Telemedicine in perinatal mental health: perspectives.

Background: The prevalence of perinatal mood and anxiety disorders has significantly increased with the COVID-19 pandemic. In parallel, the pandemic has caused a major shift in delivery of care to telemedicine.Purpose: This article aimed to discuss the different advantages and disadvantages of telemedicine for perinatal mental health. Telemedicine has significant benefits for perinatal mental health patients, including increased accessibility to specialized care, direct observation of child-parent interactions in their home environment, and facilitation of collaborative work between obstetrical providers and psychiatrists. Alternatively, telemedicine may impede recovery and contribute to an increase in social isolation. The use of telemedicine by obstetrical care providers may also contribute to a reduction in screening and identification of these disorders.Conclusion: A hybrid model of in-person and telemedicine delivery of care may serve as a durable compromise solution for these women and their families.

Correction: Two distinct colonic CD14+ subsets characterized by single-cell RNA profiling in Crohn's disease.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Two distinct colonic CD14+ subsets characterized by single-cell RNA profiling in Crohn's disease.

Inflammatory bowel diseases are associated with dysregulated immune responses in the intestinal tissue. Four molecularly identified macrophage subsets control immune homeostasis in healthy gut. However, the specific roles and transcriptomic profiles of the phenotypically heterogeneous CD14+ macrophage-like population in inflamed gut remain to be investigated in Crohn's disease (CD). Here we identified two phenotypically, morphologically and functionally distinct colonic HLADR+SIRPα+CD14+ subpopulations that were further characterized using single-cell RNA-sequencing (scRNAseq) in CD. Frequencies of CD64hiCD163-/dim cells selectively augmented in inflamed colon and correlated with endoscopic score of disease severity. IL-1ß and IL-23-producing CD64hiCD163-/dim cells predominated over TNF-α-producing CD64hiCD163hi cells in lesions. Purified "inflammatory monocyte-like" CD163-, but not "macrophage-like" CD163hi cells, through IL-1ß, promoted Th17/Th1 but not Th1 responses in tissue memory CD4+T cells. Unsupervised scRNAseq analysis that captures the entire HLADR+SIRPα+ population revealed six clusters, two of which were enriched in either CD163- or CD163hi cells, and best defined by TREM1/FCAR/FCN1/IL1RN or CD209/MERTK/MRCI/CD163L1 genes, respectively. Selected newly identified discriminating markers were used beyond CD163 to isolate cells that shared pro-Th17/Th1 function with CD163- cells. In conclusion, a molecularly distinct pro-inflammatory CD14+ subpopulation accumulates in inflamed colon, drives intestinal inflammatory T-cell responses, and thus, might contribute to CD disease severity.