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Pregnancy, Delivery and Postpartum
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Zahra Ameen, Katy Kuhrt, Kopal Singhal Agarwal, Chawan Baran, Rebecca Best, Maria Garcia de Frutos, Miranda Geddes-Barton, Laura Bridle, Black Benjamin
The conditions of the journey or even the settlement might pose a risk to the nutritional needs of pregnant women. Some might be malnourished prior to arrival. There is no agreed international Cut off points for Mid-Upper Arm Circumference (MUAC) screening for Pregnant and Lactating Women (PLW) so national MUAC cut off points may vary but normally between < 210 mm and < 230 mm and for those identified it can be possible to enroll them as part of a Targeted Supplementary Feeding Programme or treat as Severe Acute Malnutrition if indicated as part of a Community-based Management of Acute Malnutrition (CMAM) programme. Regardless of nutritional status it is important to transmit health promotion messages related to diet and food hygiene. In some circumstances, it might be possible to ask the food distribution organisation to provide adapted meals to women who are expecting or breastfeeding (needs of 2,500 calories/day) in general. Adequate fluid intake should be encouraged for all women in these groups.
Ectopic Pregnancy and Pregnancy of Unknown Location
Published in Arianna D'Angelo, Nazar N. Amso, Ultrasound in Assisted Reproduction and Early Pregnancy, 2020
Several markers have been used to predict the outcome of PULs, including β-hCG and serum progesterone [218–221]. Both the β-hCG discriminatory level (which indicates the level of serum β-hCG when a pregnancy can be visualized on ultrasound scan (1000–1500 IU/L for TVS and 6500 IU/L for TAS) [222–227] and the serial changes in the serum β-hCG level over 2 days have been described [228,229]. In general, a decreasing β-hCG value on serial measurements and/or a low serum progesterone level can help recognize women in whom pregnancy is failing, regardless of its location [230,231]. It is important to note that many ectopic pregnancies can be seen with β-hCG levels well below the discriminatory zone [221,229,232]. Thus, an ultrasound scan assessment should be offered to all symptomatic women and not be delayed until the β-hCG level is above this zone. In 7%–20%, ectopic pregnancy will be eventually diagnosed, and a small minority (2%) will have a persistent PUL, a term used in cases were β-hCG levels are either static or slowly increasing or decreasing in the absence of a visible pregnancy on ultrasound scan [201,210,224].
Micronutrient Supplementation and Ergogenesis — Vitamins
Published in Luke Bucci, Nutrients as Ergogenic Aids for Sports and Exercise, 2020
In summary, if no deficiencies exist, low to moderate doses (1 to 5 times RDA amounts) of supplemental B vitamins do not appear to enhance performance, and high doses of niacin may reduce performance. Upon closer examination, it is obvious that research on ergogenic effects of B vitamins is incomplete. First, very few studies examined megadoses (greater than 1000% RDA) of single or multiple B vitamins given before exercise or for more extended time periods. Those that did found significant improvements in physical performance.228,230,231 This suggests that proper dose response studies have not been performed. Also, the differences between chronic and acute administration schedules have not been compared adequately. In addition, combined megadoses of each B vitamin listed in Table 2 have not been analyzed, except in two reports with only three and six components, both of which found some ergogenic properties.230,231
Inhibitors of phosphoinositide 3-kinase (PI3K) and phosphoinositide 3-kinase-related protein kinase family (PIKK)
Published in Journal of Enzyme Inhibition and Medicinal Chemistry, 2023
Xueqin Huang, Li You, Eugenie Nepovimova, Miroslav Psotka, David Malinak, Marian Valko, Ladislav Sivak, Jan Korabecny, Zbynek Heger, Vojtech Adam, Qinghua Wu, Kamil Kuca
Ridaforolimus is a sirolimus analog that was initially used to treat soft tissue and osteosarcoma before being extended to treat a wide range of solid and hematological malignancies229. A phase III trial evaluated the maintenance of disease control in advanced sarcoma with ridaforolimus. The median PFS was 17.7 weeks for ridaforolimus and 14.6 weeks for placebo. However, serious adverse effects (grade > 3) were more common with ridaforolimus (64.1% vs. 25.6%)230. Due to its poor risk-benefit profile, the US FDA has not approved ridaforolimus for the treatment of sarcoma. Ridaforolimus underwent subsequent clinical trials for the treatment of various malignancies, but its safety still restricts its clinical application. In patients with advanced endometrial cancer, single-agent ridaforolimus displayed anticancer activity and tolerable tolerability, with 13 patients (29%) attaining clinical benefit and a 6-month PFS rate of 18%231. Based on the positive clinical outcomes of this trial, a follow-up phase II trial was conducted in patients with endometrial cancer232. The median PFS for the ridaforolimus group was 3.6 months and 1.9 months for the control group (progestin or chemotherapy). However, the proportion of patients in the ridaforolimus group who discontinued treatment due to AE was 33%, compared to 6% in the control group, with typical grade 3 toxicities being hyperglycaemia, anaemia, and diarrhoea232. Thus, oral ridaforolimus has strong toxicity in advanced endometrial cancer. Currently, ridaforolimus has stopped development.
The proximity of the N- and C- termini of bovine knob domains enable engineering of target specificity into polypeptide chains
Published in mAbs, 2022
Alice Hawkins, Callum Joyce, Kevin Brady, Adam Hold, Alan Smith, Michael Knight, Conor Howard, Jean van den Elsen, Alastair D.G. Lawson, Alex Macpherson
Multi-cycle kinetics experiments were performed using Biacore 8 K and 8 K+ instruments (GE Healthcare). Following normalization of a Biacore sensor chip CM5, human C5 protein (purified from serum, as described)29 was amine coupled as follows: flow cells 1 and 2 were activated using a 1:2 molar ratio of 1-ethyl-3-(3-dimethylaminopropyl)-carbodiimide and N-hydroxysuccinimide (flow rate 10 µL/minute; contact time, 30s). A 5 µg/mL solution of human C5 in 10 mM sodium acetate at pH 4.5 was immobilized in flow cell two only and, finally, both flow cells were blocked with 1 M ethanolamine-HCl, pH 8 (flow rate 10 µL/minute; contact time, 420 s). This typically resulted in immobilization of 230–730 response units (RU). To derive kinetics, five point, three-fold serial dilutions of analyte (range of 100–0.4 nM) were prepared in HBS-EP+ buffer. For each injection, a flow rate of 40 µL/minute, a contact time of 300 s and dissociation time of 5400 s was used. After each injection, regeneration of the surface was performed with sequential injections of 2 M MgCl2 (flow rate 30 µL/min; contact time 30s). The data was fitted with the reference surface subtracted using a Biacore evaluation software 1:1 binding model to determine the binding kinetics.
Undocuqueer Stress: How Safe are “Safe” Spaces, and for Whom?
Published in Journal of Homosexuality, 2020
Jesus Cisneros, Christian Bracho
Participants in this study often sought relationships as additional means of support, safety, and comfort. Forming relationships, however, was a process that participants often approached with ambivalence, as the implications imposed by their immigration status always invoked the need for self-disclosure. These findings align with the work of Goode-Cross and Good (2008), in a study that examined how African-American men who have sex with men grapple with coming out. The authors write: The men reported that disclosing their sexual identity was often a salient aspect of feeling safe in revealing their full identities to others and in being able to be themselves, which is a vital aspect of experiencing safe spaces in which they could express their full identities. Nonetheless, disclosure of minority-status sexual identity involved significant risks. Individuals risked ridicule, shame, hostility, rejection, and physical injury each time they disclosed this aspect of their identity. (p. 230)