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Our results suggest that these events alter the transient α-synuclein intramolecular contacts, inducing a greater solvent exposure of its hydrophobic, aggregation-prone NAC domain, in full agreement with a recent experimental study on Ca2+ binding. Moreover, metal-binding residues directly participate in the long-range contacts that shield this domain and regulate α-synuclein aggregation. These results provide a molecular-level rationalization of the enhanced fibrillation experimentally observed in the presence of Cu2+ or Ca2+ and the oligomerization induced by methionine sulfoxidation.
Preterm birth is the leading cause of neonatal morbidity and mortality. Individuals who survive preterm birth are at a higher risk for many long-term adverse effects, including neurodevelopmental deficits. There are many well-established risk factors for worse neurologic outcomes spanning the prenatal and postnatal periods; however, investigators have yet to assess whether the cause of preterm birth has an impact on neurodevelopment.
Our objective was to assess whether neurologic outcomes differ by children born via indicated versus spontaneous preterm birth.
We performed secondary analysis of a multicenter trial assessing magnesium for neuroprotection in women at risk for preterm delivery from 24 to 31 weeks. We included women with live, nonanomalous, singleton gestations who delivered preterm; we excluded women whose children were missing 2-year follow-up information for reasons other than perinatal demise. The primary exposure was type of preterm birth (1) spontaneous if the child's mother presented omotor Developmental Index score 2 standard deviations or less or death remained significant higher in the indicated preterm birth group (adjusted odds ratio, 1.98; 95% confidence interval, 1.01-3.88).
In this cohort of pregnant women who delivered preterm, indicated deliveries were associated with worse psychomotor development than were spontaneous deliveries. Other outcomes appeared to be poor, but our numbers were limited. This finding should be confirmed in a larger cohort of women undergoing medically indicated preterm deliveries.
In this cohort of pregnant women who delivered preterm, indicated deliveries were associated with worse psychomotor development than were spontaneous deliveries. Other outcomes appeared to be poor, but our numbers were limited. This finding should be confirmed in a larger cohort of women undergoing medically indicated preterm deliveries.
Access to prenatal care can be challenging due to physician shortages and rural geography. The multiple prenatal visits performed to collect basic fetal measurements lead to significant patient burden as well. The standard of care tools for fetal monitoring, external fetal heart rate monitoring with cardiotocography, as used today, must be applied by a medical professional in a healthcare setting. Novel tools to enable a remote and self-administered fetal monitoring solution would significantly alleviate some of the current barriers to care.
To compare maternal and fetal heart rate monitoring data obtained by 'Invu system' (a wireless, wearable, self-administered, fixed-location device containing passive electrical and acoustic sensors) to cardiotocography, toward a true remote fetal monitoring solution.
A prospective, open-label, multicenter study evaluated concurrent use of Invu and cardiotocography in pregnant women, aged 18 to 50 years, with singleton pregnancies ≥32+0 weeks' gestation (NCT03504189)/clinicaltrials.gov/ct2/show/NCT03504189.
Registration date April 20, 2018; First participant enrollment February 28, 2018; ClinicalTrials.gov registration NCT03504189; https//clinicaltrials.gov/ct2/show/NCT03504189.
Early prediction of preeclampsia is challenging because of poorly understood causes, various risk factors, and likely multiple pathogenic phenotypes of preeclampsia. Statistical learning methods are well-equipped to deal with a large number of variables, such as patients' clinical and laboratory data, and to select the most informative features automatically.
Our objective was to use statistical learning methods to analyze all available clinical and laboratory data that were obtained during routine prenatal visits in early pregnancy and to use them to develop a prediction model for preeclampsia.
This was a retrospective cohort study that used data from 16,370 births at Lucile Packard Children Hospital at Stanford, CA, from April 2014 to January 2018. Two statistical learning algorithms were used to build a predictive model (1) elastic net and (2) gradient boosting algorithm. Gefitinib chemical structure Models for all preeclampsia and early-onset preeclampsia (<34 weeks gestation) were fitted with the use of patient data that we preeclampsia risk from routine early pregnancy information.
Statistical learning methods in a retrospective cohort study automatically identified a set of significant features for prediction and yielded high prediction performance for preeclampsia risk from routine early pregnancy information.
Screening for peripartum depression is widely recommended and should now be the standard of care. However, little research exists on peripartum anxiety screening.
The purpose of this study was to assess whether adding perinatal anxiety screening would increase the identification of women who would benefit from mental health support.
The existing practice at our clinic was depression screening via the Patient Health Questionnaire-2 at all prenatal visits; screenings were prospectively tracked for 3 months in women presenting for visit at 24-28 weeks gestation (Patient Health Questionnaire-2-only group). We then added Generalized Anxiety Disorder 2-item validated anxiety scale assessment to prenatal visits at 24-28 weeks gestation (Patient Health Questionnaire-2+Generalized Anxiety Disorder 2-item group). Our primary study outcome was the rate of positive depression and anxiety screens during pregnancy; secondary outcomes included referral rates to mental health services and obstetric and medical outcomesterval, 4.6-155.0).
Screening for perinatal anxiety may increase referral rates to mental health professionals who can then diagnose and treat women who experience mood and anxiety disorders. Anxiety screening may be particularly useful in populations with a history of mental health diagnoses or substance abuse. Further research is necessary to understand how perinatal anxiety screening should be best implemented.
Screening for perinatal anxiety may increase referral rates to mental health professionals who can then diagnose and treat women who experience mood and anxiety disorders. Anxiety screening may be particularly useful in populations with a history of mental health diagnoses or substance abuse. Further research is necessary to understand how perinatal anxiety screening should be best implemented.