidative stress and resultant mass-action amino acid transport. Indeed, some of the neuroprotective effects of antioxidants may be due to interference with these events rather than direct protection against neuronal oxidation.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
To identify research and gaps in literature about FGM/C–related attitudes and experiences among individuals from FGM/C–practicing countries living in the United States, we conducted a scoping review ...guided by Arksey and O’Malley’s framework. We searched Medline (OVID), Embase (OVID), PubMed, and SCOPUS and conducted a grey literature search for studies assessing attitudes or experiences related to FGM/C with data collected directly from individuals from FGM/C-practicing countries living in the United States. The search yielded 417 studies, and 40 met the inclusion criteria. Findings suggest that women and men from FGM/C-practicing countries living in the United States generally oppose FGM/C, and that women with FGM/C have significant physical and mental health needs and have found US healthcare providers to lack understanding of FGM/C. Future research can improve measurement of FGM/C by taking into account the sociocultural influences on FGM/C–related attitudes and experiences.
The Women's Health Needs Study (WHNS) collected information on the health characteristics, needs, and experiences, including female genital mutilation (FGM) experiences, attitudes, and beliefs, of ...women aged 18 to 49 years who were born, or whose mothers were born, in a country where FGM is prevalent living in the US. The purpose of this paper is to describe the WHNS design, methods, strengths and limitations, as well as select demographic and health-related characteristics of participants.
We conducted a cross-sectional survey from November 2020 -June 2021 in four US metropolitan areas, using a hybrid venue-based sampling (VBS) and respondent-driven sampling (RDS) approach to identify women for recruitment.
Of 1,132 participants, 395 were recruited via VBS and 737 RDS. Most were born, or their mothers were born, in either a West African country (Burkina Faso, Guinea, Mali, Mauritania, Sierra Leone, The Gambia) (39.0%) or Ethiopia (30.7%). More than a third were aged 30-39 years (37.5%) with a majority who immigrated at ages ≥13 years (86.6%) and had lived in the United States for ≥5 years (68.9%). Medicaid was the top health insurer (52.5%), followed by private health insurance (30.5%); 17% of participants had no insurance. Nearly half of women reported 1-2 healthcare visits within the past 12 months (47.7%). One in seven did not get needed health care due to cost (14.8%). Over half have ever used contraception (52.1%) to delay or avoid pregnancy and 76.9% had their last pelvic and/or Papanicolaou (pap) exam within the past 3 years. More than half experienced FGM (55.0%). Nearly all women believed that FGM should be stopped (92.0%).
The VBS/RDS approach enabled recruitment of a diverse study population. WHNS advances research related to the health characteristics, needs, and experiences of women living in the US from countries where FGM is prevalent.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background Previous research shows that the prevalence of intimate partner violence (IPV) around the time of pregnancy varies from 4% to 9%, but no studies have distinguished between abuse rates by ...former versus current partners. Purpose This study aims to estimate the prevalence of IPV among U.S. women shortly before and during pregnancy and to compare the rates and predictors of abuse perpetrated by current partners with the rates and predictors of abuse perpetrated by former partners. Methods Using data from 27 states and New York City, the prevalence of physical abuse by current and former intimate male partners was estimated among 134,955 women who delivered a singleton, full-term infant in 2004–2007. Multivariable logistic regression was used to determine the demographic, pregnancy-related, and stress factors that predicted the risk of IPV. Results Prevalence of IPV from either a former or current partner was 5.3% before and 3.6% during pregnancy. Prevalence of abuse by a former partner was consistently higher than the prevalence of abuse by a current partner. The three strongest predictors of IPV during pregnancy were the woman's partner not wanting the pregnancy (current: AOR=3.47, 95% CI=3.13, 3.85; former: AOR=3.22, 95% CI=2.90, 3.76); having had a recent divorce or separation (current: AOR=3.23, 95% CI=2.92, 3.58; former: AOR=3.54, 95% CI=3.20, 3.91); and being close to someone having a drug or alcohol problem (current: AOR=3.05, 95% CI=2.78, 3.36; former: AOR=2.97, 95% CI=2.70, 3.27). Maternal characteristics (age, education, race, marital status, woman did not want the pregnancy) were less important predictors. Conclusions Assessments of abuse should ask specifically about actions by both current and ex-partners.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Using a nationally representative sample from the 2008 Paraguayan National Survey of Demography and Sexual and Reproductive Health, we examine the association between emotional, physical, and sexual ...intimate partner violence (IPV) and mental health among women aged 15–44 years who have ever been married or in a consensual union. The results from multivariate logistic regression models demonstrate that controlling for women’s socioeconomic and marital status and history of childhood abuse and their male partners’ unemployment and alcohol consumption, IPV is independently associated with an increased risk for common mental disorders (CMD) and suicidal ideation measured by the Self Reporting Questionnaire (SRQ-20). IPV variables substantially improve the explanatory power of the models, particularly for suicidal ideation. Emotional abuse, regardless of when it occurred, is associated with the greatest increased risk for CMD whereas recent physical abuse is associated with the greatest increased risk for suicidal ideation. These findings suggest that efforts to identify women with mental health problems, particularly suicidal ideation, should include screening for the types and history of IPV victimization.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
In her article "Mapping Memory in Tran's Vietnamerica" Mary Goodwin explores the use of maps, landscape paintings, and other topographic images in Gia-Bao Tran's graphic memoir chronicling the ..."postmemory" of the US-American son of wartime refugees. Tran's family immigrated to the United States in 1975 following the fall of Saigon. Tran knew nothing of his parents' hardships and struggle to escape Vietnam until he returned for relatives' funerals in his 20s. Similar to Spiegelman's Maus, Vietnamerica is a mixed-media memoir containing photographs, maps, and comics in various styles. Following Hirsch's lead in demonstrating the special historical value of photographs in Maus, Goodwin argues for the unique value of the maps and landscape visuals Tran uses to relate Vietnam's history and his family's experiences. The medium of the graphic novel presents its own challenges as auto/biography and historical record and topographic images introduce a complication in juxtaposing the "real" public world with the personal and individual. Thus Vietamerica becomes an ever-shifting kaleidoscope of perspective on a multi-dimensional history of war, exile, and personal struggles to come to terms with cultural and familial identity.
We evaluated nucleic acid amplification testing (NAAT) for Zika virus on whole-blood specimens compared with NAAT on serum and urine specimens among asymptomatic pregnant women during the 2015-2016 ...Puerto Rico Zika outbreak. Using NAAT, more infections were detected in serum and urine than in whole blood specimens.
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DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Travel to Japan inspired in writers Lafcadio Hearn and Angela Carter new perspectives on the Gothic vision that played a prominent role in their work. Hearn, an Anglo-American literary journalist ...whose essays and short fiction in New Orleans and the French West Indies evinced a strong penchant for the macabre and the occult, found in fin-de-siecle Japan his dream home. Hearn, who became a Japanese citizen, made a name for himself that endures to the present day with his observations of Japanese life, customs and history, as well as his reworking of old legends and tales of the weird and supernatural. Nearly a century later, British novelist and short-story writer Angela Carter spent two years in Japan and produced a collection of travel articles and stories based on her experiences there. Although the travel motif has always been a feature of Gothic fiction, in this essay I analyze the Gothic mode as it appears in the travel literature Hearn and Carter produced, in which they reworked the Gothic tradition they had inherited to produce work that reveals startling insights into cultural crossing and personal identity, inflected with race, status and gender norms. New approaches to both the Self and Other emerge from their innovations to the Gothic genre from the remote perspective of Japan, a country that metamorphoses in their writing into both a scenic location and a symbolic imaginary that haunts Hearn and Carter, and their readers, in different ways.
Maternal and perinatal mortality is a global development priority that continues to present major challenges in sub-Saharan Africa. Saving Mothers, Giving Life (SMGL) was a multipartner initiative ...implemented from 2012 to 2017 with the goal of improving maternal and perinatal health in high-mortality settings. The initiative accomplished this by reducing delays to timely and appropriate obstetric care through the introduction and support of community and facility evidence-based and district-wide health systems strengthening interventions.
SMGL-designated pilot districts in Uganda and Zambia documented baseline and endline maternal and perinatal health outcomes using multiple approaches. These included health facility assessments, pregnancy outcome monitoring, enhanced maternal mortality detection in facilities, and district population-based identification and investigation of maternal deaths in communities.
Over the course of the 5-year SMGL initiative, population-based estimates documented a 44% reduction in the SMGL-supported district-wide maternal mortality ratio (MMR) in Uganda (from 452 to 255 maternal deaths per 100,000 live births) and a 41% reduction in Zambia (from 480 to 284 maternal deaths per 100,000 live births). The MMR in SMGL-supported health facilities declined by 44% in Uganda and by 38% in Zambia. The institutional delivery rate increased by 47% in Uganda (from 45.5% to 66.8% of district births) and by 44% in Zambia (from 62.6% to 90.2% of district births). The number of facilities providing emergency obstetric and newborn care (EmONC) rose from 10 to 26 in Uganda and from 7 to 13 in Zambia, and lower- and mid-level facilities increased the number of EmONC signal functions performed. Cesarean delivery rates increased by more than 70% in both countries, reaching 9% and 5% of all births in Uganda and Zambia districts, respectively. Maternal deaths in facilities due to obstetric hemorrhage declined by 42% in Uganda and 65% in Zambia. Overall, perinatal mortality rates declined, largely due to reductions in stillbirths in both countries; however, no statistically significant changes were found in predischarge neonatal death rates in predischarge either country.
MMRs fell significantly in Uganda and Zambia following the introduction of the SMGL interventions, and SMGL's comprehensive district systems-strengthening approach successfully improved coverage and quality of care for mothers and newborns. The lessons learned from the initiative can inform policy makers and program managers in other low- and middle-income settings where similar approaches could be used to rapidly reduce preventable maternal and newborn deaths.
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