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Fulltext Maternal and foetal outcomes following natural vaginal versus caesarean section (c-section) delivery in women with bleeding disorders and carriers

Karanth L, Kanagasabai S, Abas AB

Cochrane Database Syst Rev, 2017 08 04;8:CD011059.
PMID: 28776324 DOI: 10.1002/14651858.CD011059.pub3

BACKGROUND: Bleeding disorders are uncommon but may pose significant bleeding complications during pregnancy, labour and following delivery for both the woman and the foetus. While many bleeding disorders in women tend to improve in pregnancy, thus decreasing the haemorrhagic risk to the mother at the time of delivery, some do not correct or return quite quickly to their pre-pregnancy levels in the postpartum period. Therefore, specific measures to prevent maternal bleeding and foetal complications during childbirth, are required. The safest method of delivery to reduce morbidity and mortality in these women is controversial. This is an update of a previously published review.
OBJECTIVES: To assess the optimal mode of delivery in women with, or carriers of, bleeding disorders.
SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Coagulopathies Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books. We also searched the Cochrane Pregnancy and Childbirth Group's Trials Register as well as trials registries and the reference lists of relevant articles and reviews.Date of last search of the Group's Trials Registers: 16 February 2017.
SELECTION CRITERIA: Randomised controlled trials and all types of controlled clinical trials investigating the optimal mode of delivery in women with, or carriers of, any type of bleeding disorder during pregnancy were eligible for the review.
DATA COLLECTION AND ANALYSIS: No trials matching the selection criteria were eligible for inclusion MAIN RESULTS: No results from randomised controlled trials were found.
AUTHORS' CONCLUSIONS: The review did not identify any randomised controlled trials investigating the safest mode of delivery and associated maternal and foetal complications during delivery in women with, or carriers of, a bleeding disorder. In the absence of high quality evidence, clinicians need to use their clinical judgement and lower level evidence (e.g. from observational trials, case studies) to decide upon the optimal mode of delivery to ensure the safety of both mother and foetus.Given the ethical considerations, the rarity of the disorders and the low incidence of both maternal and foetal complications, future randomised controlled trials to find the optimal mode of delivery in this population are unlikely to be carried out. Other high quality controlled studies (such as risk allocation designs, sequential design, and parallel cohort design) are needed to investigate the risks and benefits of natural vaginal and caesarean section in this population or extrapolation from other clinical conditions that incur a haemorrhagic risk to the baby, such as platelet alloimmunisation.

Matched MeSH terms: Fetus
Fulltext Maternal and foetal outcomes following natural vaginal versus caesarean section (c-section) delivery in women with bleeding disorders and carriers

Karanth L, Abas AB

Cochrane Database Syst Rev, 2021 Dec 09;12(12):CD011059.
PMID: 34881425 DOI: 10.1002/14651858.CD011059.pub4

BACKGROUND: Bleeding disorders are uncommon but may pose significant bleeding complications during pregnancy, labour and following delivery for both the woman and the foetus. While many bleeding disorders in women tend to improve in pregnancy, thus decreasing the haemorrhagic risk to the mother at the time of delivery, some do not correct or return quite quickly to their pre-pregnancy levels in the postpartum period. Therefore, specific measures to prevent maternal bleeding and foetal complications during childbirth, are required. The safest method of delivery to reduce morbidity and mortality in these women is controversial. This is an update of a previously published review.
OBJECTIVES: To assess the optimal mode of delivery in women with, or carriers of, bleeding disorders.
SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Coagulopathies Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books. We also searched the Cochrane Pregnancy and Childbirth Group's Trials Register as well as trials registries and the reference lists of relevant articles and reviews. Date of last search of the Group's Trials Registers: 21 June 2021.
SELECTION CRITERIA: Randomised controlled trials and quasi-randomised controlled clinical trials investigating the optimal mode of delivery in women with, or carriers of, any type of bleeding disorder during pregnancy were eligible for the review.
DATA COLLECTION AND ANALYSIS: No trials matching the selection criteria were eligible for inclusion.
MAIN RESULTS: No trials matching the selection criteria were eligible for inclusion.
AUTHORS' CONCLUSIONS: The review did not identify any randomised controlled trials investigating the safest mode of delivery and associated maternal and foetal complications during delivery in women with, or carriers of, a bleeding disorder. In the absence of high quality evidence, clinicians need to use their clinical judgement and lower level evidence (e.g. from observational trials, case studies) to decide upon the optimal mode of delivery to ensure the safety of both mother and foetus. Given the ethical considerations, the rarity of the disorders and the low incidence of both maternal and foetal complications, future randomised controlled trials to find the optimal mode of delivery in this population are unlikely to be carried out. Other high quality controlled studies (such as risk allocation designs, sequential design, and parallel cohort design) are needed to investigate the risks and benefits of natural vaginal and caesarean section in this population or extrapolation from other clinical conditions that incur a haemorrhagic risk to the baby, such as platelet alloimmunisation.

Matched MeSH terms: Fetus
Fulltext Transverse cerebellar diameter as a sonographic parameter for estimating gestational age: an experience from Yemeni population

Muneera A. S. Yahya, Husni A. Al- Goshae, Hameed M. Aklan, Maha Abdul-aziz, Abdullah A. Al-Mikhlafy

Malaysian Journal of Medicine and Health Sciences, 2020;16(107):23-27.
MyJurnal

Introduction: Estimation of gestational age (GA) is clinically crucial for managing pregnancy and assessing the foetal anatomy, growth and development. Transverse cerebellar diameter (TCD) has been reported as an accurate tool for dating the pregnancy. This study aimed to determine the accuracy of foetal TCD for dating the pregnancy and to con- struct a reference chart for GA of Yemeni foetuses. Methods: We conducted this prospective cross-sectional study among 400 Yemeni pregnant women between 18 and 40 weeks of gestation provided that they were with known last menstrual period and singleton normal pregnancies. Sonographic TCDs were measured for each foetus. The mean TCD was measured for gestational weeks separately, and a polynomial regression model was then used to predict the GA by TCD. Results: There was a robust correlation between GA and TCD (r = 0.995, p

Matched MeSH terms: Fetus
Proliferation study and microscopy evaluation on the effects of tannic acid in human fetal osteoblast cell line (hFOB 1.19)

Hapidin H, Romli NAA, Abdullah H

Microsc Res Tech, 2019 Nov;82(11):1928-1940.
PMID: 31423711 DOI: 10.1002/jemt.23361

Tannic acid (TA) is a phenolic compound that might act directly on osteoblast metabolism. The study was performed to investigate the effects of TA on the proliferation, mineralization, and morphology of human fetal osteoblast cells (hFOB 1.19). The cells were divided into TA-treated, untreated, and pamidronate-treated (control drug) groups. Half maximal effective concentration (EC50 ) values for TA and pamidronate were measured using MTT assay. The EC50 of hFOB 1.19 cells treated with TA was 2.94 M. This concentration was more effective compared to the pamidronate (15.27 M). Cell proliferation assay was performed to compare cell viability from Day 1 until Day 14. The morphology of hFOB 1.19 was observed via inverted microscope and scanning electron microscope. Calcium (Ca) and phosphate (P) were assessed using energy-dispersive X-ray (EDX) analysis. Furthermore, the mineralization of hFOB 1.19 was determined by von Kossa staining (P depositions) and Alizarin Red S staining (Ca depositions). The number of cells treated with TA was significantly higher than the two control groups at Day 10 and Day 14. The morphology of cells treated with TA was uniformly fusiform-shaped with filopodia extensions. Besides, globular-like structures of deposited minerals were observed in the TA-treated group. In line with other findings, EDX spectrum analysis confirmed the presence of Ca and P. The cells treated with TA had significantly higher percentage of both minerals at Day 3 and Day 10 compared to the two control groups. In conclusion, TA enhances cell proliferation and causes cell morphology changes, as well as improved mineralization.

Matched MeSH terms: Fetus/cytology*
Fulltext Stem cells research: therapeutic potentials and ethical issues from Islamic perspective

Che Anuar Che Mohamad, Abdurezak Abdullahi Hashi

International Medical Journal Malaysia, 2018;17(101):65-69.
MyJurnal

The advancement in human stem cell research has promised a viable alternative treatment for a range of ‘incurable diseases’ such as neurological diseases. To date, several studies have documented substantial evidences on the therapeutic properties of stem cells in promoting repair in different diseases including common neurological disorders i.e. ischaemic stroke and spinal cord injury. However, the progress of stem cell research has been surrounded by ethical issues which largely due to the usage of human embryos as one of the sources. These embryonic stem cells which originally derived from human embryo of aborted foetus or already existing human embryonic stem cells (hESCs) lines, has sparked an intense moral and religious argument among people of various faith, including Muslim community. From the therapeutic point of view, amongst the currently available stem cells, hESCs show the greatest potential for the broadest range of cell replacement therapies and are regarded as the most commercially viable. This review focuses on the major ethical issues, particularly to Muslim community, related to human embryonic stem cells research with special emphasis on the moral status of the embryo and the beginning of life according to the Islamic ethics and rulings. In this paper, we also discuss some ethical positions towards embryonic stem cell research in the Islamic world, including official regulations existing in some Muslim countries. We examine the justification and the necessity on the usage of hESCs following the newly discovered Induced Pluripotent Stem Cells (IPSCs) in the laboratory. In addition, we supplement the discussions with the general views and positions from the other two Abrahamic religions i.e. Christianity and Judaism.

Matched MeSH terms: Aborted Fetus
Survival and immunomodulation of stem cells from human extracted deciduous teeth expanded in pooled human and foetal bovine sera

Haque N, Khan IM, Abu Kasim NH

Cytokine, 2019 08;120:144-154.
PMID: 31071675 DOI: 10.1016/j.cyto.2019.04.018

The immunomodulatory properties of mesenchymal stem cells (MSCs) from autologous and allogeneic sources are useful in stimulating tissue regeneration and repair. To obtain a high number of MSCs for transplantation requires extensive in vitro expansion with culture media supplements that can cause xeno-contamination of cells potentially compromising function and clinical outcomes. In this study stem cells from human extracted deciduous teeth (SHED) were cultured in Knockout™ DMEM supplemented with either pooled human serum (pHS) or foetal bovine serum (FBS) to compare their suitability in maintaining immunomodulatory properties of cells during in vitro expansion. No significant difference in cell survival of SHED grown in pHS (pHS-SHED) or FBS (FBS-SHED) was observed when co-cultured with complement, monocytes or lymphocytes. However, significant changes in the expression of sixteen paracrine factors involved in immunomodulation were observed in the supernatants of FBS-SHED co-cultures with monocytes or lymphocytes compared to that in pHS-SHEDs after both 24 and 120 h of incubation. Further analysis of changing protein levels of paracrine factors in co-cultures using biological pathway analysis software predicted upregulation of functions associated with immunogenicity in FBS-SHED and lymphocyte co-cultures compared to pHS-SHED co-cultures. Pathway analysis also predicted significant stimulation of HMGB1 and TREM1 signalling pathways in FBS-SHED co-cultures indicating activation of immune cells and inflammation. Though FBS supplementation does not impact survival of SHED, our combinatorial biological pathway analysis supports the idea that in vitro expansion of SHEDs in pHS provides optimal conditions to minimise xeno-contamination and inflammation and maintain their immunomodulatory properties.

Matched MeSH terms: Fetus
Fulltext Indigenous maternity care-giving practice: implications for maternal, foetal and neonatal health in Northern Ghana

Bassoumah, B., Adam, M.A.

JUMMEC, 2018;21(1):32-38.
MyJurnal

The study aimed at government efforts in making maternal and child healthcare services more available to
rural women, many of whom who still seek care from traditional practitioners during the postpartum period
after childbirth. In this research, we explored the role of traditional practitioners, such as Traditional Birth
Attendants (TBAs), herbalists and spiritualists, in traditional maternity care and the implications for the health
of the expectant mother, foetus or baby. This qualitative inquiry used purposive sampling and snowballing to
select the respondents in their various localities. It was observed that the traditional practitioners performed
both spiritual and medical roles during pregnancy and childbirth.
In the study, we discovered that both mothers and babies were exposed to health risks, as administration
of the herbal medicines and assistance at deliveries were carried out under unhygienic conditions. The
techniques used in labour management were not in compliance with the recommendations of the World
Health Organisation. The stages of maternity were characterised with the application of herbal concoctions
with spirituality attached.
The study recommends re-examination of mediating socio-cultural factors to professional health care. There
is a need for the Ghana Health Service to ensure the efficacy and safety of herbal drugs as well as to monitor
the production and application of such medicines.

Matched MeSH terms: Fetus
Fulltext Thanatophoric Dysplasia: Case Report

Roszaman Ramli, Ahmad Murad Zainudin

International Medical Journal Malaysia, 2006;5(2):1-6.
MyJurnal

Thanatophoric dysplasia (TD) was reported earlier in the previous publication. It is one of the most common lethal human skletal dysplasia characterized by severe dwarfism. It occurs in 3 to 4 per 100,000 live births1 and is due to autosomal dominant sporadic de novo mutations in the fibroblast growth factor receptor 3 (FGFR3) gene3 which codes for the FGFR3 transmembrane receptor expressed largely by skeletal and brain tissues in the developing fetus where it is involved with growth regulation. The FGFR3 mutation in TD leads to generalized defects and lack of endochondral ossification, with membranous ossification being less impaired1. Male and female fetuses are equally affected. Two thanatophoric case of this extremely rare occurance are reported and discussed.

Matched MeSH terms: Fetus
Fulltext Toxicity Evaluation of the Naphthalen-2-yl 3,5-Dinitrobenzoate: A Drug Candidate for Alzheimer Disease

Anwar F, Saleem U, Rehman AU, Ahmad B, Froeyen M, Mirza MU, et al.

Front Pharmacol, 2021;12:607026.
PMID: 34040515 DOI: 10.3389/fphar.2021.607026

The presented study was designed to probe the toxicity potential of newly identified compound naphthalen-2-yl 3,5-dinitrobenzoate (SF1). Acute, subacute toxicity and teratogenicity studies were performed as per Organization of economic cooperation and development (OECD) 425, 407, and 414 test guidelines, respectively. An oral dose of 2000 mg/kg to rats for acute toxicity. Furthermore, 5, 10, 20, and 40 mg/kg doses were administered once daily for 28 days in subacute toxicity study. Teratogenicity study was performed with 40 mg/kg due to its excellent anti-Alzheimer results at this dose. SF1 induced a significant rise in Alkaline Phosphatases (ALP), bilirubin, white blood cells (WBC), and lymphocyte levels with a decrease in platelet count. Furthermore, the reduction in urea, uric acid, and aspartate transaminase (AST) levels and an increase in total protein levels were measured in subacute toxicity. SF1 increased spermatogenesis at 5 and 10 mg/kg doses. Teratogenicity study depicted no resorptions, early abortions, cleft palate, spina bifida and any skeletal abnormalities in the fetuses. Oxidative stress markers (Superoxide dismutase (SOD), Catalase (CAT), and glutathione (GSH) were increased in all the experiments, whereas the effect on melanoaldehyde Malondialdehyde (MDA) levels was variable. Histopathology further corroborated these results with no change in the architectures of selected organs. Consequently, a 2000 mg/kg dose of SF1 tends to induce minor liver dysfunction along with immunomodulation, and it is well below its LD
50
. Moreover, it can be safely used in pregnancy owing to its no detectable teratogenicity.

Matched MeSH terms: Fetus
Fulltext Abattoirs – a hidden centre for livestock genetic resources loss in Nigeria

Khaleel, Aliyu Garba, Nasir, Mudassir, Salisu, Nasiru, Abdullahi, Auwalu Yusuf, Saidu, Sulaiman Shehu, Saleh, Ahmadu, et al.

Malaysian Journal of Applied Sciences, 2020;5(2):1-16.
MyJurnal

Nigeria is naturally blessed with wide diversity of native animal genetic resources. Indigenous ruminant livestock such as cattle, camel, donkey, sheep and goat contributes largely in both protein supply, revenue generation and national economy. In Nigeria, these animal resources are mismanaged and undermined through the indiscriminate slaughter of pregnant animals and foetal losses in abattoirs. This unethical practice resulted in the loss of genetic diversity, preferred traits and superior females ruminant animals. The current research focus on reported incidences across abattoirs, which is a centre where such practice is highly occurs within the country. Lack of modern facilities, law enforcement, poor management and animal welfare in abattoirs to protect pregnant animals are among few factors responsible for an increase in incidences. It is unprofitable to continue the tradition of pregnant animal slaughter that causes foetal losses. This is a condition that significantly threatens the animal genetic resources and general livestock industry in Nigeria. This practice must be discard with a proper conservation and documentation of these valuable animal genetic resources. Both long and short terms conservation programs must aim for substantial benefits of these resources. Laws must be enforced with strict penalties to those involved in pregnant animal slaughter. Genetic resources of these species and meat industry future could be safe with proper implementation of these laws and conservation measures.

Matched MeSH terms: Fetus
Fulltext Expression of survivin in fetal and adult normal tissues of rat

Iskandar ZA, Al-Joudi FS

Malays J Pathol, 2006 Dec;28(2):101-5.
PMID: 18376799 MyJurnal

Survivin is an inhibitor of apoptosis protein and regulates the cell cycle in the G2/M phase. Survivin is expressed during embryonic and fetal development, selectively over-expressed in common human cancers and completely down-regulated in normal adult tissue. This work was aimed at studying the expression of the survivin homologues and their subcellular distribution in fetal and normal adult tissues of rat. Survivin expression was evaluated by immunohistochemistry in formalin-fixed, paraffin-embedded tissue sections of fetal and normal adult tissues of rat using the polyclonal serum SUR12A-CFI. This serum demonstrated intense positive survivin staining in adult kidney, ovary and oviduct, and a variable expression in different fetal organs, with particularly intense expression detected in the adrenal gland, liver, stomach, small intestine, colon, kidney and skin. In both fetal and adult tissues, the expression was predominantly cytoplasmic. It was concluded that survivin was abundantly and prominently expressed during fetal development in rat and that the polyclonal anti-human survivin antibody SUR12A-CFI is reactive with rat survivin.

Matched MeSH terms: Fetus/metabolism*
Prenatal developmental toxicity evaluation of Verbena officinalis during gestation period in female Sprague-Dawley rats

Fateh AH, Mohamed Z, Chik Z, Alsalahi A, Md Zin SR, Alshawsh MA

Chem Biol Interact, 2019 May 01;304:28-42.
PMID: 30807743 DOI: 10.1016/j.cbi.2019.02.016

Verbena officinalis is widely used by women for maintaining general health and treating various gynaecological disorders during pregnancy. A case report has indicated that the consumption of V. officinalis induced an abortifacient effect. Hence, this study aimed to investigate the prenatal developmental toxicity of this plant according to OECD guideline (no. 414). A total of 50 pregnant female rats (dams) were distributed into five groups (n = 10); 500 mg/kg 1000 mg/2000 mg/kg and 3000 mg/kg of V. offcinalis extracts and the fifth group served as a normal control. All dams received their respective oral single daily treatment from the 6th to the 20th day of gestation. Maternal clinical toxicity signs, body weight and weight gain were recorded. Caesarean sections were performed on day 21 to evaluate embryo-foetal developmental toxicity. For dams, ovaries were harvested and weighed. The number of corpora lutea, implantation sites, and resorptions were recorded. No mortality was observed in dams, but their body weight gain was significantly reduced particularly in dams treated with 2000 and 3000 mg/kg V. officinalis. Asymmetrical distribution of implantation sites and embryos were observed. Embryo-fetotoxicity retardation was observed as evident by the decrease in foetal weight, head cranium, tail length, and higher incidence in the pre-and post-implantation loss. Some foetal skeleton abnormalities such as incomplete ossification of skull, sternebrae, and metatarsal bones were observed in foetuses of the 2000 and 3000 mg/kg V. officinalis-treated dams. LC/MS analysis identified the major constituents including geniposidic acid, tuberonic acid glucoside, luteolin 7, 3'-digalacturonide, iridotrial and apigenin. The glycosylated flavonoids such as apigenin and luteolin could be responsible for the reported prenatal developmental toxicity. In conclusion, the use of V. officinalis during pregnancy is not safe indicating evidence-based toxic effects on the reproductive performance of dams and dose-dependent risk potentials to the foetuses.

Matched MeSH terms: Fetus/drug effects*
Onset of labour

Chong HL, Ong HC, Ang LT

Med J Malaysia, 1974 Sep;29(1):44-53.
PMID: 4282630
Matched MeSH terms: Fetus/physiology
Fetal and maternal lactate increase during active second stage of labour

Nordström L, Achanna S, Naka K, Arulkumaran S

BJOG, 2001 Mar;108(3):263-8.
PMID: 11281466

To determine longitudinally fetal and maternal blood lactate concentrations during the second stage of labour.

Matched MeSH terms: Fetus/chemistry*
Fulltext Optimization of nanoemulsion containing gemcitabine and evaluation of its cytotoxicity towards human fetal lung fibroblast (MRC5) and human lung carcinoma (A549) cells

Wahgiman NA, Salim N, Abdul Rahman MB, Ashari SE

Int J Nanomedicine, 2019;14:7323-7338.
PMID: 31686809 DOI: 10.2147/IJN.S212635

Background: Gemcitabine (GEM) is a chemotherapeutic agent, which is known to battle cancer but challenging due to its hydrophilic nature. Nanoemulsion is water-in-oil (W/O) nanoemulsion shows potential as a carrier system in delivering gemcitabine to the cancer cell.
Methods: The behaviour of GEM in MCT/surfactants/NaCl systems was studied in the ternary system at different ratios of Tween 80 and Span 80. The system with surfactant ratio 3:7 of Tween 80 and Span 80 was chosen for further study on the preparation of nanoemulsion formulation due to the highest isotropic region. Based on the selected ternary phase diagram, a composition of F1 was chosen and used for optimization by using the D-optimal mixture design. The interaction variables between medium chain triglyceride (MCT), surfactant mixture Tween 80: Span 80 (ratio 3:7), 0.9 % sodium chloride solution and gemcitabine were evaluated towards particle size as a response.
Results: The results showed that NaCl solution and GEM gave more effects on particle size, polydispersity index and zeta potential of 141.57±0.05 nm, 0.168 and -37.10 mV, respectively. The optimized nanoemulsion showed good stability (no phase separation) against centrifugation test and storage at three different temperatures. The in vitro release of gemcitabine at different pH buffer solution was evaluated. The results showed the release of GEM in buffer pH 6.5 (45.19%) was higher than GEM in buffer pH 7.4 (13.62%). The cytotoxicity study showed that the optimized nanoemulsion containing GEM induced cytotoxicity towards A549 cell and at the same time reduced cytotoxicity towards MRC5 when compared to the control (GEM solution).

Matched MeSH terms: Fetus/cytology*
Fulltext A New Approach for Testing Fetal Heart Rate Monitors

Bibbo D, Klinkovsky T, Penhaker M, Kudrna P, Peter L, Augustynek M, et al.

Sensors (Basel), 2020 Jul 25;20(15).
PMID: 32722397 DOI: 10.3390/s20154139

In this paper, a new approach for the periodical testing and the functionality evaluation of a fetal heart rate monitor device based on ultrasound principle is proposed. The design and realization of the device are presented, together with the description of its features and functioning tests. In the designed device, a relay element, driven by an electric signal that allows switching at two specific frequencies, is used to simulate the fetus and the mother's heartbeat. The simulator was designed to be compliant with the standard requirements for accurate assessment and measurement of medical devices. The accuracy of the simulated signals was evaluated, and it resulted to be stable and reliable. The generated frequencies show an error of about 0.5% with respect to the nominal one while the accuracy of the test equipment was within ±3% of the test signal set frequency. This value complies with the technical standard for the accuracy of fetal heart rate monitor devices. Moreover, the performed tests and measurements show the correct functionality of the developed simulator. The proposed equipment and testing respect the technical requirements for medical devices. The features of the proposed device make it simple and quick in testing a fetal heart rate monitor, thus providing an efficient way to evaluate and test the correlation capabilities of commercial apparatuses.

Matched MeSH terms: Fetus*
iSegMSI: An Interactive Strategy to Improve Spatial Segmentation of Mass Spectrometry Imaging Data

Guo L, Liu X, Zhao C, Hu Z, Xu X, Cheng KK, et al.

Anal Chem, 2022 Oct 25;94(42):14522-14529.
PMID: 36223650 DOI: 10.1021/acs.analchem.2c01456

Spatial segmentation is a critical procedure in mass spectrometry imaging (MSI)-based biochemical analysis. However, the commonly used unsupervised MSI segmentation methods may lead to inappropriate segmentation results as the MSI data is characterized by high dimensionality and low signal-to-noise ratio. This process can be improved by the incorporation of precise prior knowledge, which is hard to obtain in most cases. In this study, we show that the incorporation of partial or coarse prior knowledge from different sources such as reference images or biological knowledge may also help to improve MSI segmentation results. Here, we propose a novel interactive segmentation strategy for MSI data called iSegMSI, which incorporates prior information in the form of scribble-regularization of the unsupervised model to fine-tune the segmentation results. By using two typical MSI data sets (including a whole-body mouse fetus and human thyroid cancer), the present results demonstrate the effectiveness of the iSegMSI strategy in improving the MSI segmentations. Specifically, the method can be used to subdivide a region into several subregions specified by the user-defined scribbles or to merge several subregions into a single region. Additionally, these fine-tuned results are highly tolerant to the imprecision of the scribbles. Our results suggest that the proposed iSegMSI method may be an effective preprocessing strategy to facilitate the analysis of MSI data.

Matched MeSH terms: Fetus*
Acute, reproductive toxicity and two-generation teratology studies of a standardized quassinoid-rich extract of Eurycoma longifolia Jack in Sprague-Dawley rats

Low BS, Das PK, Chan KL

Phytother Res, 2014 Jul;28(7):1022-9.
PMID: 24318772 DOI: 10.1002/ptr.5094

The roots of Eurycoma longifolia Jack are popularly sought as herbal medicinal supplements to improve libido and general health amongst the local ethnic population. The major quassinoids of E. longifolia improved spermatogenesis and fertility but toxicity studies have not been well documented. The reproductive toxicity, two generation of foetus teratology and the up-and-down acute toxicity were investigated in Sprague-Dawley rats orally treated with quassinoid-rich E. longifolia extract (TAF273). The results showed that the median lethal dose (LD50 ) of TAF273 for female and male rats was 1293 and >2000 mg/kg, respectively. Fertility index and litter size of the TAF273 treated were significantly increased when compared with those of the non-treated animals. The TAF273-treated dams decreased in percentage of pre-implantation loss, post-implantation loss and late resorption. No toxic symptoms were observed on the TAF273-treated pregnant female rats and their foetuses were normal. The no-observed adverse effect level (NOAEL) obtained from reproductive toxicity and teratology studies of TAF273 in rats was 100 mg/kg body weight/day, being more than 10-fold lower than the LD50 value. Thus, any human dose derived from converting the rat doses of 100 mg/kg and below may be considered as safe for further clinical studies.

Matched MeSH terms: Fetus/drug effects
In-vitro and in-vivo studies of a cytotoxin from Campylobacter jejuni

Pang T, Wong PY, Puthucheary SD, Sihotang K, Chang WK

J Med Microbiol, 1987 May;23(3):193-8.
PMID: 3585956

Studies were performed on a cytotoxin (CT) from human strains of Campylobacter jejuni isolated in Malaysia. CT was detected by cytopathic effect (CPE) on HeLa cells at titres from 8 to 32, in culture filtrates from 14 (48%) of 29 human isolates. The CPE correlated well with a quantitative 51Cr-release assay where a specific release of 54-68% was noted. CT production was lost after 5-7 subcultures. CT activity was also detected in 5 (26%) of 19 faecal filtrates from which CT-producing isolates were subsequently obtained. The mol. wt of CT was estimated by Sephadex G-50 chromatography to be greater than 30,000. In a suckling-mouse assay, CT consistently failed to demonstrate fluid accumulation after intragastric inoculation of culture filtrate. The Removable Intestinal Tie Adult Rabbit Diarrhoea (RITARD) assay was also used. Rabbits given CT-producing strains of C. jejuni developed bacteraemia and severe watery mucus-containing diarrhoea for the duration of the experiment with death of some animals. Rabbits given CT non-producing strains had less severe disease and none died. Rabbits given partially-purified CT had diarrhoea for 3 days but none died.

Matched MeSH terms: Campylobacter fetus/metabolism*; Campylobacter fetus/pathogenicity
Fulltext Association between intrauterine growth restriction and patent ductus arteriosus: Use of a dichorionic twin pregnancy model

Yang CY, Hoong MF, Li CS, Li WF, You SH, Lee YC, et al.

Taiwan J Obstet Gynecol, 2021 May;60(3):517-522.
PMID: 33966739 DOI: 10.1016/j.tjog.2021.03.023

OBJECTIVE: To evaluate the association between intrauterine growth restriction (IUGR) and the incidence of fetuses with patent ductus arteriosus (PDA) and Hemodynamically significant PDA (Hs-PDA) in dichorionic twins (DC) with selective IUGR.
MATERIALS AND METHODS: This is an observational cohort study and retrospective case assessment, involved twins born at Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan between 2013 and 2018. DC twins with selective IUGR (sIUGR) were defined as the presence of a birth weight discordance of >25% and a smaller twin with a birth weight below the tenth percentile. PDA was diagnosed using echocardiography between postnatal day 3 and 7. Hs-PDA was defined as PDA plus increased pulmonary circulation, poor systemic perfusion, cardiomegaly, pulmonary edema, or hypotension requiring pharmacotherapeutic intervention.
RESULT: A total of 1187 twins were delivered during the study period, and 53 DC twins with selective IUGR were included in this study. DC twins with PDA have higher rate of preterm birth, lower gestational age of delivery, and lower mean birth weight of both twins compared with DC twins without PDA. In a comparison of the sIUGR twin with the appropriate for gestational age co-twin, both the incidences of PDA (28.30% vs. 7.55%, respectively; P = 0.003) and Hs-PDA (24.53% vs. 5.66%, respectively; P = 0.002) were higher in sIUGR fetuses than in the appropriate for gestational age co-twins. Small gestational age of delivery was the only variable to predict PDA and Hs-PDA [p = 0.002, Odds ratio = 0.57 (0.39-0.82), p = 0.009, Odds ratio = 0.71 (0.55-0.92), respectively].
CONCLUSION: An analysis of dichorionic twins with sIUGR indicated that IUGR increased the risk of PDA and hemodynamically significant PDA.

Matched MeSH terms: Fetus

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