Family centered maternity care: its relationship to perinatal regionalization and neonatal intensive care

For several months prior to birth a major portion of a family's attention, conversation, thought, and often worry, is directed toward the idea of a new child. This prolonged attention and anticipation contribute to making childbirth an emotionally charged experience. In psychological terms, it is therefore a critical period of peak motivation for learning, and a time to peak susceptibility to reinforcement. Theory, reason, and scientific evidence indicate thng with childbirth and early postpartum experiences, can significantly affect subsequent parental behaviors, the child's central environment influence. Evidence strongly suggests that these parental attitudes and behaviors so crucial to the child's ultimate well-being are learned rather than derived instinctually, and therefore they are malleable and can be taught, directed, and corrected. Through education and reinforcement it is possible to encourage parental behaviors and child interactions which are products of feelings of control, competence, accomplishment, understanding, and caring. Similarly we can recognize and work toward replacing attitudes, feelings, and behaviors that express fear, worry, and insecurity about the child. Over the past 50 years major changes have occurred in the practice of obstetrics and newborn pediatrics. Other major changes will necessarily occur as we move toward perinatal regionalization. Changes instigated solely on physiologic data can have unrecognized collateral effects on the psychological component of the childbirth experience. All concerned health care personnel, especially obstetricians and pediatricians, can insist that the importance of desirable mother-father-child interactions be recognized and that practices fostering them be afforded a high priority. I would like to endorse a comment from a recent article by Richmond concerning the advent of behavioral pediatrics by adding that behavioral obstetrics is also "an idea whose time has arrived".     

Micromechanical constitutive modelling of granular media: Evolution and loss of contact in particle clusters

Micromechanical constitutive equations are developed which allow for the broad range of interparticle interactions observed in a real deforming granular assembly: microslip contact, gross slip contact, loss of contact and an evolution in these modes of contact as the deformation proceeds. This was accomplished through a synergetic use of contact laws, which account for interparticle resistance to both sliding and rolling, together withstrain-dependent anisotropies in contacts and the normal contact force. By applying the constitutive model to the bi-axial test it is demonstrated that the model can correctly predict the evolution of various anisotropies as well as the formation of a distinct shear band. Moreover, the predicted shear-band properties (e.g. thickness, prolonged localisation, void ratio) are an even better fit with experimental observations than were previously found by use of previously developed micromechanical models.     

Thermomechanical modelling the fire properties of fibre–polymer composites

Simple-to-use models are presented in this paper for determining the residual tension, compression and flexural properties of burnt fibre reinforced polymer composite materials following a fire. The post-fire mechanical properties are calculated using analytical equations that combine the properties of the fire-damaged (i.e. char) and undamaged regions of a composite. Fire tests were performed on composites containing carbon, glass or Kevlar fibres with an epoxy, polyester, vinyl ester or phenolic resin matrix to assess the accuracy of the models. The composites were tested to a wide range of fire conditions with temperatures from 525 to 850 °C for times up to 30 min. It is found that the post-fire properties drop rapidly with increasing heat flux and duration of a fire due to the thermal degradation of the polymer matrix. It is shown that the reduction to the post-fire properties of the burnt composites can be accurately determined using the models. In almost all test cases, the agreement between the calculated and measured residual mechanical properties is within 10%.     

Determination of IgG1 and IgG3 SARS-CoV-2 Spike Protein and Nucleocapsid Binding—Who Is Binding Who and Why?

The involvement of immunoglobulin (Ig) G3 in the humoral immune response to SARS-CoV-2 infection has been implicated in the pathogenesis of acute respiratory distress syndrome (ARDS) in COVID-19. The exact molecular mechanism is unknown, but it is thought to involve this IgG subtype’s differential ability to fix, complement and stimulate cytokine release. We examined the binding of convalescent patient antibodies to immobilized nucleocapsids and spike proteins by matrix-assisted laser desorption/ionization–time of flight (MALDI-ToF) mass spectrometry. IgG3 was a major immunoglobulin found in all samples. Differential analysis of the spectral signatures found for the nucleocapsid versus the spike protein demonstrated that the predominant humoral immune response to the nucleocapsid was IgG3, whilst for the spike protein it was IgG1. However, the spike protein displayed a strong affinity for IgG3 itself, as it would bind from control plasma samples, as well as from those previously infected with SARS-CoV-2, similar to the way protein G binds IgG1. Furthermore, detailed spectral analysis indicated that a mass shift consistent with hyper-glycosylation or glycation was a characteristic of the IgG3 captured by the spike protein.     

SARS-CoV-2 Spike Protein Binding of Glycated Serum Albumin—Its Potential Role in the Pathogenesis of the COVID-19 Clinical Syndromes and Bias towards Individuals with Pre-Diabetes/Type 2 Diabetes and Metabolic Diseases

The immune response to SARS-CoV-2 infection requires antibody recognition of the spike protein. In a study designed to examine the molecular features of anti-spike and anti-nucleocapsid antibodies, patient plasma proteins binding to pre-fusion stabilised complete spike and nucleocapsid proteins were isolated and analysed by matrix-assisted laser desorption ionisation–time of flight (MALDI-ToF) mass spectrometry. Amongst the immunoglobulins, a high affinity for human serum albumin was evident in the anti-spike preparations. Careful mass comparison revealed the preferential capture of advanced glycation end product (AGE) forms of glycated human serum albumin by the pre-fusion spike protein. The ability of bacteria and viruses to surround themselves with serum proteins is a recognised immune evasion and pathogenic process. The preference of SARS-CoV-2 for AGE forms of glycated serum albumin may in part explain the severity and pathology of acute respiratory distress and the bias towards the elderly and those with (pre)diabetic and atherosclerotic/metabolic disease.     

Restricted mandibular opening complicating intraoral galeal flap reconstruction and radiotherapy: case report

The delto-pectoral flap has been used to repair burned scar in the faciocervical region for some years. However, its limited size restricts its application. Furthermore, direct transfer of the flap may result in a swelling and inexpressive face and the donor site needs skin grafting. To avoid the above disadvantages, we have tried pre-expansion of the flap. In this article, the authors report the experiences in the application of the method to eighteen cases, including the surgical procedure, the applied anatomy, and typical cases as well. Also included in the article are the comparison between various therapies to the burned scar of the face, the key points for successful pre-expansion of the delto-pectoral flap, accurately maintaining the desired position. The method has been proved to have many advantages and can be widely applied.     

The role of angiotensin AT1 receptors in the diuretic, natriuretic, kaliuretic and blood pressure responses induced by angiotensin II activation of the median preoptic nucleus in conscious rats

We determined the effects of two classical angiotensin II (ANG II) antagonists, [Sar1, Ala8]-ANG II and [Sar1, Thr8]-ANG II, and losartan (a nonpeptide and selective antagonist for the AT1 angiotensin receptors) on diuresis, natriuresis, kaliuresis and arterial blood pressure induced by ANG II administration into the median preoptic nucleus (MnPO) of male Holtzman rats weighing 250-300 g. Urine was collected in rats submitted to a water load (5% body weight) 1 h later. The volume of the drug solutions injected was 0.5 microliters over 10-15 s. Pre-treatment with [Sar1, Ala8]-ANG II (12 rats) and [Sar1, Thr8]-ANG II (9 rats), at the dose of 60 ng reduced (13.7 +/- 1.0 vs 11.0 +/0 1.0 and 10.7 +/0 1.2, respectively), whereas losartan (14 rats) at the dose of 160 ng totally blocked (13.7 +/- 1.0 vs 7.6 +/- 1.5) the urine excretion induced by injection o 12 ng of ANG II (14 rats). [Sar1, Ala8]-ANG II impaired Na+ excretion (193 +/- 16 vs 120 +/- 19), whereas [Sar1, Thr8]-ANG II and losartan block Na+ excretion (193 +/- 16 vs 77 +/- 15 and 100 +/- 12, respectively) induced by ANG II. Similar effects induced by ANG II on K+ excretion were observed with [Sar1, Ala8]-ANG II, [Sar1, Thr8]- ANG II, and losartan pretreatment (133 +/- 18 vs 108 +/- 11, 80 +/- 12, and 82 +/- 15, respectively). The same doses as above of [Sar1, Ala8]-ANG II (8 rats), [Sar1, Thr8]-ANG II (8 rats), and losartan (9 rats) blocked the increase in the arterial blood pressure induced by 12 ng of ANG II (12 rats) (32 +/- 4 vs 4 +/- 2, 3.5 +/- 1, and 2 +/- 1, respectively. The results indicate that the AT1 receptor subtype participates in the increases of diuresis, natriuresis, kaliuresis and arterial blood pressure induced by the administration of ANG II into the MnPO.