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Antenatal anxiety is among the risk factors for adverse birth outcomes, which are common in Pakistan. Between 2019 and 2022, we conducted a randomized controlled trial to evaluate the effects of the Happy Mother-Healthy Baby program, designed to reduce anxiety during pregnancy through use of Cognitive Behavior Therapy, on birth outcomes with 796 women in Rwalpindi, Pakistan. We performed intent-to-treat analysis and per protocol analyses. Intention-to-treat analyses showed no difference in the odds of low birthweight (LBW) (Adj. OR = 0.82, 95% CI 0.55–1.28 p = 0.37), preterm birth (PTB) (Adj. OR = 1.20 95% CI 0.83–1.71, p = 0.33) or small-for-gestational age (SGA) birth, (Adj. OR = 0.76, 95% CI 0.56–1.09, p = 0.16). Among completers who received ≥ 5 intervention sessions, the odds of LBW and SGA were 39% and 32% lower (Adj. OR = 0.61, 95% CI 0.43–0.87, p < 0.01; Adj. OR = 0.68, 95% CI 0.53–0.89, p < 0.01). The significant LBW and SGA results among the intervention completers suggest that the program may be effective when a sufficient dose is received. However, confirmation of these findings is needed due to the fact that randomization is not maintained in completer analyses. Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT03880032, 19/03/2019. [ABSTRACT FROM AUTHOR]

Niclosamide, a potent anthelmintic agent, has emerged as a candidate against COVID‐19 in recent studies. Its formulation has been investigated extensively to address challenges related to systemic exposure. In this study, niclosamide was formulated as a long‐acting intramuscular injection to achieve systemic exposure in the lungs for combating the virus. To establish the dose–exposure relationship, a hamster model was selected, given its utility in previous COVID‐19 infection studies. Pharmacokinetic (PK) analysis was performed using NONMEM and PsN. Hamsters were administered doses of 55, 96, 128, and 240 mg/kg with each group comprising five animals. Two types of PK models were developed, linear models incorporating partition coefficients and power‐law distributed models, to characterize the relationship between drug concentrations in the plasma and lungs of the hamsters. Numerical and visual diagnostics, including basic goodness‐of‐fit and visual predictive checks, were employed to assess the models. The power‐law‐based PK model not only demonstrated superior numerical performance compared with the linear model but also exhibited better agreement in visual diagnostic evaluations. This phenomenon was attributed to the nonlinear relationship between drug concentrations in the plasma and lungs, reflecting kinetic heterogeneity. Dose optimization, based on predicting lung exposure, was conducted iteratively across different drug doses, with the minimum effective dose estimated to be ~1115 mg/kg. The development of a power‐law‐based PK model proved successful and effectively captured the nonlinearities observed in this study. This method is expected to be applicable for investigating the drug disposition of specific formulations in the lungs. [ABSTRACT FROM AUTHOR]

Background: Labor pain management is a critical aspect of midwifery care and an essential purpose of childbirth-related care. There is a need for comprehensive results on relevant non-therapeutic methods of reducing labor pain. This systematic review and meta-analysis study was conducted to investigate the effect of yoga practice on labor pain. Material and Methods: We performed a systematic literature search from SCOPUS, PubMed, Web of Science, and Science Direct for relevant studies from January 1, 1990 to June 2, 2022. We selected published quasi-randomized and randomized controlled trial studies that evaluated the effect of yoga practice on labor pain. Quality research was applied. We pooled the Standardized Mean Dfference (SMD) of labor pain in pregnant women with and without yoga practice during pregnancy using a random-effects model at 95% Confidence Intervals (CIs). Results: Nine studies including 660 women were included in the meta-analysis. Pregnant women in the yoga practice group experienced statistically significantly low labor pain at the beginning of the active phase compared to the control group (SMD: -1.10, 95% CI: -1.61, -0.58, p < 0.001; I2 = 89%). Yoga interventions also reduced the intensity of labor pain in active (SMD: -1.32, 95% CI: -2.03, -0.60, p < 0.001; I2 = 92%) and transition (SMD: -1.93, 95% CI: -2.87, -0.99, p < 0.001; I2 = 92%) phases compared to the control group, respectively. Conclusions: The results of the study showed that yoga practice during pregnancy reduces the intensity of labor pain in different labor phases. However, these findings should be considered cautiously due to the substantial heterogeneity between studies. [ABSTRACT FROM AUTHOR]

Apicomplexan parasites constitute more than 6,000 species infecting a wide range of hosts. These include important pathogens such as those causing malaria and toxoplasmosis. Their evolutionary emergence coincided with the dawn of animals. Mitochondrial genomes of apicomplexan parasites have undergone dramatic reduction in their coding capacity, with genes for only three proteins and ribosomal RNA genes present in scrambled fragments originating from both strands. Different branches of the apicomplexans have undergone rearrangements of these genes, with Toxoplasma having massive variations in gene arrangements spread over multiple copies. The vast evolutionary distance between the parasite and the host mitochondria has been exploited for the development of antiparasitic drugs, especially those used to treat malaria, wherein inhibition of the parasite mitochondrial respiratory chain is selectively targeted with little toxicity to the host mitochondria. We describe additional unique characteristics of the parasite mitochondria that are being investigated and provide greater insights into these deep-branching eukaryotic pathogens. [ABSTRACT FROM AUTHOR]

Oceanic flows are turbulent and multi-scale in nature, and are composed of fast internal waves and slowly evolving balanced eddies. Contrary to conventional wisdom in physical oceanography, the past two decades of in situ, satellite altimeter and realistically forced global scale ocean model outputs have revealed that internal gravity waves can have comparable or higher energy levels than geostrophically balanced flows at 10–100 km scales in different parts of the world's oceans. These relatively recent findings have fuelled a wide range of research activities aimed at understanding how fast internal gravity waves interact with slowly evolving balanced flows, particularly with the goal of deducing whether internal waves can form an energy sink for oceanic balanced flows. In this paper, we comprehensively review theoretical, numerical and observational investigations undertaken to study internal wave-balance flow exchanges. Theoretical calculations, inspired by different wave-balance regimes seen in observational and global ocean model outputs, are used to point out that internal waves can affect balanced flow dynamics. The theoretical results are followed up by a detailed discussion of numerical results on wave-balance interactions in a broad set of parameter regimes. The numerical results reveal how different kinds of waves exchange energy with balance flow, affect energy flux across scales of balanced flow and facilitate the generation of small-scale dissipative balanced flow structures. The numerical simulation results and global internal wave energy and balanced energy maps are used to conjecture that out of the 0.8 TW of power going to balanced flow kinetic energy in the ocean, at least 0.1 TW could be dissipated by internal gravity waves. We therefore hypothesize that internal waves can form a non-negligible energy sink for balanced flow in the world's oceans. [ABSTRACT FROM AUTHOR]

Objective: In determining the effects of yoga practice on mild preeclampsia, this study examines the blood pressure, blood platelet (PLT) count, and proteinuria status in pregnant women over 20 weeks of pregnancy. Materials and Methods: This research is an experimental study with a pre–post intervention design. We collected forty pregnant women with mild preeclampsia from all populations. All participants agreed to practice 30 min of yoga every week for 1 month. The blood pressure, the blood PLT count, and proteinuria were measured before and after the yoga intervention. The statistical analysis used the t-test for the blood PLT count variable, the McNemar test for the proteinuria variable, and the Wilcoxon test for the blood pressure variable. Results: The results showed a decrease in systole blood pressure from 134.17 ± 7.17 mmHg before a yoga intervention to 120 ± 4.17 mmHg after yoga intervention (P < 0.001) and a decrease in diastole blood pressure from 89.58 ± 5.5 mmHg before the intervention to 79.38 ± 4.25 mmHg after the intervention (P < 0.001). However, there was no significant difference in blood PLT count (P = 0.104) and proteinuria (P = 0.063) before and after a yoga intervention in pregnant women with mild preeclampsia patients. Conclusions: Yoga exercise during pregnancy (upper 20 weeks of gestation) significantly decreased systolic and diastolic blood pressure in mild preeclampsia patients. [ABSTRACT FROM AUTHOR]

Developing long-acting products and formulations for infectious diseases is a nontrivial undertaking that is frequently classified as high risk and low reward by the pharmaceutical industry. The Long-Acting/Extended Release Antiretroviral Research Resource Program (LEAP) was founded in 2015 with the support of the National Institutes of Health to encourage, promote, and accelerate the development of such products. Assessment methodology for any new proposal brought to this group is part of a framework—the LEAP Process—that includes a landscape analysis of what is currently available in the public domain. This is followed by in silico modeling and simulation offered as a service to the relevant scientific community. A variety of preclinical and clinical outcome metrics are applied to each new agent as part of a continuous feedback loop to improve product characteristics. This allows us to catalog knowledge gaps and barriers that can be addressed by engaged stakeholders. Results are communicated in scientific articles, reviews, and position papers. This undertaking serves to de-risk discovery, development, and implementation by bridging the gaps between academic, regulatory, and industrial investigators, and by engaging those in the community who will be the eventual users of these medicines. The LEAP Process has supported formulations now approved for human immunodeficiency virus, as well as products in clinical and preclinical development for tuberculosis and hepatitis viruses B and C. [ABSTRACT FROM AUTHOR]

Background: Substantial research is underway to develop next-generation interventions that address current malaria control challenges. As there is limited testing in their early development, it is difficult to predefine intervention properties such as efficacy that achieve target health goals, and therefore challenging to prioritize selection of novel candidate interventions. Here, we present a quantitative approach to guide intervention development using mathematical models of malaria dynamics coupled with machine learning. Our analysis identifies requirements of efficacy, coverage, and duration of effect for five novel malaria interventions to achieve targeted reductions in malaria prevalence. Methods: A mathematical model of malaria transmission dynamics is used to simulate deployment and predict potential impact of new malaria interventions by considering operational, health-system, population, and disease characteristics. Our method relies on consultation with product development stakeholders to define the putative space of novel intervention specifications. We couple the disease model with machine learning to search this multi-dimensional space and efficiently identify optimal intervention properties that achieve specified health goals. Results: We apply our approach to five malaria interventions under development. Aiming for malaria prevalence reduction, we identify and quantify key determinants of intervention impact along with their minimal properties required to achieve the desired health goals. While coverage is generally identified as the largest driver of impact, higher efficacy, longer protection duration or multiple deployments per year are needed to increase prevalence reduction. We show that interventions on multiple parasite or vector targets, as well as combinations the new interventions with drug treatment, lead to significant burden reductions and lower efficacy or duration requirements. Conclusions: Our approach uses disease dynamic models and machine learning to support decision-making and resource investment, facilitating development of new malaria interventions. By evaluating the intervention capabilities in relation to the targeted health goal, our analysis allows prioritization of interventions and of their specifications from an early stage in development, and subsequent investments to be channeled cost-effectively towards impact maximization. This study highlights the role of mathematical models to support intervention development. Although we focus on five malaria interventions, the analysis is generalizable to other new malaria interventions. [ABSTRACT FROM AUTHOR]

Model-informed drug repurposing: viral kinetic modelling to prioritize rational drug combinations for COVID-19. For example, some of these challenges were highlighted recently by the International Society for Aerosols in Medicine, as part of their call for consideration of inhaled delivery.[12] Several advanced drug delivery strategies can be applied much more rapidly than new drug development and do not need to be prohibitively expensive for global community programmes. Keywords: coronavirus; drug development; equitable access; repurposing; SARS-CoV-2 EN coronavirus drug development equitable access repurposing SARS-CoV-2 421 423 3 12/22/22 20230101 NES 230101 Given time, drug discovery programmes will undoubtedly yield highly potent drugs to form the basis of optimised COVID-19 regimens. [Extracted from the article]

An introduction is presented in which the author discusses various topics within the issue, including the long-acting (LA) formulations for treating infectious diseases, the approved LA products like LA-rilpivirine, and the LA Extended-Release Antiretroviral Research Resource Program (LEAP).

Drug delivery is an integral part of the drug development process, influencing safety and efficacy of active pharmaceutical ingredients. The application of nanotechnology has enabled the discovery of novel formulations for numerous therapeutic purposes across multiple disease areas. However, evaluation of novel formulations in clinical scenarios is slow and hampered due to various ethical and logistical barriers. Computational models have the ability to integrate existing domain knowledge and mathematical correlations, to rationalize the feasibility of using novel formulations for safely enhancing drug delivery, identifying suitable candidates, and reducing the burden on preclinical and clinical studies. In this review, types of novel formulations and their application through several routes of administration and the use of modeling approaches that can find application in different stages of the novel formulation development process are discussed. [ABSTRACT FROM AUTHOR]

BACKGROUND: Pregnancy is a vulnerable period of growth and enrichment along with many physiological and psychological challenges. These changes can lead to complications if compounded by external stress and anxiety. COVID-19 has emerged as a chief stressor among the general population and is a serious threat among vulnerable populations. Therefore, there is a need for stress management tools, such as Yoga and physical exercises, both at home and at work. These can be adopted during the pandemic with proper maintenance of social distancing. OBJECTIVE: To evaluate and compile literature that has reported the health outcomes of Yoga intervention on pregnancy at the workplace and analyzes both the restrictions as well as advantages of its beneficial effects in comparison to physical exercises. METHODOLOGY: A comprehensive literature review was conducted utilizing PubMed and Google Scholar. The keywords used for the search include "Yoga", "work", "complications", "physical exercise", "drugs" and "COVID" indifferent permutations and combinations with "pregnancy". We compiled the literature with respect to pregnancy complications and the effects of drugs, physical activity and Yoga for preventing these complications. RESULTS: We noted that pregnancy-related complications are becoming more prevalent because of a sedentary lifestyle, restricted physical activity and growing stress. In such situations, a home or workplace Yoga protocol can combine both exercise and mindfulness-based alleviation of anxiety for both working and non-working women. CONCLUSION: Yoga can be effective for combating stress and anxiety besides boosting immunity in pregnant working women confronted with the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

The cytochrome bc1 complex is a key component of the mitochondrial respiratory chains of many eukaryotic microorganisms that are pathogenic for plants or humans, such as fungi responsible for crop diseases and Plasmodium falciparum, which causes human malaria. Cytochrome bc1 is an enzyme that contains two (ubi)quinone/quinol‐binding sites, which can be exploited for the development of fungicidal and chemotherapeutic agents. Here, we review recent progress in determination of the structure and mechanism of action of cytochrome bc1, and the associated development of antimicrobial agents (and associated resistance mechanisms) targeting its activity. [ABSTRACT FROM AUTHOR]

The interactions between barotropic tides and mesoscale processes were studied using the results of a numerical model in which tidal forcing was turned on and off. The research area covered part of the East Atlantic Ocean, a steep continental slope, and the European Northwest Shelf. Tides affected the baroclinic fields at much smaller spatial scales than the barotropic tidal scales. Changes in the horizontal patterns of the M2 and M4 tidal constituents provided information about the two-way interactions between barotropic tides and mesoscale processes. The interaction between the atmosphere and ocean measured by the work done by wind was also affected by the barotropic tidal forcing. Tidal forcing intensified the transient processes and resulted in a substantial transformation of the wave number spectra in the transition areas from the deep ocean to the shelf. Tides flattened the sea-surface height spectra down to ~ k−2.5 power law, thus reflecting the large contribution of the processes in the high-frequency range compared to quasi-geostrophic motion. The spectra along sections parallel or normal to the continental slope differ from each other, which indicates that mesoscale turbulence was not isotropic. An analysis of the vorticity spectra showed that the flattening was mostly due to internal tides. Compared with the deep ocean, no substantial scale selectivity was observed on the shelf area. Particle tracking showed that the lengths of the Lagrangian trajectories increased by approximately 40% if the barotropic tidal forcing was activated, which contributed to changed mixing properties. The ratio between the horizontal and vertical scales of motion varied regionally depending on whether barotropic tidal forcing was included. The overall conclusion is that the barotropic tides affect substantially the diapycnal mixing. [ABSTRACT FROM AUTHOR]

An amphiphilic core/shell-type polymer-based drug carrier system (HPAE-PCL-b-MPEG), composed of hyperbranched poly(aminoester)-based polymer (HPAE) as the core building block and poly(ethylene glycol)-b-poly(ε-caprolactone) diblock polymers (MPEG-b-PCL) as the shell building block, was designed. The synthesized polymers were characterized with FTIR, ´H NMR, 13C NMR, and GPC analysis. Monodisperse HPAE-PCL-b- MPEG nanoparticles with dimensions of <200 nm and polydispersity index of <0.5 were prepared by nanoprecipitation method and characterized with SEM, particle size, and zeta potential analysis. 5-Fluorouracil was encapsulated within HPAE-PCL-b-MPEG nanoparticles. In vitro drug release profiles and cytotoxicity of blank and 5-fluorouracil-loaded nanoparticles were examined against the human colon cancer HCT116 cell line. All results suggest that HPAE-PCL-b-MPEG nanoparticles offer an alternative and effective drug nanocarrier system for drug delivery applications. [ABSTRACT FROM AUTHOR]

Background: Pre-exposure prophylaxis (PrEP) is not widely available in China. Previous studies reported low awareness and inconclusive findings on the acceptability of PrEP among Chinese men who have sex with men (MSM).Methods: We conducted a secondary analysis of an online national survey comparing preferences for oral and long-acting injectable PrEP among MSM and identifying correlates of preferences. The study did not collect detailed information about partner types that may influence negotiated safety and PrEP uptake.Results: Nine-hundred and seventy-nine men from the larger sample of 1045 men responded to the PrEP survey questions. Most men (81.9%) had never heard of PrEP, but reported interest in using PrEP. More participants chose injectable PrEP (36.3%) as their preferred formulation than oral PrEP (24.6%). Men who had at least two HIV tests (adjusted OR = 1.36, 95%CI 1.04, 1.78) more commonly preferred injectable PrEP.Conclusion: Our findings may help inform PrEP messaging in areas where PrEP has yet to be scaled up. [ABSTRACT FROM AUTHOR]

Antiretroviral drugs have revolutionized the treatment and prevention of HIV infection; however, adherence is critical for sustained efficacy. Current HIV treatment consists of three-drug regimens, and current HIV pre-exposure prophylaxis (PrEP) consists of a two-drug regimen; both generally require adherence to once-daily dosing. Long-acting formulations are useful in the treatment and prevention of other conditions (e.g., contraceptives, antipsychotics) and help promote adherence. Newer long-acting formulations of approved and investigational antiretroviral drugs in existing and newer mechanistic classes are under study for HIV treatment and prevention, including some phase III trials. Although long-acting antiretroviral drugs hold promise, some clinical challenges exist, including managing side effects, drug-drug interactions, pregnancy, and long-lasting drug concentrations that could lead to the development of drug resistance. This review aims to summarize currently available information on long-acting antiretroviral drugs for HIV treatment and prevention. [ABSTRACT FROM AUTHOR]

Complementary and alternative medicine is used by a substantial number of pregnant women and maternity care providers are often faced with the task of ensuring women are using safe and effective treatments while respecting a woman's right to autonomous decision-making. In the era of evidence-based medicine maternity health professionals are expected to draw upon the best available evidence when making clinical decisions and providing health advice. This review will outline the current trends in research evidence associated with the outcomes of complementary and alternative medicine use amongst pregnant and birthing women as well as highlight some potential directions for future development in this important yet largely unknown topic in contemporary maternity care. [ABSTRACT FROM AUTHOR]

Objectives The purpose of this article is to review all randomized control trials (RCTs) that have looked at the health effects of yoga on pregnancy, and to present their evidence on the specific ways in which pregnant women, and their infants can benefit from yoga intervention. The purpose is also to determine whether yoga intervention during pregnancy is more beneficial than other physical exercises. Methods Four databases were searched using the terms "yoga and (pregnancy or pregnant or prenatal or postnatal or postpartum)." Databases were searched from January 2004 to February 2014. Results Ten randomized controlled trials were evaluated. The findings consistently indicate that yoga intervention presented with lower incidences of prenatal disorders (p ≤ 0.05), and small gestational age (p < 0.05), lower levels of pain and stress (p < 0.05), and higher score of relationship (p < 0.05). In addition, yoga can be safely used for pregnant women who are depressed, at high-risk, or experience lumbopelvic pain. Moreover, yoga is a more effective exercise than walking or standard prenatal exercises. Conclusions The findings suggest that yoga is a safe and more effective intervention during pregnancy. However, further RCTs are needed to provide firmer evidence regarding the utility and validity of yoga intervention. [ABSTRACT FROM AUTHOR]

The primary objective of this survey was to ascertain the opinions, practices and knowledge about exercise, including yoga, during pregnancy; the secondary objective to compare the responses among women with body mass index (BMI) <30 kg/m2 versus ≥30 kg/m2. Survey consisted of 20 multiple choice questions assessing demographics and exercise practices, and five questions testing their knowledge about it during pregnancy (ACOG Committee Opinion # 267). Of the 500 surveys distributed, 84% (422) responses were analyzed. While 86% of women responded that exercise during pregnancy is beneficial, 83% felt it was beneficial to start prior to pregnancy, and walking was considered the most beneficial (62%). The majority (64%) of respondents were currently exercising during pregnancy and 51% exercised 2-3 times/week. Among the five questions testing knowledge about prenatal exercise, majority (range 60 to 92%) were aware of ACOG recommendations. About half had a BMI ≥30. Knowledge about benefits of exercise during pregnancy did not differ significantly between obese and non-obese. Yoga was tried significantly more among non-obese, 65% believed it is beneficial, and 40% had attempted yoga before pregnancy. In our population, the majority believes that exercise, including yoga, is beneficial and they are active. [ABSTRACT FROM AUTHOR]

Background: Prenatal depression can negatively affect the physical and mental health of both mother and fetus. The aim of this study was to determine the effectiveness of yoga as an intervention in the management of prenatal depression. Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted by searching PubMed, Embase, the Cochrane Library and PsycINFO from all retrieved articles describing such trials up to July 2014. Results: Six RCTs were identified in the systematic search. The sample consisted of 375 pregnant women, most of whom were between 20 and 40 years of age. The diagnoses of depression were determined by their scores on Structured Clinical Interview for DSM-IV and the Center for Epidemiological Studies Depression Scale. When compared with comparison groups (e.g., standard prenatal care, standard antenatal exercises, social support, etc.), the level of depression statistically significantly reduced in yoga groups (standardized mean difference [SMD], -0.59; 95% confidence interval [CI], -0.94 to -0.25; p = 0.0007). One subgroup analysis revealed that both the levels of depressive symptoms in prenatally depressed women (SMD, -0.46; CI, -0.90 to -0.03; p = 0.04) and non-depressed women (SMD, -0.87; CI, -1.22 to -0.52; p < 0.00001) were statistically significantly lower in yoga group than that in control group. There were two kinds of yoga: the physical-exercise-based yoga and integrated yoga, which, besides physical exercises, included pranayama, meditation or deep relaxation. Therefore, the other subgroup analysis was conducted to estimate effects of the two kinds of yoga on prenatal depression. The results showed that the level of depression was significantly decreased in the integrated yoga group (SMD, -0.79; CI, -1.07 to -0.51; p < 0.00001) but not significantly reduced in physical-exercise-based yoga group (SMD, -0.41; CI, -1.01 to -0.18; p = 0.17). Conclusions: Prenatal yoga intervention in pregnant women may be effective in partly reducing depressive symptoms. [ABSTRACT FROM AUTHOR]

Marine ecosystems can experience regime shifts, in which they shift from being organized around one set of mutually reinforcing structures and processes to another. Anthropogenic global change has broadly increased a wide variety of processes that can drive regime shifts. To assess the vulnerability of marine ecosystems to such shifts and their potential consequences, we reviewed the scientific literature for 13 types of marine regime shifts and used networks to conduct an analysis of co-occurrence of drivers and ecosystem service impacts. We found that regime shifts are caused by multiple drivers and have multiple consequences that co-occur in a non-random pattern. Drivers related to food production, climate change and coastal development are the most common co-occurring causes of regime shifts, while cultural services, biodiversity and primary production are the most common cluster of ecosystem services affected. These clusters prioritize sets of drivers for management and highlight the need for coordinated actions across multiple drivers and scales to reduce the risk of marine regime shifts. Managerial strategies are likely to fail if they only address well-understood or data-rich variables, and international cooperation and polycentric institutions will be critical to implement and coordinate action across the scales at which different drivers operate. By better understanding these underlying patterns, we hope to inform the development of managerial strategies to reduce the risk of high-impact marine regime shifts, especially for areas of the world where data are not available or monitoring programmes are not in place. [ABSTRACT FROM AUTHOR]

Introduction: Complementary and alternative medicine (CAM) is commonly used among women, but few national data exist regarding CAM use during pregnancy or the postnatal period. Methods: Data from the 2007 National Health Interview Survey were analyzed for women ages between the ages of 18 and 49 years who were pregnant or had children less than 1 year old. CAM use was identified based on standard definitions of CAM from the National Institutes of Health's National Center for Complementary and Alternative Medicine. CAM use among women who were pregnant or with a child less than 1 year was compared with the other similarly aged female responders. CAM use was examined among these women stratified by sociodemographics, health conditions, and conventional medicine use through bivariable and multivariable logistic regression models. Results: Among pregnant and postpartum women from the ages of 19 to 49 years in the United States, 37% of pregnant women and 28% of postpartum women reported using CAM in the last 12 months compared with 40% of nonpregnant/non-postpartum women. Mind-body practices were the most common CAM modality reported, with one out of four women reporting use. Biological therapies, excluding vitamins and minerals, during the postpartum period were used by only 8% of women. Using multivariable regression modeling, we report no significant difference in CAM use among pregnant compared with non-pregnant women (adjusted odds ratio [AOR], 0.88; [95% confidence interval 0.65-1.20]), but lower CAM use among postpartum women compared with non-pregnant women (AOR 0.67; [0.52-0.88]), while adjusting for sociodemographics. Conclusion: CAM use among pregnancy similar to women who are not pregnant, while postpartum CAM use decreases. Further evaluation of CAM therapies among pregnant and postpartum women is necessary to determine the costs and benefits of integrative CAM therapies in conventional care. [ABSTRACT FROM AUTHOR]

Controlled exposure experiments can be very informative, however, they are based on the assumption that pathogens maintained on artificial media under long-term storage retain the infective and pathogenic properties of the reproducing pathogen as it occurs in a host. We observed that JEL284, an in vitro cultured and maintained isolate of Batrachochytrium dendrobatidis (Bd), was becoming less infectious with successive uses. We hypothesized that passing an isolate propagated on artificial media through an amphibian host would make the isolate more infectious and pathogenic in subsequent exposures. To test our hypothesis, we used two discreet steps, a reisolation step (step 1) and a comparative exposure step (step 2). In step 1, we exposed eastern spadefoot toads, Scaphiopus holbrooki, to JEL284 and JEL197, another isolate that had been maintained in vitro for over six years. We then re-isolated JEL284 only from a successful infection and named this new isolate JEL284FMBa. JEL197 did not infect any amphibians and, thus, did not proceed to step 2. In step 2, we compared infectivity and pathogenicity (mortality and survival time) of JEL284 and JEL284FMBa by exposing 54 naïve S. holbrooki to three treatments (JEL284, JEL284FMBa, and negative control) with 18 individuals per group. We found that JEL284FMBa caused higher mortality and decreased survival time in infected individuals when compared to JEL284 and negative controls. Thus, our data show that pathogenicity of Bd can decrease when cultured successively in media only and can be partially restored by passage through an amphibian host. Therefore, we have demonstrated that pathogenicity shifts can occur rapidly in this pathogen. Given the potential for shifts in pathogenicity demonstrated here, we suspect Bd to have similar potential in natural populations. We suggest that, when possible, the use of freshly isolated or cryopreserved Bd would improve the quality of controlled exposure experiments using this pathogen. [ABSTRACT FROM AUTHOR]

Abstract: There is a direct link between healthy mothers and healthy infants. Exercise and appropriate nutrition are important contributors to maternal physical and psychological health. The benefits and potential risks of exercise during pregnancy have gained even more attention, with a number of studies having been published after the 2002 American College of Obstetrics and Gynecologists guidelines. A review of the literature was conducted by using PubMed, Scopus, and Embase to assess the literature regarding the benefits of exercise during pregnancy. The search revealed 219 publications, which the authors then narrowed to 125 publications. The purpose of this review is to briefly summarize the known benefits of exercise to the mother, fetus, and newborn. [Copyright &y& Elsevier]

Water soluble, luminescent gold nanoparticles are delivered into human platelets via a rapid, pH-controlled mechanism using a pH low insertion peptide, pHLIP. The approach introduces cocoating of gold nanoparticles with a europium luminescent complex, EuL and the pHLIP peptide to give pHLIP•EuL•Au. The 13-nm diameter gold nanoparticles act as a scaffold for the attachment of both the luminescent probe and the peptide to target delivery. Their size allows delivery of approximately 640 lanthanide probes per nanoparticle to be internalized in human platelets, which are not susceptible to transfection or microinjection. The internalization of pHLIP•EuL•Au in platelets, which takes just minutes, was studied with a variety of imaging modalities including luminescence, confocal reflection, and transmission electron microscopy. The results show that pHLIP•EuL•Au only enters the platelets in low pH conditions, pH 6.5, mediated by the pHLIP translocation across the membrane, and not at pH 7.4. Luminescence microscopy images of the treated platelets show clearly the red luminescence signal from the europium probe and confocal reflection microscopy confirms the presence of the gold particles. Furthermore, transmission electron microscopy gives a detailed insight of the internalization and spatial localization of the gold nanoparticles in the platelets. Thus, we demonstrate the potential of the design to translocate multimodal nanoparticle probes into cells in a pH dependent manner. [ABSTRACT FROM AUTHOR]

Background: High rates of psychological-distress, trauma and social complexity are reported among young pregnant women. At the Royal Women's Hospital, Australia, young pregnant women acknowledge wanting tools to improve maternal wellbeing yet remain challenging to engage in antenatal education and support. While yoga is a widely accepted and participated activity in pregnancy, with demonstrated benefits for adult pregnant women, adolescent women are often excluded from both these yoga interventions and related pregnancy studies.Methods: This mixed methods study examined the acceptability and benefits of yoga for young women. We recruited 30 participants aged under 24 years, who were offered twice a week, one-hour voluntary prenatal yoga sessions throughout their pregnancy. A medical file audit gathered baseline demographics, pre and post yoga session surveys were administered and brief individual interview were conducted with study participants.Results: While 26 study participants were positive about the availability of a yoga program, only 15 could attend yoga sessions (mean = 8 sessions, range 1-27). No differences were found in the demographic or psychosocial factors between those who did and did not attend the yoga sessions. The medical file audit found that 60% of all the study participants had a documented history of psychological distress. Barriers to participation were pragmatic, not attitudinal, based on the timing of the group sessions, transport availability and their own health. All study participants identified perceived benefits, and the yoga participants identified these as improved relaxation and reduction of psychological distress; labour preparation; bonding with their baby in utero; and social connectedness with the yoga group peers.Conclusions: This study demonstrated yoga was acceptable to young pregnant women. For those who did participate in the sessions, yoga was found to decrease self-reported distress and increase perceived skills to assist with their labour and the birth of their baby. The provision of accessible yoga programs for pregnant young women is recommended. [ABSTRACT FROM AUTHOR]

Background: The potential benefits of long-acting injectable chemoprotection (LAI-C) against malaria have been recently recognized, prompting a call for suitable candidate drugs to help meet this need. On the basis of its known pharmacodynamic and pharmacokinetic profiles after oral dosing, ELQ-331, a prodrug of the parasite mitochondrial electron transport inhibitor ELQ-300, was selected for study of pharmacokinetics and efficacy as LAI-C in mice. Methods: Four trials were conducted in which mice were injected with a single intramuscular dose of ELQ-331 or other ELQ-300 prodrugs in sesame oil with 1.2% benzyl alcohol; the ELQ-300 content of the doses ranged from 2.5 to 30 mg/kg. Initial blood stage challenges with Plasmodium yoelii were used to establish the model, but the definitive study measure of efficacy was outcome after sporozoite challenge with a luciferase-expressing P. yoelii, assessed by whole-body live animal imaging. Snapshot determinations of plasma ELQ-300 concentration ([ELQ-300]) were made after all prodrug injections; after the highest dose of ELQ-331 (equivalent to 30 mg/kg ELQ-300), both [ELQ-331] and [ELQ-300] were measured at a series of timepoints from 6 h to 5½ months after injection. Results: A single intramuscular injection of ELQ-331 outperformed four other ELQ-300 prodrugs and, at a dose equivalent to 30 mg/kg ELQ-300, protected mice against challenge with P. yoelii sporozoites for at least 4½ months. Pharmacokinetic evaluation revealed rapid and essentially complete conversion of ELQ-331 to ELQ-300, a rapidly achieved (< 6 h) and sustained (4–5 months) effective plasma ELQ-300 concentration, maximum ELQ-300 concentrations far below the estimated threshold for toxicity, and a distinctive ELQ-300 concentration versus time profile. Pharmacokinetic modeling indicates a high-capacity, slow-exchange tissue compartment which serves to accumulate and then slowly redistribute ELQ-300 into blood, and this property facilitates an extremely long period during which ELQ-300 concentration is sustained above a minimum fully-protective threshold (60–80 nM). Conclusions: Extrapolation of these results to humans predicts that ELQ-331 should be capable of meeting and far-exceeding currently published duration-of-effect goals for anti-malarial LAI-C. Furthermore, the distinctive pharmacokinetic profile of ELQ-300 after treatment with ELQ-331 may facilitate durable protection and enable protection for far longer than 3 months. These findings suggest that ELQ-331 warrants consideration as a leading prototype for LAI-C. [ABSTRACT FROM AUTHOR]