Respectful Maternity Care in the United States-Characterizing Inequities Experienced by Birthing People.

OBJECTIVE:  The purpose of this study is to understand experiences of respectful maternity care (RMC) from the perspective of birthing people in the United States from 2013 to 2018. METHODS:  We conducted an online cross-sectional survey of United States birthing people ages 18-50 in April 2018 using SurveyMonkey Audience. Quantitative survey data consisted of demographics and responses to RMC indicators. Qualitative data consisted of comments from individuals regarding their birth experiences. RESULTS:  1036 birthing people participated in the survey. Most births (95%) occurred in hospitals. 16.3% of Black or African American participants reported discrimination compared to 5.5% of participants who did not identify as Black or African American (p < 0.001). Participants who speak a language other than English were also more likely to report discrimination. 19.5% of all respondents felt neglected during their birth experience. Most prevalent experiences of disrespect and mistreatment were related to neglect (most commonly in postpartum phase of care), poor interpersonal communication, lack of respect for patient wishes, negative experience with breastfeeding services, peripartum complications, and discrimination. CONCLUSION FOR PRACTICE: Birthing people in the United States experience many forms of mistreatment, particularly those who identify as Black or African American or speak a language other than English. Patients described experiencing neglect most commonly after birth-an opportunity to improve the provision of RMC postpartum. Strategies to improve quality of maternal health care in the United States should include the provision of RMC as part of a larger effort to reduce inequities in maternal health experiences and outcomes.

Sedimentary pyrite sulfur isotope compositions preserve signatures of the surface microbial mat environment in sediments underlying low-oxygen cyanobacterial mats.

The sedimentary pyrite sulfur isotope (δ34 S) record is an archive of ancient microbial sulfur cycling and environmental conditions. Interpretations of pyrite δ34 S signatures in sediments deposited in microbial mat ecosystems are based on studies of modern microbial mat porewater sulfide δ34 S geochemistry. Pyrite δ34 S values often capture δ34 S signatures of porewater sulfide at the location of pyrite formation. However, microbial mats are dynamic environments in which biogeochemical cycling shifts vertically on diurnal cycles. Therefore, there is a need to study how the location of pyrite formation impacts pyrite δ34 S patterns in these dynamic systems. Here, we present diurnal porewater sulfide δ34 S trends and δ34 S values of pyrite and iron monosulfides from Middle Island Sinkhole, Lake Huron. The sediment-water interface of this sinkhole hosts a low-oxygen cyanobacterial mat ecosystem, which serves as a useful location to explore preservation of sedimentary pyrite δ34 S signatures in early Earth environments. Porewater sulfide δ34 S values vary by up to ~25‰ throughout the day due to light-driven changes in surface microbial community activity that propagate downwards, affecting porewater geochemistry as deep as 7.5 cm in the sediment. Progressive consumption of the sulfate reservoir drives δ34 S variability, instead of variations in average cell-specific sulfate reduction rates and/or sulfide oxidation at different depths in the sediment. The δ34 S values of pyrite are similar to porewater sulfide δ34 S values near the mat surface. We suggest that oxidative sulfur cycling and other microbial activity promote pyrite formation in and immediately adjacent to the microbial mat and that iron geochemistry limits further pyrite formation with depth in the sediment. These results imply that primary δ34 S signatures of pyrite deposited in organic-rich, iron-poor microbial mat environments capture information about microbial sulfur cycling and environmental conditions at the mat surface and are only minimally affected by deeper sedimentary processes during early diagenesis.

Self-assembly of highly ordered peptide amphiphile metalloporphyrin arrays.

Long fibers assembled from peptide amphiphiles capable of binding the metalloporphyrin zinc protoporphyrin IX ((PPIX)Zn) have been synthesized. Rational peptide design was employed to generate a peptide, c16-AHL(3)K(3)-CO(2)H, capable of forming a ß-sheet structure that propagates into larger fibrous structures. A porphyrin-binding site, a single histidine, was engineered into the peptide sequence in order to bind (PPIX)Zn to provide photophysical functionality. The resulting system indicates control from the molecular level to the macromolecular level with a high order of porphyrin organization. UV/visible and circular dichroism spectroscopies were employed to detail molecular organization, whereas electron microscopy and atomic force microscopy aided in macromolecular characterization. Preliminary picosecond transient absorption data are also reported. Reduced hemin, (PPIX)Fe(II), was also employed to highlight the material's versatility and tunability.