The Joys of Older Motherhood: A questionnaire-based survey of mothers who delivered over the age of 50 years.

OBJECTIVE: It is recognised that advanced maternal age is associated with adverse pregnancy outcomes. It is less known what the psychological impact of having a pregnancy in later maternal age is. This study aimed to establish whether women having children over 50 experience challenges with regards to their mental well-being during the pregnancy and thereafter. STUDY DESIGN: 17 women delivered aged ≥ 50 at our maternity unit in a central London hospital between 2014 and 2020. Of these, one had died of metastatic ampullary carcinoma two years following delivery, one declined taking part, and two we were unable to get hold of, leaving 13 women in the study. Two validated questionnaires were used to survey the women: (i) Warwick-Edinburgh Mental Well-being Scale (WEMWBS), (ii) Parenting Daily Hassles Scale (PDHS). We analysed the questionnaire data using their individual scoring systems. RESULTS: The WEMWBS showed a median score of 60 out of a possible 70 (range: 45-70), indicating a high level of mental well-being among these women. The PDHS results indicated that reported hassles were overall low in both frequency and intensity for the mothers. CONCLUSION: Women giving birth over 50 have often experienced long, emotional and financially-burdensome journeys in order to fall pregnant, usually involving assisted reproductive techniques (ART), with multiple antenatal and delivery complications thereafter. As a result, they are extremely happy and grateful to have the child, and are often in better socioeconomic positions that can help with the stress that comes with child-caring.

Retrospective observational RT-PCR analyses on 688 babies born to 843 SARS-CoV-2 positive mothers, placental analyses and diagnostic analyses limitations suggest vertical transmission is possible.

RESEARCH QUESTION: Is there vertical transmission (from mother to baby antenatally or intrapartum) after SARS-CoV-2 (COVID-19) infected pregnancy? STUDY DESIGN: A systematic search related to SARS-CoV-2 (COVID-19), pregnancy, neonatal complications, viral and vertical transmission. The duration was from December 2019 to May 2020. RESULTS: A total of 84 studies with 862 COVID positive women were included. Two studies had ongoing pregnancies while 82 studies included 705 babies, 1 miscarriage and 1 medical termination of pregnancy (MTOP). Most publications (50/84, 59.5%), reported small numbers (<5) of positive babies. From 75 studies, 18 babies were COVID-19 positive. The first reverse transcription polymerase chain reaction (RT-PCR) diagnostic test was done in 449 babies and 2 losses, 2nd RT-PCR was done in 82 babies, IgM tests were done in 28 babies, and IgG tests were done in 28 babies. On the first RT-PCR, 47 studies reported time of testing while 28 studies did not. Positive results in the first RT-PCR were seen in 14 babies. Earliest tested at birth and the average time of the result was 22 hours. Three babies with negative first RT-PCR became positive on the second RT-PCR at day 6, day 7 and at 24 hours which continued to be positive at 1 week.Four studies with a total of 4 placental swabs were positive demonstrating SARS-CoV-2 localised in the placenta. In 2 studies, 10 tests for amniotic fluid were positive for SARS-CoV-2. These 2 babies were found to be positive on RT-PCR on serial testing. CONCLUSION: Diagnostic testing combined with incubation period and placental pathology indicate a strong likelihood that intrapartum vertical transmission of SARS-CoV-2 (COVID-19) from mother to baby is possible.

Solvation Dynamics of HEHEHP Ligand at the Liquid-Liquid Interface.

Actinide-lanthanide separation (ALSEP) has been a topic of interest in recent years as it has been shown to selectively extract problematic metals from spent nuclear fuel. However, the process suffers from slow kinetics, prohibiting it from being applied to nuclear facilities. In an effort to improve the process, many fundamental studies have been performed, but the majority have only focused on the thermodynamics of separation. Therefore, to understand the mechanism behind the ALSEP process, molecular dynamics (MD) simulations were utilized to obtain the dynamics and solvation characteristics for an organic extractant, 2-ethylhexylphosphonic acid mono-2-ethylhexyl ester (HEHEHP). Simulations were conducted with both pure and biphasic solvent systems to evaluate the complex solvent interactions within the ALSEP extraction method. The MD simulations revealed solvation and dynamical behaviors that are consistent with the experimentally observed chemical properties of HEHEHP for the pure solvent systems (e.g., hydrophobic/hydrophilic behaviors of the polar head group and alkyl chains and dimer formation between the ligands within an organic solvent). When present in a biphasic solvent system, interfacial behaviors of the ligand revealed that, at low concentrations, the alkyl side chains of HEHEHP were parallel to the interfacial plane. Upon increasing the concentration to 0.75 M, tendency for the parallel orientation decreased and a more perpendicular-like orientation was observed. Analysis of ligand solvation energies in different solvents through the thermodynamic integration method demonstrated favorability toward n-dodecane and biphasic solvents, which is in agreement with the previous experimental findings.

Impact of Water-Dilution on the Solvation Properties of the Ionic Liquid 1-Methyltriethoxy-3-ethylimidazolium Acetate for Model Biomass Molecules.

Many studies have suggested that the processing of lignocellulosic biomass could provide a renewable feedstock to supplant much of the current demand on petroleum sources. Currently, alkyl imidazolium-based ionic liquids (ILs) have shown considerable promise in the pretreatment, solvation, and hydrolysis of lignocellulosic materials although their high cost and unfavorable viscosity has limited their widespread use. Functionalizing these ILs with an oligo(ethoxy) tail has previously been shown through experiment to decrease the IL's viscosity resulting in enhanced mass transport characteristics, in addition to other favorable traits including decreased inhibition of some enzymes. Additionally, the use of cosolvents to mitigate the cost and unfavorable traits of ILs is an area of growing interest with particular attention on water as the presence of water in biomass processes is inevitable. Through the use of biased and unbiased molecular dynamics (MD) simulations, this study provides a molecular-level perspective of the various solvent-solvent and solvent-solute interactions in binary mixtures of water and 1-methyltriethoxy-3-ethylimidazolium acetate ([Me-(OEt)3-Et-IM+] [OAc-]) in the presence of model cellulose compounds (i.e., glucose and cellobiose). It is observed that at ∼75% w/w IL and water a transition in the nanostructure of the solvent occurs between water-like and IL-like solvation characteristics. It is shown that H-bonding interactions between the anion and water are a major driving force that significantly impacts the solvent properties of the IL as well as conformational preferences of the cellulosic model compound. In addition, it is found that the oligo(ethoxy) cation tail is responsible for the reduction in the propensity for tail aggregation as compared to alkyl tails of similar length, which, combined with increased ionic shielding, results in increased diffusion and enhanced water-like solvation characteristics.

In silico insights into the solvation characteristics of the ionic liquid 1-methyltriethoxy-3-ethylimidazolium acetate for cellulosic biomass.

Lignocellulosic biomass is a domestically grown, sustainable, and potentially carbon-neutral feedstock for the production of liquid fuels and other value added chemicals. This underutilized renewable feedstock has the potential to alleviate some of the current socio-economic dependence on foreign petroleum supplies while stimulating rural economies. Unfortunately, the potential of biomass has largely been underdeveloped due to the recalcitrant nature of lignocellulosic materials. Task-specific ionic liquids (ILs) have shown considerable promise as an alternative non-aqueous solvent for solvation and deconstruction of lignocellulose in the presence of metal chloride catalyst or enzymes. Recently it has been hypothesized that adding oxygen atoms to the tail of an imidazolium cation would alleviate some of the negative characteristics of the ILs by increasing mass transport properties, and decreasing IL deactivation of enzymes, while at the same time retaining favorable solvation characteristics for lignocellulose. Reported here are fully atomistic molecular dynamic simulations of 1-methyltriethoxy-3-ethylimidazolium acetate ([Me-(OEt)3-Et-IM(+)] [OAc(-)]) that elucidate promising molecular-level details pertaining to the solvation characteristics of model compounds of cellulose, and IL-induced side-chain and ring puckering conformations. It is found that the anion interactions with the saccharide induce alternate ring puckering conformations from those seen in aqueous environments (i.e.(1)C4), while the cation interactions are found to influence the conformation of the ω dihedral. These perturbations in saccharide structures are discussed in the context of their contribution to the disruption of hydrogen bonding in cellulosic architecture and their role in solvation.

Viral and Cellular Genomes Activate Distinct DNA Damage Responses.

In response to cellular genome breaks, MRE11/RAD50/NBS1 (MRN) activates a global ATM DNA damage response (DDR) that prevents cellular replication. Here, we show that MRN-ATM also has critical functions in defending the cell against DNA viruses. We reveal temporally distinct responses to adenovirus genomes: a critical MRN-ATM DDR that must be inactivated by E1B-55K/E4-ORF3 viral oncoproteins and a global MRN-independent ATM DDR to viral nuclear domains that does not impact viral replication. We show that MRN binds to adenovirus genomes and activates a localized ATM response that specifically prevents viral DNA replication. In contrast to chromosomal breaks, ATM activation is not amplified by H2AX across megabases of chromatin to induce global signaling and replicative arrest. Thus, γH2AX foci discriminate "self" and "non-self" genomes and determine whether a localized anti-viral or global ATM response is appropriate. This provides an elegant mechanism to neutralize viral genomes without jeopardizing cellular viability.

Achieving rapid reduction of HIV-1 viral load in HIV-positive pregnant women close to term - an obstetric/medical emergency: a review of three cases.

Mother-to-child transmission (MTCT) of HIV infection is now uncommon in the UK and the management of HIV-positive pregnant women is usually relatively straightforward. However, HIV viral load suppression may be difficult to achieve peripartum for women who book very late in pregnancy and those with a poor adherence to antiretroviral therapy (ART). These pregnancies are at a higher risk of MTCT due to high viral load (VL). Therefore, the development of interventions to achieve a rapid reduction of HIV VL is essential. We describe three relevant cases that presented to our unit over a 12-month period and discuss the strategies employed to manage these challenging cases. All babies were born healthy and were HIV proviral DNA-negative at 12 weeks postpartum. No serious adverse events were reported for the mothers or their babies.

Pregnancy with known syndrome of inappropriate antidiuretic hormone.

Syndrome of inappropriate antidiuretic hormone (SIADH) is rarely encountered in pregnancy. We report a case of severe hyponatraemia with idiopathic SIADH. A total of 18 cases of hyponatraemia in pregnancy have been reported; seven fit the criteria of SIADH. Unlike our case, none were diagnosed before pregnancy. Of the cases, 13 were associated with pre-eclampsia. Our patient developed intrauterine growth restriction (IUGR) but did not develop pre-eclampsia.

Kaposi's sarcoma in pregnancy after initiation of highly active antiretroviral therapy: a manifestation of immune reconstitution syndrome.

A case of Kaposi's sarcoma (KS) presenting as an immune reconstitution inflammatory syndrome in pregnancy with conservative management is reported. Successful outcomes for mother and baby were achieved. HIV was diagnosed at antenatal booking and highly active antiretroviral therapy commenced at 20 weeks. Multiple lymphadenopathies developed two months later. Excision biopsy of a node confirmed KS. In the absence of advanced disease, she was managed conservatively until delivery. The placenta showed no evidence of KS or human herpes virus 8 (HHV-8). The baby had negative HIV and HHV-8 polymerase chain reaction tests at zero, six and 12 weeks of life. Six months postpartum, the KS had regressed and HHV-8 viral load was undetectable.

Conformation and diffusion behavior of ring polymers in solution: a comparison between molecular dynamics, multiparticle collision dynamics, and lattice Boltzmann simulations.

We have studied the effect of chain topology on the structural properties and diffusion of polymers in a dilute solution in a good solvent. Specifically, we have used three different simulation techniques to compare the chain size and diffusion coefficient of linear and ring polymers in solution. The polymer chain is modeled using a bead-spring representation. The solvent is modeled using three different techniques: molecular dynamics (MD) simulations with a particulate solvent in which hydrodynamic interactions are accounted through the intermolecular interactions, multiparticle collision dynamics (MPCD) with a point particle solvent which has stochastic interactions with the polymer, and the lattice Boltzmann method in which the polymer chains are coupled to the lattice fluid through friction. Our results show that the three methods give quantitatively similar results for the effect of chain topology on the conformation and diffusion behavior of the polymer chain in a good solvent. The ratio of diffusivities of ring and linear polymers is observed to be close to that predicted by perturbation calculations based on the Kirkwood hydrodynamic theory.

A simple molecular theory for photo-induced smectic phase.

The response of liquid crystals to light is very important for applications of liquid crystals in display and memory devices. Recently experiments have been carried out on liquid crystals doped with photoactive azo compounds. It is seen that UV rays incident on such systems can lower the nematic isotropic transition temperature T (NI). Also, in some mixtures, a photo-induced smectic phase is observed. This is attributed to the change in the trans (longer) isomer to cis (shorter) isomer of the photoactive dopant. We have earlier developed a molecular mean-field model assuming the medium to consist of inter-converting anti-parallel and parallel pairs to explain the molecular origin of "two lengths". The model was used to explain double re-entrance, the effect of electric field on T (NI), etc. This model is modified to include the change of trans to cis isomer which is equivalent to an increase of fraction of parallel (shorter) pairs. The calculated phase diagram with respect to incident UV radiation energy shows an induced smectic phase. This is in qualitative agreement with experimental trends.

Optical and photocatalytic properties of heavily F(-)-doped SnO2 nanocrystals by a novel single-source precursor approach.

Heavily F-doped SnO(2) nanocrystals were successfully prepared by a novel synthetic approach involving low-temperature oxidation of a Sn(2+)-containing fluoride complex KSnF(3) as the single-source precursor with H(2)O(2). The F-doped SnO(2) powder was characterized by powder X-ray diffraction, TG-MS, BET surface area, diffuse reflectance spectroscopy, XPS, PL, FTIR spectroscopy, Raman spectroscopy, EPR spectroscopy, SEM, and TEM. Broadening of the diffracted peaks, signifying the low crystallite size of the products, was quite evident in the powder X-ray diffraction pattern of SnO(2) obtained from KSnF(3). It was indexed in a tetragonal unit cell with lattice constants a = 4.7106 (1) Å and c = 3.1970 (1) Å. Agglomeration of particles, with an average diameter of 5-7 nm, was observed in the TEM images whose spotwise EDX analysis indicated the presence of fluoride ions. In the core level high-resolution F 1s spectrum, the peak observed at 685.08 eV was fitted by the Gaussian profile yielding the fluoride ion concentration to be 21.23% in the SnO(2) lattice. Such a high fluoride ion concentration is reported for the first time in powders. SnO(2):F nanocrystals showed greater thermal stability up to 300 °C when heated in a thermobalance under flowing helium, after which generation of small quantities of HF was observed in the TG coupled mass spectrometry analysis. The band gap value, estimated from the Kubelka-Munk function, showed a large shift from 3.52 to 3.87 eV on fluoride ion doping, as observed in the diffuse reflectance spectrum. Such a large shift was corroborated to the overdoped situation due to the Moss-Burstein effect with an increase in the carrier concentration. In the photoluminescence (PL) spectrum, SnO(2):F nanocrystals exhibited a broad green emission arising from the singly ionized oxygen vacancies created due to higher dopant concentration. The evidence for singly ionized vacancies was arrived from the presence of a signal with a g value of 1.98 in the ESR spectrum of SnO(2):F at room temperature. The disordered nature of the rutile lattice and the enormous oxygen vacancies created due to fluoride ion doping were evident from the broad bands observed at 455, 588, and 874 cm(-1) in the room-temperature Raman spectrum of SnO(2):F. As the consequence of the oxygen vacancies, F-doped SnO(2) was examined for the function as a photocatalyst in the degradation of aqueous RhB dye solution under UV irradiation. A very high photocatalytic efficiency was observed for the F-doped SnO(2) nanocrystals as compared to pure SnO(2). The BET surface area of pure SnO(2) was quite high (207.81 m(2)/g) as compared to the F-doped SnO(2) nanocrystals (45.16 m(2)/g). Pore size analysis showed a mean pore diameter of 1.97 and 13.97 nm for the pure and doped samples. The increased photocatalytic efficiency was related to the very high concentration of oxygen vacancies in SnO(2) induced by F doping.

Prevalence of vitamin D deficiency in a North London antenatal population.

OBJECTIVE: We evaluated the prevalence of vitamin D deficiency in the antenatal patients attending North Middlesex University Hospital between March 2008 and March 2009. STUDY DESIGN: A prospective study of maternal levels of vitamin D at booking. RESULTS: The prevalence of both deficient and insufficient levels of 25[OH]D was 87.6% across all included patients. CONCLUSION: There is a high prevalence of asymptomatic vitamin D deficiency in the antenatal booking population.

Palmitoylation of nicotinic acetylcholine receptors.

It is well established that nicotinic acetylcholine receptors (nAChRs) undergo a number of different posttranslational modifications, such as disulfide bond formation, glycosylation, and phosphorylation. Recently, our laboratory has developed more sensitive assays of protein palmitoylation that have allowed us and others to detect the palmitoylation of relatively low abundant proteins such as ligand-gated ion channels. Here, we present evidence that palmitoylation is prevalent on many subunits of different nAChR subtypes, both muscle-type nAChRs and the neuronal "alpha(4)beta(2)" and "alpha(7)" subtypes most abundant in brain. The loss of ligand binding sites that occurs when palmitoylation is blocked with the inhibitor bromopalmitate suggests that palmitoylation of alpha(4)beta(2) and alpha(7) subtypes occurs during subunit assembly and regulates the formation of ligand binding sites. However, additional experiments are needed to test whether nAChR subunit palmitoylation is involved in other aspects of nAChR trafficking or whether palmitoylation regulates nAChR function. Further investigation would be aided by identifying the sites of palmitoylation on the subunits, and here we propose a mass spectrometry strategy for identification of these sites.

Obstructive nephropathy and chronic kidney disease secondary to uterine leiomyomas.

We present three cases of chronic kidney disease secondary to large fibroid uterus. The difficulties experienced in their clinical management and a review of literature is outlined.

Anaesthetic burns.

Patients frequently complain of numbness after surgery via the Pfannensteil incision. The two cases in this report demonstrate clear evidence of impaired sensory perception following such an incision. While this is often regarded as a trivial complication, a brief warning to patients should help avoid such superficial burns.