Efficient Large-Scale, Targeted Gravitational-Wave Probes of Supermassive Black-Hole Binaries.

Binary systems of supermassive black holes are promising sources of low-frequency gravitational waves (GWs) and bright electromagnetic emission. Pulsar timing array GW searches for individual binaries have been limited to only a few candidate systems due to computational demands, which get worse as more pulsars are added. By modeling the GW signal using only components from when the GW passes Earth (rather than also each pulsar), we find constraints on the binary's total mass and GW frequency that are similar to a full signal analysis, yet ∼70 times more efficient.

Co-occurrence of depression, anxiety, and perinatal posttraumatic stress in postpartum persons.

BACKGROUND: The study aim was to describe the incidence of depression, anxiety, perinatal-post-traumatic stress disorder (PTSD), and their co-occurrences in the early postpartum period in a low-resource OB/GYN clinic serving majority Medicaid-eligible persons. We hypothesized that postpartum persons screening positive for depression will have an increased risk of a positive screen for anxiety and perinatal PTSD. METHODS: A retrospective study of postpartum persons receiving care in Baton Rouge, Louisiana was conducted using responses abstracted from the electronic medical record (EMR) of the Patient Health Questionnaire-9 (PHQ9), Generalized Anxiety Disorder-7 (GAD7), and Perinatal Post Traumatic Stress Disorder Questionnaire-II (PPQII). Categorical distributions were compared using Fisher exact tests, while t-tests were used to compare continuous covariates. Multivariable logistic regression was used to predict anxiety (GAD7) and perinatal PTSD (PPQII) scores while adjusting for potential confounders, as well as to predict continuous PPQII and GAD7 based on continuous PHQ9 scores. RESULTS: There were 613 birthing persons 4-12 weeks postpartum that completed mental health screening (PHQ9, GAD7, and PPQII) between November 2020 and June 2022 as part of routine postpartum care in the clinic. The incidence of screening positive for symptoms of depression (PHQ9 > 4) was 25.4% (n = 156), while the incidence of positive screening for symptoms of anxiety (GAD7 > 4) and perinatal PTSD (PPQII [Formula: see text] 19) were 23.0% (n = 141) and 5.1% (n = 31) respectively. Postpartum patients with mild anxiety or more (i.e. GAD7 > 4) had 26 times higher odds of screening positive for symptoms of depression (PHQ9 > 4) (adjusted odds ratio [aOR] 26.3; 95% confidence interval [CI] 15.29-46.92; p < 0.001). Postpartum persons with a PPQII score indicating symptoms of perinatal PTSD (PPQII [Formula: see text] 19) had 44 times higher odds of screening positive for symptoms of depression (PHQ > 4) (aOR 44.14; 95%CI 5.07-5856.17; p < 0.001). CONCLUSIONS: Depression, anxiety, and perinatal PTSD are each independent risk factors for each other. To comply with the American College of Obstetricians and Gynecologists (ACOG) recommendations, providers should universally screen postpartum persons with validated screening tools for mood disturbances. However, if a complete full mood assessment is not feasible, this study provides evidence to support screening patients for depression, and if the patient screens positive, prompt additional screening for anxiety and perinatal PTSD.

Uterine adenosarcoma presenting as uterine inversion: A case study.

•Non-puerperal uterine inversion can be associated with uterine sarcomas.•Adenosarcoma is a tumor composed of benign epithelium and malignant stroma.•If malignancy is suspected or confirmed treatment of uterine inversion with hysterectomy is advised.

Characterization of High-Risk-Other Human Papillomavirus Genotypes in Papanicolaou Tests, High-Grade Squamous Intraepithelial Lesions, and Cervical Cancer.

Background: The objective of this study was to determine the human papillomavirus (HPV) genotypes of high-risk-other HPV Papanicolaou (Pap) tests and of biopsy tissues from patients with high-grade squamous intraepithelial lesion (HGSIL) or cervical cancer. High-risk-other HPV status was determined with the cobas HPV Test (Roche Diagnostics, North America) that identifies 12 high-risk, non-16/18 HPV genotypes. We hypothesized that we would find genotypes of HPV in our population that are not covered by the 9-valent HPV vaccine. Methods: For this retrospective cohort study, we randomly selected 50 high-risk-other HPV Pap test samples from 2018 from our pathology department registries for HPV genotype determination by Roche Linear Array (Roche Diagnostics, North America). Then we randomly selected 76 cervical biopsy samples of HGSIL or cervical cancer with high-risk-other HPV or HPV unknown status from 2016 to 2022 for HPV genotype determination by next-generation sequencing. Results are reported as counts and frequencies. Results: In the 50 high-risk-other HPV Pap test samples, 21 genotypes of HPV were noted; the most common were 53 (n=6), 51 (n=6), and 59 (n=5). In the samples with HGSIL or cervical cancer, 16 HPV genotypes were detected; the most common were 16 (n=26), 58 (n=12), and 33 (n=8). Among the patients with HGSIL or cervical cancer, the 9-valent HPV vaccine provided coverage for all the HPV variants found in 88% of patients, partial coverage in 8% of patients, and no coverage in 4% of patients. Conclusion: The 3 most common HPV genotypes seen in our high-risk-other HPV Pap test samples are not covered by the 9-valent HPV vaccine. For the HGSIL and cancer samples, 88% of the samples had full HPV genotype coverage with the 9-valent HPV vaccine. This study highlights a presence of HPV that will not be protected by vaccination in a high-risk population.

Factors Attributed to Breastfeeding Success in a Tertiary Obstetric Hospital.

Introduction: Increasing breastfeeding rates is a national health objective, however substantial barriers and disparities continue to exist in breastfeeding initiation and continuation. Our study aim is to identify factors associated with birthing persons' breastfeeding "success" (patients admitted to Labor & Delivery desiring to breastfeed and discharged breastfeeding) and breastfeeding "failure" (patients admitted to Labor & Delivery desiring to breastfeed and discharged exclusively formula feeding). Materials and Methods: We conducted a retrospective cohort study between July 2015 and June 2016. Patients were asked infant feeding plan intentions (breast, formula, combination) upon admission for delivery. Feeding plan was reassessed at discharge from delivery stay and validated to serve as proxy for feeding status at discharge. Logistic regression was used to identify the population(s) most likely to voice intent to breastfeed and to identify predictors of altered breastfeeding intent at discharge. Results: Between July 2015 and June 2016, 6690 patients met criteria for analysis. Patients reporting intent to breastfeed before delivery were more likely Caucasian (p < 0.0001), married (p < 0.001), nulliparous (p < 0.01), privately insured (p < 0.0001), educated (p < 0.0001), and older (p < 0.01) compared with patients not intending to breastfeed. These characteristics were similar in those who were "successful breastfeeders," that is, breastfeeding at discharge. The strongest predictor of breastfeeding at discharge was intent to breastfeed before delivery (p < 0.0001). African American race was the strongest predictor of nonbreastfeeding intent at admission (p < 0.0001) and conversion to formula feeding by hospital discharge (p < 0.001). Conclusion: Intent to breastfeed before delivery was the strongest predictor of breastfeeding at discharge; thus, prenatal breastfeeding education within the at-risk population is crucial to increasing breastfeeding rates.

Floral Color Variation in Drosera cistiflora Is Associated With Switches in Beetle Pollinator Assemblages.

Floral color shifts are thought to be one of the most common evolutionary transitions in plants, and pollinators are often proposed as important selective agents driving these transitions. However, shifts in flower color can also be related to neutral genetic processes or pleiotropy linked with selection via other biotic agents or abiotic factors. Here we ask whether abiotic factors or pollinators provide the best explanation for divergence in flower color among populations of the sundew Drosera cistiflora s.l. (Droseraceae). This species complex in the Greater Cape Floristic Region contains at least five distinctive floral color forms. Abiotic factors do not appear to play a significant role in color determination, as the forms are not specific to a single soil or vegetation type, sometimes co-occur in the same habitat, and maintain their color traits in common-garden and soil switching experiments. Instead, we found strong associations between flower color and the composition of pollinator assemblages which are dominated by hopliine scarab beetles. Pollinator assemblages show geographical structuring, both within and among color forms. This makes it difficult to dissect the roles of geography versus floral traits in explaining pollinator assemblages, but strong pollinator partitioning among color forms at sites where they are sympatric indicates that pollinators may select strongly on color. These results suggest that beetle pollinators are a significant factor in the evolution of D. cistiflora s.l. flower color.