Evidence on the impact of low-molecular-weight heparin, alone or in combination with low-dose aspirin, for the prevention for preeclampsia in high-risk patients is conflicting.
We conducted a ...meta-analysis of studies published to assess the effectiveness of low-molecular-weight heparin for the prevention of preeclampsia and other placenta-related complications in high-risk women.
A systematic search was performed to identify relevant studies, using the databases PubMed and Cochrane Central Register of Controlled Trials, without publication time restrictions.
Randomized controlled trials comparing treatment with low-molecular-weight heparin or unfractionated heparin (with or without low-dose aspirin), in high-risk women, defined as either history of preeclampsia, intrauterine growth restriction, fetal demise, or miscarriage or being at high risk after first-trimester screening of preeclampsia.
The systematic review was conducted according to the Cochrane Handbook guidelines. The primary outcome was the development of preeclampsia. We performed prespecified subgroup analyses according to combination with low-dose aspirin, low-molecular-weight heparin type, gestational age when treatment was started, and study population (patients with thrombophilia, at high risk of preeclampsia or miscarriage). Secondary outcomes included small for gestational age, perinatal death, miscarriage, and placental abruption. Pooled odds ratios with 95% confidence intervals were calculated using a random-effects model. Quality of evidence was assessed using the grading of recommendations assessment, development, and evaluation methodology.
A total of 15 studies (2795 participants) were included. In high-risk women, treatment with low-molecular-weight heparin was associated with a reduction in the development of preeclampsia (odds ratio, 0.62; 95% confidence interval, 0.43–0.90; P=.010); small for gestational age (odds ratio, 0.61; 95% confidence interval, 0.44–0.85; P=.003), and perinatal death (odds ratio, 0.49; 95% confidence interval, 0.25–0.94; P=.030). This reduction was stronger if low-molecular-weight heparin was started before 16 weeks’ gestation (13 studies, 2474 participants) for preeclampsia (odds ratio, 0.55; 95% confidence interval, 0.39–0.76; P=.0004). When only studies including low-dose aspirin as an intervention were analyzed (6 randomized controlled trials, 920 participants), a significant reduction was observed in those with combined treatment (low-molecular-weight heparin plus low-dose aspirin) compared with low-dose aspirin alone (odds ratio, 0.62; 95% confidence interval, 0.41–0.95; P=.030). Overall, adverse events were neither serious nor significantly different. Quality of evidence ranged from very low to moderate, mostly because of the lack of blinding, imprecision, and inconsistency.
Low-molecular-weight heparin use was associated with a significant reduction in the risk of preeclampsia and other placenta-mediated complications in high-risk women and when treatment was started before 16 weeks’ gestation. Combined treatment with low-dose aspirin was associated with a significant reduction in the risk of preeclampsia compared with low-dose aspirin alone. However, there exists important clinical and statistical heterogeneity, and therefore, these results merit confirmation in large well-designed clinical trials.
We describe automated technologies to probe the structure of neural tissue at nanometer resolution and use them to generate a saturated reconstruction of a sub-volume of mouse neocortex in which all ...cellular objects (axons, dendrites, and glia) and many sub-cellular components (synapses, synaptic vesicles, spines, spine apparati, postsynaptic densities, and mitochondria) are rendered and itemized in a database. We explore these data to study physical properties of brain tissue. For example, by tracing the trajectories of all excitatory axons and noting their juxtapositions, both synaptic and non-synaptic, with every dendritic spine we refute the idea that physical proximity is sufficient to predict synaptic connectivity (the so-called Peters’ rule). This online minable database provides general access to the intrinsic complexity of the neocortex and enables further data-driven inquiries.
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•Tape-based pipeline for electron microscopic reconstruction of brain tissue•Annotated database of 1,700 synapses from a saturated reconstruction of cortex•Excitatory axon proximity to dendritic spines not sufficient to predict synapses
Automated technologies probing the structure of neural tissue at nanometer resolution generate a saturated reconstruction of a sub-volume of mouse neocortex, refuting the idea that physical proximity is sufficient to predict excitatory synaptic connectivity.
Objective
To analyze the impact of COVID‐19 on the number of births in Yucatan, Mexico during 2020 and 2021.
Material and Methods
A total of 470 651 live births occurred in Yucatan from January 1st, ...2008, to December 31st, 2021, and were included in the analysis. The monthly number of births observed during January 2008–February 2020 was used to describe pre‐pandemic trends. Time‐series analysis was applied to examine whether the number of births observed from December 2020 (9 months after the beginning of the pandemic) to December 2021 differed from the expected values. Trends in the number of births according to maternal age, parity and education were examined to identify changes differentiated by sociodemographic characteristics.
Results
The number of births in 2021 decreased by 18% (5869 births) compared with 2019, which represents a reduction from 12.89 to 12.48 per thousand inhabitants. The observed number of births from December 2020 to July 2021 was significantly lower than the figure expected. April (expected = 2863 vs. observed = 1722), May (expected = 2948 vs. observed = 1990), and June (expected = 2997 vs. observed = 1978) 2021 showed the largest differences between expected and observed values. Then, from August to December 2021, the observed number of births fell within the expected range. Birth decline was slightly more pronounced among mothers between 20 and 29 years of age and in those without previous offspring.
Conclusion
We provide evidence of birth decline in Yucatan during the COVID‐19 pandemic. Birth rate reduction in Yucatan doubled the world average and young women without children were the most affected.
Nutrient transport by rivers strongly influences ecosystem productivity and hypoxia zone formation in coastal areas. In this study, we estimated the transport of nitrogen and phosphorus by the ...Grijalva and Usumacinta rivers that combined represent the second largest source of fresh water into the Gulf of Mexico. Water samples were collected monthly within an annual cycle at different sites (mainstem and tributaries) in the Lower Grijalva and Usumacinta basins to encompass the seasonal variation in discharge. Nitrogen (total nitrogen, nitrate‐N, ammonium‐N, and nitrite‐N), phosphorus (total phosphorus, soluble reactive phosphorus), and chlorophyll concentrations were determined, and annual loads estimated using the Beale ratio approach. Nutrient and chlorophyll concentrations were greater in the Grijalva than in the Usumacinta River. Stronger seasonal patterns in nutrient concentrations and discharge were identified in the Usumacinta, evincing the flow regulation experimented by the Grijalva. In the Grijalva, higher nutrient concentrations were measured at the De la Sierra and Pichucalco rivers, compared to the regulated Carrizal. TN:TP ratios were greater during the dry season in both rivers, and higher TN:TP occurred in the Usumacinta than in the Grijalva. The Usumacinta showed greater nutrient loads (nitrogen, 26790.6 × 103 kg year−1; phosphorus, 3056.9 × 103 kg year−1) than the Grijalva (nitrogen 19974.7 × 103 kg year−1; phosphorus, 1941.8 × 103 kg year−1). However, the Grijalva River showed higher soluble reactive phosphorus and ammonium‐N loads and yields than the Usumacinta, likely explained by greater delivery of urban wastewater in the lower Grijalva Basin. The Grijalva–Usumacinta represents an important source of nitrogen compared to other rivers draining into the Gulf of Mexico, even though more disturbed rivers can exceed the phosphorus load. This study can contribute to the modelling of nutrient delivery into the Gulf of Mexico and to better understand the influence of tropical rivers in the formation of coastal hypoxia.
The Grijalva–Usumacinta river system is the second freshwater input and an important source of nutrients for the Gulf of Mexico.
Higher nutrient and chlorophyll concentrations were measured in the Grijalva River, as result of higher human pressures related to urbanization and agriculture.
Seasonal patterns in discharge and nutrient concentration were stronger in the Usumacinta River, evincing the flow regulation in the Grijalva.
The Usumacinta River showed higher nutrient load, although the Grijalva River transports more soluble reactive phosphorus and ammonium.
The
genus contains important pathogens, such as West Nile virus (WNV), Zika virus (ZIKV), and Dengue virus (DENV), which are enveloped plus-strand RNA viruses transmitted by mosquitoes and constitute ...a worrisome threat to global human and animal health. Currently no licensed drugs against them are available, being, thus, still necessary the search for effective antiviral molecules. In this line, a novel antiviral approach (economical, simple to use, and environmental friendly) is the use of natural compounds. Consequently, we have tested the antiviral potential of different polyphenols present in plants and natural products, such as wine and tea, against WNV, ZIKV, and DENV. So that, we assayed the effect of a panel of structurally related polyphenols delphinidin (D), cyanidin (Cy), catechin (C), epicatechin (EC), epigallocatechin (EGC), and epigallocatechin gallate (EGCG) on WNV infection, and found that D and EGCG inhibited more effectively the virus production. Further analysis with both compounds indicated that they mainly affected the attachment and entry steps of the virus life cycle. Moreover, D and EGCG showed a direct effect on WNV particles exerting a virucidal effect. We showed a similar inhibition of viral production of these compounds on WNV variants that differed on acidic pH requirements for viral fusion, indicating that their antiviral activity against WNV is produced by a virucidal effect rather than by an inhibition of pH-dependent viral fusion. Both polyphenols also reduced the infectivity of ZIKV and DENV. Therefore, D and EGCG impair the infectivity in cell culture of these three medically relevant flaviviruses.
Background
No data are available about whether Coronavirus disease 2019 (COVID‐19) pandemic have led to changes in clinical profiles or results of exercise testing once the usual activity was ...reassumed, as well as if wearing a facemask has any impact on the tests. The aim of this study is to evaluate differences in the patients referred to exercise stress testing in the context of COVID‐19 pandemic and analyse the feasibility and results of these tests wearing a facemask.
Methods
We included all patients referred for an exercise test from 1 June to 30 September 2020 and compared them with the patients attended within the same period in 2019 before and after propensity score matching. All patients referred in 2020 wore a facemask.
Results
A total of 854 patients were included: 398 in the 2020 group and 456 in 2019. No significant differences in baseline characteristics of the patients were observed, with the exception of dyspnoea, which was nearly twice as high in 2020 as compared with 2019. Regarding the results of the tests, no differences were observed, with almost 80% of maximal tests, similar functional capacity and over a 20% of positive exercise tests in both groups. These results remained after propensity score matching.
Conclusion
COVID‐19 pandemic has not changed the clinical profile of patients referred to exercise testing. In addition, performing exercise testing wearing a facemask is feasible, with no influence in functional capacity and clinical results.
Tissue engineering has been able to develop novel decellularization‐recellularization techniques, which facilitates the research for the generation of functional organs. This is based in the initial ...obtention of the organ's extracellular matrix (ECM). Therefore, any improvement in the decellularization process would have a positive impact in the results of the recellularization process. Nevertheless, commonly the methods and equipment employed for this process are expensive and thus limit the access of this technique to various research groups globally. To develop a decellularization technique with the exclusive use of hydrostatic pressure of detergent solutions, to have an easily accessible and low‐cost technique that meets the basic requirements of acellularity and functionality of the ECM. This experimental study was performed in 10 male Wistar rats, obtaining the liver to carry out serial washes, with 1%, 2%, and 3% Triton X‐100 solutions and 0.1% SDS. The washes were performed by using a gravity perfusion system (GPS), which assured us a continuous hydrostatic pressure of 7.5 mmHg. The obtained ECM was processed using stains and immunostaining to determine the residual cell content and preservation of its components. The staining showed a removal of cellular and nuclear components of approximately 97% of the acellular ECM, with an adequate three‐dimensional pattern of collagen and proteoglycans. Furthermore, the acellular ECM allowed the viability of a primary hepatocyte culture. The use of the GPS decellularization technique allowed us to obtain an acellular and functional ECM, drastically reducing experimentation costs.
Aging is the major risk factor for many human diseases. In vitro studies have demonstrated that cellular reprogramming to pluripotency reverses cellular age, but alteration of the aging process ...through reprogramming has not been directly demonstrated in vivo. Here, we report that partial reprogramming by short-term cyclic expression of Oct4, Sox2, Klf4, and c-Myc (OSKM) ameliorates cellular and physiological hallmarks of aging and prolongs lifespan in a mouse model of premature aging. Similarly, expression of OSKM in vivo improves recovery from metabolic disease and muscle injury in older wild-type mice. The amelioration of age-associated phenotypes by epigenetic remodeling during cellular reprogramming highlights the role of epigenetic dysregulation as a driver of mammalian aging. Establishing in vivo platforms to modulate age-associated epigenetic marks may provide further insights into the biology of aging.
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•Partial reprogramming erases cellular markers of aging in mouse and human cells•Induction of OSKM in progeria mice ameliorates signs of aging and extends lifespan•In vivo reprogramming improves regeneration in 12-month-old wild-type mice
Cellular reprogramming by transient expression of Yamanaka factors ameliorates age-associated symptoms, prolongs lifespan in progeroid mice, and improves tissue homeostasis in older mice.
On 31 December 2019, the Wuhan Municipal Committee of Health and Healthcare (Hubei Province, China) reported that there were 27 cases of pneumonia of unknown origin with symptoms starting on the 8 ...December. There were 7 serious cases with common exposure in market with shellfish, fish, and live animals, in the city of Wuhan. On 7 January 2020, the Chinese authorities identified that the agent causing the outbreak was a new type of virus of the
family, temporarily called «new coronavirus», 2019-nCoV. On January 30th, 2020, the World Health Organisation (WHO) declared the outbreak an International Emergency. On 11 February 2020 the WHO assigned it the name of SARS-CoV2 and COVID-19 (SARS-CoV2 and COVID-19). The Ministry of Health summoned the Specialties Societies to prepare a clinical protocol for the management of COVID-19. The Spanish Paediatric Association appointed a Working Group of the Societies of Paediatric Infectious Diseases and Paediatric Intensive Care to prepare the present recommendations with the evidence available at the time of preparing them.
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