The Temporal Pattern of Repeat Intimate Partner Violence Incidents Among High-Risk Survivors in Taiwan: A Survival Analysis.

Intimate partner violence (IPV) is rarely an isolated incident, with survivors often experiencing repeat violence. Few studies, however, have been conducted to investigate the temporal pattern of IPV revictimization using a validated risk assessment instrument. In Taiwan, service professionals are mandated to report any known IPV incidents using the Taiwan Intimate Partner Violence Danger Assessment (TIPVDA), a validated risk assessment designed to assess the level of lethality faced by IPV survivors. The mandatory reporting policy and the universal use of the TIPVDA provide a unique opportunity to investigate the time course of repeat IPV victimization. This study analyzes high-risk IPV incidents (n = 18,740) reported in Taiwan from 2017 to 2019 using Cox regression analysis. Analysis results suggested three main findings: (a) The time interval between IPV victimizations shortened and the severity of violence increased; (b) the TIPVDA score was consistently associated with repeat victimization, unlike self-assessed dangerousness; (c) specific TIPVDA items, such as IPV history and financial stress, predicted the rate of repeat victimization. Those who reported ever being hurt by their partner during pregnancy, an escalation in physical violence during the past year, their partner threatening to kill them, and their partner being stressed about their financial situation were likely to have a faster rate of reporting the second and third high-risk victimization reports. These findings highlight the importance of using validated risk assessments in practice, not only for predicting reassault, severe reassault, or homicide but also for estimating the timing of revictimization. This can significantly inform intervention strategies and policy decisions.

Micro-CT Analysis of Radicular Dentin Thickness in Mandibular Second Molars Across Diverse Anatomical Root Variations: Identifying Potential Danger Zones.

INTRODUCTION: This study aimed to investigate radicular dentin thicknesses in mandibular second molars (MSMs), considering variations in root configuration and the morphology of the pulp chamber floor (PCF). The types of radicular grooves and potential danger zones were also identified. METHODS: A total of 149 MSMs were scanned with micro-CT and classified into four groups according to root fusion and PCF morphology: (1) 45 with fused roots and C-shaped PCFs; (2) 45 with fused roots and non-C-shaped PCFs; (3) 14 with a single canal; and (4) 45 with separated roots. The first two groups were subdivided into Ω-shaped, U-shaped, and V-shaped radicular groove subgroups. Measurements included minimum and mean dentin thickness from the start of the radicular groove or root bifurcation extending 5mm apically, the ratio of outer to inner dentin thickness, and the distribution of dentin thickness. RESULTS: Ω-shaped and U-shaped subgroups showed significant thinner minimum inner wall thickness than V-shaped subgroups at 2-5mm from starting point of radicular groove in both C-shaped and non-C-shaped pulp floor categories (p < 0.05). Mesial roots of separated-rooted MSMs showed significant thinner dentin than non-C-shaped floor regarding minimum and mean inner thickness and mean outer thickness (p < 0.05). Teeth with a single canal had significantly thicker walls compared to the other three groups. CONCLUSIONS: In MSMs, caution must be exercised especially in the presence of Ω-shaped and U-shaped grooves in C-shaped roots and around the root furcation of separated roots.

Identifying gaps in maternal knowledge and care-seeking for neonatal health: A mixed methods study in rural pregnant women.

BACKGROUND: Knowledge of neonatal danger signs is crucial for timely care-seeking and improved newborn survival. This study assessed this knowledge among pregnant women in rural western Gujarat. MATERIALS AND METHODS: A mixed methods study was conducted among 390 pregnant women selected through a two-stage sampling procedure. Quantitative data were collected using a structured questionnaire. Qualitative data were gathered via in-depth interviews with 20 purposively sampled women. Logistic regression identified determinants of knowledge. Thematic analysis was done for qualitative data. RESULTS: The majority of women were young (220, 56.5% ≤25 years), literate (333, 85%), and from rural backgrounds (320, 82%). Overall, 232 (59.5%) knew about cord care, and 301 (77.2%) correctly identified breastfeeding initiation time. Recognition of key danger signs such as fever (311, 79.7%), vomiting (292, 74.8%), and jaundice (275, 70.5%) was high, but only 70 (18%) identified chest in-drawing. Multiparity (adjusted odds ratio (AOR): 1.4, 95% confidence interval (95% CI): 1.2-3.9), lower age (AOR: 3.8, 95% CI: 2.4-5.8), education (AOR: 3.1, 95% CI: 1.5-6.4), inadequate counseling (AOR: 2.2, 95% CI: 1.82-5.190), and normative delivery (AOR: 2.4, 95% CI: 1.16-5.006) were associated with poor knowledge. Qualitative findings revealed reliance on informal sources, family elders, and financial constraints as key barriers along with limited comprehension of some danger signs. CONCLUSION: Focused interventions via health workers, family members, and community platforms are needed to increase neonatal danger signs awareness among vulnerable women in the region to enable timely care-seeking.

Predictors of Birth Preparedness and Complication Readiness Practices Among Pregnant Women in Ethiopia, a Systematic Review and Meta-Analysis.

Objectives: We conducted this review to identify factors associated with birth preparedness and complication readiness (BPCR) among pregnant women in Ethiopia. BPCR is a comprehensive approach that helps address delays in seeking care for obstetric problems. Methods: PRISMA was followed and different databases were used to find studies. Adjusted Odds Ratio (AOR) with a 95% Confidence Interval was used to identify factors. The I2 statistic, funnel plot, and Egger test were used to assess the heterogeneity of studies and publication bias. Results: Knowledge of BPCR, danger signs during pregnancy, labor, and postpartum (AOR = 1.99, 95% CI: 1.51, 2.64, AOR = 1.55; 95% CI: 1.35, 1.80; AOR = 1.45; 95% CI: 1.27, 1.63, and AOR = 1.4; 95% CI: 1.21, 1.63), respectively, residency (AOR = 1.49; 95% CI: 1.32, 1.68), antenatal care visit (AOR = 1.59; 95% CI: 1.43, 1.78), history of stillbirth (AOR = 1.58; 95% CI: 1.36, 1.86), and educational status (AOR = 1.62: 95% CI: 1.45, 1.78) were significantly associated with BPCR practice. Conclusion: This study identified some modifiable factors in the practice of BPCR. Integrating counseling and expanding ANC services in health facilities may improve BPCR practice.

Eco(geno)toxicity of an acaricidal formulation containing chlorpyrifos, cypermethrin, and fenthion on different plant models and Artemia salina L.

The mixture of pesticides is widely employed in cattle farming to combat ectoparasite resistance, such as ticks. The commercial formulation COLOSSO FC30, which contains three active ingredients (Cypermethrin, Chlorpyrifos, and Fenthion), stands out due to its efficiency. However, animals exposed to this product may become vectors of potentially toxic molecules, possibly causing contamination in aquatic and terrestrial ecosystems. In light of this, this study evaluated the eco(geno)toxic potential of the commercial formulation COLOSSO FC30, using plants (Allium cepa L., Lactuca sativa L., Raphanus sativus L., Pennisetum glaucum L., and Triticum aestivum L.) and Artemia salina L. as model organisms. In the phytotoxicity test, the species were ranked in order of sensitivity to the commercial formulation as follows: P. glaucum > L. sativa > T. aestivum > R. sativus. The most sensitive parameters were root length (RL) and shoot length (SL) of seedlings. In the cytogenotoxicity test with A. cepa, cell division was decreased at concentrations from 0.351 mL L-1 in the meristematic region and root F1. Chromosomal aberrations and micronucleus were observed at all concentrations. In the test with A. salina, the IC50 after 24 h of exposure was 0.01207 mL L-1 of the commercial formulation. The results highlight the need for further research and regulations to understand and minimize the potential environmental impacts of COLOSSO FC30.

Phagolysosomal resistance hypothesized to be a danger signal.

Antigen presenting cells sometimes require T cell "help" to kill and decompose microbes they capture, especially when those microbes resist effector molecules including nitric oxide and reactive oxygen species. Pathogens are more likely to resist those effectors, shared by the innate and adaptive immune systems, than are commensals. Does such resistance alert the immune system to the danger posed by those pathogens? Several lines of evidence suggest this occurs. Mouse studies showed a surprising exacerbation, not alleviation of experimental autoimmune encephalomyelitis, by suppression of nitric oxide production, but only when the suppression was applied to animals undergoing vaccination with myelin. In contrast, animals receiving T cells activated by vaccination without suppression of nitric oxide benefitted from reduced autoimmune cytotoxicity when nitric oxide production was suppressed after adoptive transfer. Vaccinia and adenovirus suppress nitric oxide production and have been successful vaccine platforms, also consistent with the above phagolysosomal resistance hypothesis. The hypothesis solves a long-standing quandary-how can nitric oxide protect against both infection and autoimmunity, especially autoimmune diseases for which it seems a major effector? The importance of physical linkage between epitopes, first proposed in Bretscher's Two-Step, Two-Signal theory dependent on B cells, is extended to include phagolysosomal resistance in general, plus a corollary proposition that the immune system detects resistance to dissociation of high-affinity pathogenic ligands from host binding sites to make neutralizing antibodies.

Effectiveness of a predator avoidance program for elementary-aged youth.

Introduction: With thousands of children abducted and abused each year, efforts are needed to keep children safe from predators. Revved Up Kids (RUK) is an intervention that gives elementary-aged children the necessary tools to recognize and avoid dangerous people and situations. The purposes of this study were to describe the RUK intervention components and document its effectiveness. Methods: This evaluation utilized a quasi-experimental design to determine the effectiveness of RUK. The single-session intervention was offered in two formats: one-hour (n = 119 youth) and three-hour (n = 28 youth) workshops. RUK workshop effectiveness was compared to a comparison group (n = 211 youth) that did not receive an intervention. Data were collected at baseline, immediate-post, and 1-month follow-up from second to fourth grade participants. A series of linear mixed models were fitted. Results: Compared to the comparison group, participants in both RUK workshops showed significant improvements across the three time points. More specifically, participants in the one-hour and three-hour RUK workshops significantly increased their safety knowledge measured by the Recognize Score (p < 0.01), Avoid Score (p < 0.01), and Escape Score (p < 0.01), respectively. Discussion: These effective single-session workshops can be easily introduced into schools and community-based settings to complement existing efforts to prevent child abduction and abuse.

Quantitative analysis of surgical landmarks of the face in fixed cadaveric heads: clinical and anatomical implications.

PURPOSE: This study aimed to examine and analyze the presence of sexual dimorphism and symmetry/asymmetry in fixed cadaveric heads and their contributions to clinical practice. METHODS: Measurements were conducted on 6 cadavers and 24 fixed cadaveric heads (n = 30) using a digital microcaliper to assess cranial dimensions, including surgical landmarks, facial index (FI), orbital index (OI), and the danger triangle of the face, offering crucial references for surgeons during surgical interventions. RESULTS: Analyses were conducted on cadavers consisting of 10 females (33.3%) and 20 males (66.7%). Males demonstrated significantly higher values than females in terms of Zy-Zy (Zy = Zygion), nasal body, and width/length of the columella. Hyperleptoprosop types were the most frequently observed, followed by the leptoprosop type. Females exhibited megaseme characteristics according to OI on both sides. Additionally, the danger triangle of the face was greater in males compared than in females, suggesting a higher risk of infection in this region among males. CONCLUSION: The observed sex differences in facial and nasal dimensions, along with facial indices, are crucial for customizing surgical procedures to individual patients. For example, the greater distance in the danger triangle among males highlights the importance of considering anatomical variations to avoid complications, such as septic cavernous sinus thrombosis. Integrating these measurements into preoperative planning can enhance the precision of facial reconstruction and aesthetic surgeries, thereby improving patient outcomes and safety.

Global insights on flood risk mitigation in arid regions using geomorphological and geophysical modeling from a local case study.

This research provides a comprehensive examination of flood risk mitigation in Saudi Arabia, with a focus on Wadi Al-Laith. It highlights the critical importance of addressing flood risks in arid regions, given their profound impact on communities, infrastructure, and the economy. Analysis of morphometric parameters ((drainage density (Dd), stream frequency (Fs), drainage intensity (Di), and infiltration number (If)) reveals a complex hydrological landscape, indicating elevated flood risk. due to low drainage density, low stream frequency, high bifurcation ratio, and low infiltration number. Effective mitigation strategies are imperative to protect both communities and infrastructure in Wadi Al-Laith. Geophysical investigations, using specialized software, improve the quality of the dataset by addressing irregularities in field data. A multi-layer geoelectric model, derived from vertical electrical sounding (VES) and time domain electromagnetic (TDEM) surveys, provides precise information about the geoelectric strata parameters such as electrical resistivity, layer thicknesses, and depths in the study area. This identifies a well-saturated sedimentary layer and a cracked rocky layer containing water content. The second region, proposed for a new dam, scores significantly higher at 56% in suitability compared to the first region's 44%. The study advocates for the construction of a supporting dam in the second region with a height between 230 and 280 m and 800 m in length. This new dam can play a crucial role in mitigating flash flood risks, considering various design parameters. This research contributes to flood risk management in Saudi Arabia by offering innovative dam site selection approaches. It provides insights for policymakers, researchers, and practitioners involved in flood risk reduction, water resource management, and sustainable development in arid regions globally.

Ultrasound-guided percutaneous radiofrequency ablation versus surgery for solitary T1N0M0 papillary thyroid carcinoma in the danger triangle.

OBJECTIVES: To compare the safety and efficiency of ultrasound-guided percutaneous radiofrequency ablation (RFA) and surgical resection (SR) for thyroid papillary carcinoma (PTC) in the danger triangle area. METHODS: The clinical data of 298 patients who underwent either percutaneous RFA or SR for PTC in the thyroid danger triangle at our hospital between January 2018 and April 2020 were retrospectively analyzed. Propensity score matching is employed to regulate for confounding factors. All patients undergoing ablation were treated using a strategy that combined sufficient paratracheal fluid isolation with a low-power, short electrode. Disease progression was analyzed in patients with T1N0M0 PTC (T1a and T1b) employed in Kaplan‒Meier curves. Treatment parameters and the rates of local recurrence, distant metastasis, and complications are recorded and compared. RESULTS: Of 182 eligible patients who were included, 91 were in the RFA (age 44.84 ± 13.19; 71 females; 77 T1a) and 91 were in the SR (age 47.36 ± 11.05; 68 females; 69 T1a). The average treatment time, length of hospital stays, blood loss volume, and scar length are substantially less in the RFA than in the SR. Major complications as well as postoperative permanent recurrent laryngeal nerve injury and postoperative transient parathyroid dysfunction occurred only in the SR, with a substantial distinction between the two groups (p < 0.05). There is no substantial distinction in the disease progression between RFA and SR treatment of T1N0M0 PTC. CONCLUSION: RFA is as effective as surgery for PTC in the danger triangle area in the short term, with faster recovery and fewer complications. CLINICAL RELEVANCE STATEMENT: Radiofrequency ablation has a clinical efficacy comparable to surgery in the treatment of papillary thyroid carcinoma in the danger triangle area in the short term with the advantages of faster recovery and fewer complications when compared with surgery. KEY POINTS: Use of radiofrequency ablation (RFA) in the thyroid danger triangle is still controversial. RFA and surgery groups showed no difference in disease progressions, and no major complications occurred with RFA. Radiofrequency ablation offers a new option for papillary thyroid carcinoma patients in the danger triangle.

Image-Acceleration Multimodal Danger Detection Model on Mobile Phone for Phone Addicts.

With the popularity of smartphones, a large number of "phubbers" have emerged who are engrossed in their phones regardless of the situation. In response to the potential dangers that phubbers face while traveling, this paper proposes a multimodal danger perception network model and early warning system for phubbers, designed for mobile devices. This proposed model consists of surrounding environment feature extraction, user behavior feature extraction, and multimodal feature fusion and recognition modules. The environmental feature module utilizes MobileNet as the backbone network to extract environmental description features from the rear-view image of the mobile phone. The behavior feature module uses acceleration time series as observation data, maps the acceleration observation data to a two-dimensional image space through GADFs (Gramian Angular Difference Fields), and extracts behavior description features through MobileNet, while utilizing statistical feature vectors to enhance the representation capability of behavioral features. Finally, in the recognition module, the environmental and behavioral characteristics are fused to output the type of hazardous state. Experiments indicate that the accuracy of the proposed model surpasses existing methods, and it possesses the advantages of compact model size (28.36 Mb) and fast execution speed (0.08 s), making it more suitable for deployment on mobile devices. Moreover, the developed image-acceleration multimodal phubber hazard recognition network combines the behavior of mobile phone users with surrounding environmental information, effectively identifying potential hazards for phubbers.

FAS(APO), DAMP, and AKT Phosphoproteins Expression Predict the Development of Nosocomial Infection After Pediatric Burn Injury.

Pediatric burn injuries are a leading cause of morbidity with infections being the most common acute complication. Thermal injuries elicit a heightened cytokine response while suppressing immune function; however, the mechanisms leading to this dysfunction are still unknown. Our aim was to identify extracellular proteins and circulating phosphoprotein expression in the plasma after burn injury to predict the development of nosocomial infection (NI). Plasma was collected within 72 hours after injury from sixty-four pediatric burn subjects; of these, eighteen went on to develop a NI. Extracellular damage associated molecular proteins (DAMPs), FAS(APO), and protein kinase b (AKT) signaling phosphoproteins were analyzed. Subjects who went on to develop a NI had elevated high mobility group box 1 (HMGB1), heat shock protein 90 (HSP90), and FAS expression than those who did not develop a NI after injury (NoNI). Concurrently, phosphorylated (p-) AKT and mammalian target of rapamycin (p-mTOR) were elevated in those subjects who went on to develop a NI. Quadratic discriminant analysis revealed distinct differential profiles between NI and NoNI burn subjects using HSP90, FAS, and p-mTOR. The area under the receiver-operator characteristic curves displayed significant ability to distinguish between these two burn subject cohorts. These findings provide insight into predicting the signaling proteins involved in the development of NI in pediatric burn patients. Further these proteins show promise as a diagnostic tool for pediatric burn patients at risk of developing infection while additional investigation may lead to potential therapeutics to prevent NI.

Sex Disparities: Couple's Knowledge and Attitude Towards Obstetric Danger Signs and Maternal Health Care: in Rural Jimma Zone of Ethiopia.

Purpose: This study aimed to compare knowledge and attitudes towards obstetric danger signs and care between females receiving maternal care and their male partners. Methods and Materials: A community-based comparative cross-sectional study was conducted in the rural setting of Jimma, Ethiopia. Female and their male partners were selected randomly. The number of participants included from each sex was 3235 totaling 6470. Face-to-face data collection was employed using open data kit (ODK) software. A pre-test was performed before the data collection. Descriptive and analytical statistical analysis was used to compare knowledge and attitudes regarding obstetric danger signs and care. Predictor variables were declared considering a 95% confidence interval, adjusted odds ratio (AOR) and P-value less than 0.05. Results: On average, male and female participants identified at least two obstetric danger signs. More females could mention more antenatal, childbirth, and postnatal danger signs than their male partners. Both females and their male partners who listened to the radio at least once per week had a statistically significant positive attitude towards obstetric care. Nonetheless, both had an almost similar magnitude of attitude towards obstetric care irrespective of belonging to different occupational, educational, and other social strata. Males' knowledge of danger signs during pregnancy (95% CI = (1.07-1.62), AOR = 1.32, P < 0.008) and postnatal care (95% CI = (1.16-1.89), AOR = 1.48, P < 0.002) had a statistically significant association with the females utilization antenatal care (ANC) service, though not delivery care (DC) or postnatal (PNC). Conclusion: There were inequalities in obstetric danger signs knowledge between females and their male partners. Male partners' knowledge of obstetric danger signs is not only significant during pregnancy and delivery but also has a lasting impact on post-natal service utilization, which underscores the importance of their involvement in maternal healthcare.

The receipt of health information on neonatal dangers signs during the immediate postpartum period and its determinants in Ethiopia: a multilevel mixed-effects logistic regression analysis of the 2016 Ethiopian demographic health survey report.

BACKGROUND: Identification of neonatal danger signs and immediate access to health care are two global efforts aimed at enhancing newborn and child survival by preventing 75% of neonatal deaths. Despite various small-scale studies on women's awareness of neonatal danger signs in Ethiopia, little is known about the level of receiving health information on those danger signs during the immediate postpartum period at the national level. Hence, this study aimed at assessing the level, and its determinants of the service uptake in Ethiopia. METHODS: The data for this study was taken from the Ethiopian Demographic and Health Survey (EDHS), which took place from January to June 2016 and covered all administrative regions of Ethiopia. A weighted sample of 7,589.8 women was analyzed using STATA version 16. To account for data clustering, a multivariable multilevel mixed-effect logistic regression analysis was employed to determine the effects of each predictor on the outcome variable. Adjusted odds ratio with its corresponding 95% confidence interval was used to declare the statistical significance of the explanatory variables. RESULTS: The receipt of health information on neonatal danger signs during the immediate postpartum period was 10.70% [95% CI:10.01, 11.40]. Variables namely living in Metropolitans [AOR = 2.06; 95%CI: 1.48, 2.88] and Large central [AOR = 1.83; 95%CI: 1.38, 2.42] regions, being in the highest wealth quintile [AOR = 1.87; 95% CI: 1.23, 2.84], being nulliparous [AOR = 0.27; 95% CI: 0.08, 0.87] and primiparous[AOR = 0.61;95% CI: 0.46, 0.79], getting adequate antenatal visits [AOR = 2.42; 95% CI: 1.75, 3.33], institutional delivery [AOR = 5.91; 95% CI: 4.66, 7.53], and receipt of postnatal visits [AOR = 3.52; 95% CI: 2.84, 4.38] were identified as significant determinants of receiving health information on newborn danger signs. CONCLUSION: The findings revealed that unacceptably low uptake of health information on newborn danger signs during the immediate postpartum period in Ethiopia. A concerted effort is needed from all stakeholders in the health sector to enhance the uptake of maternal health services (antenatal care, skilled delivery service, and postnatal care). Healthcare providers should pay special attention to nulliparous and primiparous women during and after delivery, and the government should also focus on women of peripheral regions, who make up a large portion of the low coverage.

Mitochondrial homeostasis in odontoblast: Physiology, pathogenesis and targeting strategies.

Caries and pulpitis remain a major global disease burden and affect the quality of life of patients. Odontoblasts are key players in the progression of caries and pulpitis, not only secreting and mineralizing to form dentin, but also acting as a wall of defense to initiate immune defenses. Mitochondrion is an information processor for numerous cellular activities, and dysregulation of mitochondrion homeostasis not only affects cellular metabolism but also triggers a wide range of diseases. Elucidating mitochondrial homeostasis in odontoblasts can help deepen scholars' understanding of odontoblast-associated diseases. Articles on mitochondrial homeostasis in odontoblasts were evaluated for information pertinent to include in this narrative review. This narrative review focused on understanding the complex interplay between mitochondrial homeostasis in odontoblasts under physiological and pathological conditions. Furthermore, mitochondria-centered therapeutic strategies (including mitochondrial base editing, targeting platforms, and mitochondrial transplantation) were emphasized by resolving key genes that regulate mitochondrial function. Mitochondria are involved in odontoblast differentiation and function, and act as mitochondrial danger-associated molecular patterns (mtDAMPs) to mediate odontoblast pathological progression. Novel mitochondria-centered therapeutic strategies are particularly attractive as emerging therapeutic approaches for the maintenance of mitochondrial homeostasis. It is expected to probe key events of odontoblast differentiation and advance the clinical resolution of dentin formation and mineralization disorders and odontoblast-related diseases.

Clinically relevant GABARAP deficiency abrogates bortezomib-induced immunogenic cell death in multiple myeloma.

Recently, it was revealed that the high-risk, poor-prognosis downregulation of GABA type A receptor-associated protein (GABARAP) causes a defect in both autophagy and surface exposure of calreticulin (CALR) in multiple myeloma (MM) cells responding to bortezomib. Hence, GABARAP-defective MM cells fail to undergo immunogenic cell death.

Stretch Causes cffDNA and HMGB1-Mediated Inflammation and Cellular Stress in Human Fetal Membranes.

Danger-associated molecular patterns (DAMPs) are elevated within the amniotic cavity, and their increases correlate with advancing gestational age, chorioamnionitis, and labor. Although the specific triggers for their release in utero remain unclear, it is thought that they may contribute to the initiation of parturition by influencing cellular stress mechanisms that make the fetal membranes (FMs) more susceptible to rupture. DAMPs induce inflammation in many different tissue types. Indeed, they precipitate the subsequent release of several proinflammatory cytokines that are known to be key for the weakening of FMs. Previously, we have shown that in vitro stretch of human amnion epithelial cells (hAECs) induces a cellular stress response that increases high-mobility group box-1 (HMGB1) secretion. We have also shown that cell-free fetal DNA (cffDNA) induces a cytokine response in FM explants that is fetal sex-specific. Therefore, the aim of this work was to further investigate the link between stretch and the DAMPs HMGB1 and cffDNA in the FM. These data show that stretch increases the level of cffDNA released from hAECs. It also confirms the importance of the sex of the fetus by demonstrating that female cffDNA induced more cellular stress than male fetuses. Our data treating hAECs and human amnion mesenchymal cells with HMGB1 show that it has a differential effect on the ability of the cells of the amnion to upregulate the proinflammatory cytokines and propagate a proinflammatory signal through the FM that may weaken it. Finally, our data show that sulforaphane (SFN), a potent activator of Nrf2, is able to mitigate the proinflammatory effects of stretch by decreasing the levels of HMGB1 release and ROS generation after stretch and modulating the increase of key cytokines after cell stress. HMGB1 and cffDNA are two of the few DAMPs that are known to induce cytokine release and matrix metalloproteinase (MMP) activation in the FMs; thus, these data support the general thesis that they can function as potential central players in the normal mechanisms of FM weakening during the normal distension of this tissue at the end of a normal pregnancy.

Innate immune sensing of macromolecule homeostasis.

The innate immune system uses a distinct set of germline-encoded pattern recognition receptors to recognize molecular patterns initially thought to be unique to microbial invaders, named pathogen-associated molecular patterns. The concept was later further developed to include similar molecular patterns originating from host cells during tissue damage, known as damage-associated molecular patterns. However, recent advances in the mechanism of monogenic inflammatory diseases have highlighted a much more expansive repertoire of cellular functions that are monitored by innate immunity. Here, we summarize several examples in which an innate immune response is triggered when homeostasis of macromolecule in the cell is disrupted in non-infectious or sterile settings. These ever-growing sensing mechanisms expand the repertoire of innate immune recognition, positioning it not only as a key player in host defense but also as a gatekeeper of cellular homeostasis. Therapeutics inspired by these advances to restore cellular homeostasis and correct the immune system could have far-reaching implications.

Cavernous Sinus Thrombosis.

Cavernous sinus thrombosis is a potentially lethal subset of cerebral venous sinus thrombosis that may occur as a result of septic and aseptic etiologies. The overall incidence is estimated to be between 0.2 and 1.6 per 100,000 persons; and treatments include antibiotics, anticoagulation, corticosteroids, and surgery. Recent morbidity and mortality estimates are approximately 15% and 11%, respectively. Rapid identification and treatment are essential and may reduce the risk of poor outcome or death.